Category: Viagra

Q. For most of my life, I’ve been a little overweight. In recent years, my weight problem seems to have become a bit more worrisome, probably because I’m less active. As a result, I’ve been having serious erection problems. Would a sensible weight-loss program help me to regain normal erectile function?

A. Carrying around a lot of extra weight puts heavy demands on your heart and all of the body’s vital organs. Your heart must work extra hard to pump oxygen-rich blood to every corner of your body. It’s impossible to know how much damage these extra pounds have done to your overall vascular system, but it’s clear that getting your weight back under control should be reflected in improved erectile function.

An Italian study conducted in the early 2000s looked at the effects of a weight loss program on the health and sexual function of 110 men diagnosed as obese. The university-sponsored weight loss program entailed a 300-calorie reduction in daily intake coupled with a program of increased physical activity. At the end of the two-year study period, 30 percent of the men enrolled in the program had regained normal sexual function. The Italian study was reviewed on January 10, 2005, issue of “Canadian Family Physician.”

Q. I’ve never been very careful about what I eat, and I know my overall health — including erectile function — has suffered as a result. What types of foods should I eat to become healthier overall and perhaps improve erectile function?

A. Try to aim for a diet that includes plenty of fresh fruits and vegetables and whole grains and minimizes your consumption of fatty red meats, which should be eaten only once or twice a week. Although many diets incorporate these basics, the Mediterranean diet is perhaps the best model for erection-friendly eating.

This diet, favored by people living in the Mediterranean basin, also features fish and other seafood high in omega-3 fatty acids. Your best choices in the fish-seafood category are wild salmon, Atlantic mackerel, sardines, black cod, anchovies, oysters, rainbow trout, albacore tuna, mussels, Pacific halibut, rockfish, and catfish.

Other key elements in the Mediterranean diet include healthy fats, most notably olive oil; nuts; seeds; legumes; and potatoes. The diet also allows moderate intake of cheese, eggs, and yogurt, as well as some poultry.

Q. On occasion I’ve had a little too much to drink and found that in those situations I was either unable to get an erection or to keep it long enough to complete the sexual activity? Do such incidents have any long-term implications or do I just need to moderate my alcohol consumption?

A. If, as your question suggests, your overindulgence in alcohol is only an occasional problem, your erectile function is unlikely to take a long-term hit. However, chronic overindulgence in alcohol can morph into full-blown alcoholism for those who aren’t cautious.

And chronic and persistent alcohol use are clearly inconsistent with optimal sexual function. A study published in the April-June 2007 issue of the “Indian Journal of Psychiatry,” assessed the prevalence of sexual dysfunction among 100 men diagnosed with alcohol dependence and admitted to a rehabilitation facility.

Researchers found that 72 of the men suffered from one form or another of sexual dysfunction, the most commonly observed being premature ejaculation, loss of sexual desire, and erectile dysfunction.

Researchers theorized that these manifestations of sexual dysfunction could be traced to “the depressant effect of alcohol itself, alcohol-related disease, or due to a multitude of psychological forces related to the alcohol use.”

Although erectile dysfunction is more common among older men, it is not an inevitable consequence of aging. Rather, the older you get the more likely you are to have damaged your health in ways that can lead to impotence. Erectile dysfunction can arise from a variety of different causes, but the one most widely observed is insufficient blood flow to the penis.

Compromised blood flow itself has a number of causes and contributing factors, including atherosclerosis, the buildup of plaque on the inner walls of arteries; poorly managed diabetes, which damages blood vessels and nerves; and smoking. If your lifestyle invites some of these ills, you can help to head off the onset of impotence by changing your behavior.

Another cause of ED said to account for 10 to 20 percent of all cases, is depression and related mental and emotional ills. To overcome these psychological problems, you will probably need to enlist the aid of a psychiatrist or mental counselor.

Lastly, some men suffer a congenital or traumatic injury to the genitals, which makes it difficult or even impossible to get an erection. The only way to correct such problems is through surgical intervention.

Your best strategy to improve erectile function is to live as healthy a life as possible. It can’t be emphasized enough that what you eat provides the foundation for your overall health. If you can’t resist the siren call of fast food’s high fats and empty calories, that foundation will be a very weak one indeed.

Eating plenty of fresh fruits and vegetables and minimizing your intake of red meat are good first steps. If you crave animal products, try to satisfy that hunger with poultry and fish that are rich in healthy fats.

You can further reinforce your healthy foundation by staying active. According to WebMD.com, “Sedentary men may be able to reduce their risk of erectile dysfunction by adopting regular physical activity at a level of at least 200 calories a day, which corresponds to walking briskly for two miles.”

