The Hard Facts - Sildenafil (Viagra)

It’s the little blue pill that's serves up a big deal in the bedroom.

Interestingly, researchers only stumbled across Viagra indirectly whilst trying to find a cure for something else (similarly to how the hair loss treatments Finasteride and Minoxidil were discovered). 

It was the 1980s, and scientists were looking for a treatment for angina, which is caused by reduced blood flow to the heart. The researchers found an active ingredient called Sildenafil, which increases blood flow to certain regions of the body.

After several clinical studies, the scientists realised something was afoot. It became clear that men in the studies were getting healthier erections, as Sildenafil also increased blood flow to the penis...

What is Viagra?

Viagra is a brand name for erectile dysfunction treatment that contains Sildenafil as the active ingredient.

Sildenafil (and by extension, Viagra) is a highly effective treatment that relaxes muscles found in the walls of blood vessels.

This increases blood flow to certain areas of the body, such as the penis, making it a lot easier to get, and to maintain an erection.

How does an erection happen?

It takes a finely choreographed series of events to produce an erection. It begins with arousal signals from the brain, and it all hinges on good blood flow to the penis.

An erection occurs when the penis fills with blood. The penis fills with blood when the blood vessels that take blood to the penis widen, and those blood vessels that take blood away from the penis contract.

Under normal conditions, sexual stimulation leads to the production and release of nitric oxide in the penis. Nitric oxide then activates the production of cyclic guanosine monophosphate (cGMP).

cGMP is primarily responsible for erections. It acts as a signalling molecule which relaxes the smooth muscle cells in artery walls, and the resulting dilation of blood vessels leads to an erection as blood flows into the penis. 

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How does Viagra help?

Our bodies also produce an enzyme called PDE5. This enzyme breaks down the cGMP which makes it harder to get and maintain an erection.

Viagra serves as a PDE5 inhibitor. It prevents PDE5 from destroying cGMP so that the cGMP stays around longer, making it easy to get, and achieve, a more prolonged erection. 

Who should use Viagra?

The main licensed use is for men between the ages of 18-65 who are suffering from erectile dysfunction. 

Viagra is widely consumed in the UK, with millions of men taking the treatment annually. Indeed, Viagra at a dosage of 50mg, also called Viagra Connect, is available over-the-counter without a prescription.

However, some men who suffer from certain conditions are advised either to avoid taking Viagra, or seek medical advice before doing so. This includes those taking nitrates, which also lower blood pressure and if taken with Viagra, can amplify the drop in blood pressure.

How long does Viagra last?

It is advised that Viagra is taken only when needed, about 30 minutes to 1 hour before sexual activity. It usually lasts for about 4 hours.

It's best to take Viagra after having a light meal, and it works most effective without drinking alcohol.  

What are the side effects of Viagra?

Clinical trials have shown that side effects are uncommon and affect only a small percentage of men. Indeed, Viagra at 50mg can be bought at a pharmacy and no longer needs a prescription, so it’s safe enough for the reclassification.

However, just as how weight loss can’t be targeted with exercise, Viagra's dilating properties effect other blood vessels in the body, not just the penis. As a result, side effects can include headaches, blurred vision and skin flushing.

Also, when taking Viagra, the recommended guidance is to avoid grapefruit and grapefruit juice, as well as other medicines to treat impotence, such as alprostadil or yohimbine, without first talking to your doctor.

Is Viagra the only type?

There are several other PDE5 inhibitors which are widely available and used to treat erectile dysfunction. These include tadalafil (brand name: Cialis), vardenafil (Levitra) and avanafil (Spedra).

These all work in a similar way to Viagra, which is to increase blood flow to the penis. It may be the case that if Viagra doesn’t work, one of these will do. All are taken in a similar tablet form.

Where can I get Viagra from?

You can get purchase Sildenafil (generic Viagra) or the branded Viagra from Man Behind The Mirror here.

You first must complete a brief and free online consultation so that we can determine your suitability. It will be then delivered quickly and discreetly to your door.

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If you have any follow-up questions don't hesitate to contact us at help@manbehindthemirror.co.uk

Written by Mike Firth, GP and Medical Director

This article is for informational purposes only and is not a substitute for professional medical advice or diagnosis. Always talk to your doctor about the risks and benefits of any treatment.