Pros & cons of Viagra

Besides curing impotence, the wonder drug can also prevent lung problems, writes Dr KK Aggarwal.

Sildenafil, or more popularly known as Viagra, is widely used for its performance boosting abilities. New research indicates that the use of Viagra skyrocketed 312 per cent among men aged 18-45 between 1998 and 2002. There's also been a 216 per cent increase among men between ages 45 and 55, according to Tom Delate, PhD, whose research analyzed data on medical insurance claims by some five million patients.

What is interesting in this data is that use among younger men has escalated faster than in older men. While Viagra is a safe drug, particularly for young, healthy men, and side effects such as headache, facial flushing, stuffy nose and blurred vision are usually minor and temporary, many healthy users with normal erections expecting the drug to give them very lengthy erections are likely to be disappointed.

However, in a study published in Human Reproduction, Italian researchers note men without erectile dysfunction who took Viagra cut in half their "refractory period" -- the time it takes to get another erection following orgasm -- from the typical 20 minutes to about 10. However, in older men, in combination with nitroglycerin (a medication for heart problems), Viagra can cause a dramatic drop in blood pressure and, if the user has undiagnosed coronary artery disease, there is a risk of heart attack.

Delate's study -- published in the August issue of the International Journal of Impotence -- also shows a 13 per cent increase in Viagra prescriptions for younger women between ages 18 and 45. Sildenafil is also believed to ramp up the sex lives of women who take it, just as it has done for men. The 12-week study focused on 202 post-menopausal or post-hysterectomy women who complained of female sexual arousal disorder.

The women in the group who took notes after each sexual experience, and reported better overall sexual satisfaction compared with those who took a placebo. Their enhanced sex lives included better arousal, lubrication and orgasm. In terms of ability to achieve orgasm, there was a statistically significant movement. It increases blood flow to the genital area, increases the sensation of warmth, tingling and fullness.

In addition, Viagra may help infertile women. In a US study carried out by Las Vegas doctor Geoffrey Sher, who ground up the Viagra tablets and made them into a vaginal suppository, which the women inserted four times a day, has shown that three out of four previously infertile women who used Viagra became pregnant. However, the doctor who carried out the study has warned that infertile women should not rush to take the drug hoping that it will solve their problems. The drug only appears to work for women who have a specific problem - a thin lining of the uterus. This medical condition prevents the embryo from attaching to the wall of the uterus.

Doctors believe it may also act to increased blood flow to the uterus. This would increase the thickness of the uterus lining and boost the chances that the embryo could attach and develop successfully. However, some experts fear Viagra may also damage the mother and the developing fetus. Known side effects for women include high levels of nitric oxide in the womb, which can be both dangerous for the mother and toxic to developing embryos.

Clearly this "wonder drug" has other medical uses as well. Researchers at University of Geissen in Germany have shown that Viagra, besides curing impotence, also can protect mountaineers from developing lung problems at high altitudes. It helps fight pulmonary hypertension caused by a lack of oxygen. A study published by them in the Annals of Internal Medicine, says Viagra causes more blood to be distributed through the lung's blood vessels. In patients with pulmonary hypertension, the lung's blood vessels constrict, making the heart work harder.

There is also growing evidence that Viagra has the power to save babies with deadly pulmonary hypertension. Viagra is now being tried to treat a condition known as acholasia. This is a spasm of the sphincter between the stomach and the gullet, which results in food being vomited back into the mouth. Evidently, from a doctor's view point, regarding Sildenafil, there is more to it than meets the eye, while from the layman's perspective, they need to curb their enthusiasm and restrain rampant and indiscriminate use of this drug.

(Dr. Aggarwal is President, Heart Care Foundation of India, Deputy Dean, Board of Medical Education, Moolchand Hospital and President Elect, Delhi Medical Association.)