How Sildenafil and Viagra Work to Treat Erectile Dysfunction

Erectile dysfunction, or ED, is an issue many people have to contend with, and drugs such as sildenafil, the active ingredient in Viagra, have quite literally revolutionized the treatment of it.  It’s helpful to have a handle on how these medications work, their efficacy, their side effects, and how best to use them in order to make informed decisions about treating ED.

Let’s talk about the science of Sildenafil and Viagra.

Sildenafil, perhaps better known as Viagra, belongs to a class of drugs called phosphodiesterase type 5 (PDE5) inhibitors.  Sildenafil was originally designed to treat angina, but it ended up having a profound effect on erectile function, so it was approved to treat ED in 1998.

Getting an erection is purely a matter of sexual stimulation. When that occurs, it triggers the release of nitric oxide (NO) in the penile corpus cavernosum.  NO activates the enzyme guanylate cyclase, which increases the concentration of cyclic guanosine monophosphate (cGMP).  This molecule relaxes the smooth muscle within the penile tissue, increasing blood flow and causing an erection.

The cGMP-degrading enzyme PDE5 is specifically inhibited by sildenafil, which allows it to achieve this effect. Sildenafil achieves this by inhibiting PDE5, which prevents cGMP from being degraded. This results in increased smooth muscle relaxation for longer periods of time and increases blood flow to the penis during sexual arousal.  So be aware that sildenafil requires some sexual stimulation to take effect; it will not simply cause an erection when you’re not aroused.

Why these medications do this on a biological level to enhance erectile function.

Sildenafil and Viagra are able to achieve this by inhibiting the PDE5 enzyme, increasing the body’s natural reaction to sexual stimulation.

Let me explain what happens in the process:

• Once an individual becomes sexually stimulated, it releases nitric oxide within the penile tissue.
• NO increases cGMP synthesis, causing relaxation of smooth muscles and vasodilation.
• An erection is produced when blood fills the penis’s spongy tissue.
• PDE5 breaks down cGMP, and sildenafil does this by preventing breakdown, which sustains the erection.

Sildenafil acts primarily against PDE5, and thus it acts mostly in the penis, although this enzyme is also found in other tissues such as the lungs and retina.  Sildenafil is also used to treat pulmonary arterial hypertension, and some have reported side effects in the form of visual disturbances on taking high doses.

How Effective Are They? Let’s Talk About Clinical Trial Results

There has been quite some research done on Sildenafil and Viagra in trials.  Research has repeatedly demonstrated that these medications are much more effective than a placebo in treating Erectile dysfunction:

• In meta-analyses, it has been found that 42-49% of men taking sildenafil (50-100 mg) were able to have at least 60% successful attempts at intercourse, whereas fewer than 10% achieved the same level of success with a placebo.
• Dose optimization studies revealed that nearly half of the men had successful intercourse with sildenafil, whereas just 11% did so with the placebo.
• So, it seems that after around 36 to 52 weeks, a rather staggering 89 to 92% of patients reported improved erections with sildenafil treatment.

Utilizing things the correct way and receiving the proper education truly enhances how well they perform in real life.  So, in one trial, it so happened that 74% of men were able to have successful sex when they received treatment that involved counseling and risk factor management.

These findings truly demonstrate sildenafil’s effectiveness for most men with ED, regardless of what’s responsible.

Let’s talk about some possible side effects and the precautions you need to be aware of.

As with any other medication, sildenafil and Viagra have some side effects.  Most of them are relatively mild to moderate and they don’t last very long, but there are a few that can be quite severe:

Here are some common side effects:

• I’ve got a headache.
• Flushing, eh?
• So you’re familiar with that, you know, sensation when your stomach just isn’t feeling quite right? That’s indigestion, or dyspepsia. That awful feeling that can really ruin your day.
• Nasal congestion, yeah?
• Rhinitis

Some less frequent side effects or slightly more serious side effects:

• Seeing a little askew, colors looking weird or things being slightly blurry.
• Feeling dizzy
• Priapism is when you get a long and painful erection lasting longer than 4 hours, and it’s a medical emergency.
• Sudden hearing loss is relatively uncommon.
• Allergic reactions are a real pain, aren’t they?

Just a quick mention of staying safe:

• Be careful if you have severe heart problems, have recently suffered a heart attack or stroke, or have low blood pressure.
• It’s also not a good idea to take sildenafil with nitrate medications for chest pain because it can drop your blood pressure too low.
• Hence, a word of caution—drinking grapefruit juice might raise sildenafil levels, which in turn can heighten the risk of side effects.
• Be sure to inform your doctor of all the medications and supplements you are taking prior to initiating sildenafil.

Tips for Maximizing Sildenafil and Viagra

If you wish to maximize the benefits of sildenafil/Viagra while maintaining safety, here are some insider tips to note:

• So, make sure to take the drug about 30 to 60 minutes before you plan to have sex.It can last for around 4 to 5 hours.
• You will require some sexual stimulation so that the drug has an effect.
• When it’s time for dosage, start with what your doctor prescribed, which should be about 50 mg, and don’t hesitate to adjust as needed.  Just don’t take more than one dose per 24 hours.
• Hi, just a reminder about food! If you’re taking sildenafil with a meal high in fat, it may take slightly longer to take effect.
• Consistency is everything! If the initial dose doesn’t work, try the medication on several different occasions.  Some men may have to try as many as eight times to achieve optimal results.

Let’s discuss what you hope and how things have been going with your healthcare provider.  Having some counseling and your partner included can greatly improve things.

Wrapping it up

Sildenafil and Viagra are established therapies for erectile dysfunction. They enhance the body’s spontaneous response to obtain an erection by selectively inhibiting PDE5. Sildenafil and Viagra have truly come to the rescue of millions of men, restoring their sexual confidence and pleasure, owing to impressive clinical trial success rates and a good safety record. To get the best results, just follow the directions, chat with your healthcare provider, and keep an eye out for any side effects or interactions.