IMPOTENCE AND SILDENAFIL (VIAGRA)
Report #7275
More than 20% of men over 60 are impotent all the time while more than 95% are impotent some of the time. The Food and Drug Administration will soon approve a pill that will improve the quality of the lives of most older men.
A man has two balloons in his penis that fill with blood when he has an erection. The penis is different from all other tissues in the body. It has small muscles that close the arteries most of the time. If the muscles didn't squeeze the blood vessels bringing blood to the penis, a man would have an erection all the time. A man develops an erection when the muscles surrounding the blood vessels relax to increase blood flow into the balloons. The balloons then fill and press on and close the veins that carry blood from the penis. The treatment for impotence is to relax the muscles so more blood can flow into the penis. First there were alprostadil injections called Caverjet, then there were alprostadil pellets called Muse that can be inserted into the urinary tube. In the next couple of months, men will be able to take a sildenafil pill, and soon there'll be more pills. Apomorphine stimulates the brain to cause an erection and phentolamine blocks adrenaline to relax the muscles and cause an erection.
Viagra (sildenafil) pill is taken one hour before making love. It can cause headaches and diarrhea. Spontane (apomorphine) is not as effective and still requires a potent mental stimulant and touching to cause an erection. Vasomax (phentolamine) is not as effective and requires intense stimulation for an erection.
If you are impotent, get the following blood tests: hemoglobin A1C, HDL/LDL cholesterol, testosterone, prolactin and vitamin B12. Check for medications that cause impotence. 85% of impotence is caused by arteriosclerosis or diabetes.
By Gabe Mirkin, M.D., for CBS Radio News
Reported 11/11/97; see report #M127.