If you’re overweight, which puts unnecessary stress on your overall body, take sensible steps to lose those excess pounds. Smokers need to kick the habit, and all men should take care to use alcohol in moderation. Following these steps can significantly improve a man’s health and promote optimal erectile function.

Q. After getting a prescription from my doctor, I recently began taking Viagra, which is working just fine for me. However, the pills are more expensive than I can readily afford. Are Viagra and the other oral ED drugs usually covered under health care insurer’s prescription drug plans?

A. If your health care insurance includes reimbursement for prescription medications, you’ll have to check to determine whether ED drugs such as Viagra are covered. Be warned that many plans do not offer such coverage. Medicare’s Part D prescription coverage doesn’t reimburse for ED drugs. However, some relief from high prices is just around the corner. The arrival of generic competition beginning in December 2017 will help to bring prices down. The more generics that enter the market, the lower the average price for the drug will drop. In the meantime, you may be able to reduce what you pay for the drug by using manufacturer discounts and coupons.

Q. I’ve been taking Viagra for the last few months. How long will it take before I can once again get an erection without using the pill?

A. Viagra is not a cure for erectile dysfunction, and you could take it for years without reducing your need for the drug. However, if your ED symptoms are relatively mild and you are taking steps to make your lifestyle healthier, you may indeed reach a point where you will no longer need the helping hand that the medication offers.

To achieve that goal, you should eat a healthy diet, incorporate physical activity — even brisk walking — into your daily routine, quit smoking, and drink alcohol in moderation.

If you’re suffering from one of the underlying medical conditions, such as atherosclerosis, diabetes, or high blood pressure, that can lead to ED, you need to work with your doctor to manage that condition and thus reduce your risk of impotence. It could already be too late to reverse your ED symptoms altogether. But taking these commonsense steps to live a healthier life can help to ensure that you’re around longer to enjoy sex and everything else that life has to offer.

Q. Because of recurring difficulties in getting an erection, my doctor has prescribed Viagra for me. However, I’m worried that the pill would cause me to have erections at inconvenient times, causing me embarrassment. Is that a realistic concern?

A. You needn’t worry that you’ll start having spontaneous erections once you begin taking Viagra. The drug doesn’t work that way. You will still need to get your erections the old-fashioned way, either as a result of feelings of sexual desire or physical stimuli to your penis or other erogenous zones. Sildenafil citrate, the active ingredient in Viagra, works by temporarily improving blood flow to the penis, which facilitates the erection process. But that surge of blood toward the penis probably isn’t going to get started until your brain gets signals from elsewhere in the body that sexual activity is imminent.

Q. My doctor orders routine blood tests before my annual physical exam, mostly to check my cholesterol levels and to make sure that my kidneys and liver are functioning properly. For the most recent blood test, she authorized a test to measure the levels of testosterone in my blood. During my appointment, she told me that my T-levels were low but still within the broad range of what’s considered normal. Would testosterone replacement therapy bolster my erectile function better than Viagra?

A. Although testosterone is the primary male sex hormone, it doesn’t play a direct role in erectile function. However, it does have a great deal to do with a man’s sex drive, without which it’s unlikely he’d be having any erections at all.

If you find that your spirit is willing but the flesh is weak, it’s unlikely that testosterone replacement therapy would be of much help to you. If, however, your sex drive is not what it once was, it’s possible that hormone replacement therapy could help to fire up your libido once again.

Q. Viagra doesn’t seem to be working for me. I started out with one 50-milligram tablet taken an hour before I expected to have sex but was still unable to get an erection strong and long-lasting enough to have intercourse with my partner. What other options are available to me?

A. You can increase your Viagra dose to 100 milligrams to see if the larger dose does the trick. If that also fails to overcome your symptoms of ED, you might find relief with one of the other ED drugs on the market. Although all of these drugs are similar in chemical structure to one another, there is enough variation that one drug may work for one man but be less effective in another. If neither of these solutions works, it’s possible that you will have to try another form of treatment altogether.

Such alternatives include penile injection therapy, which involves the injection of a vasodilating drug directly into the shaft of the penis, or a penile implant. Yet another option is a vacuum erection device, which basically consists of a plastic cylinder that fits over the penis and a pump mechanism to pump all the air out of the cylinder.

As a vacuum is created, blood rushes into the penis, creating an erection. At that point, the plastic cylinder is removed and a constricting band is placed at the base of the penis to keep the blood in place until the sexual activity has been completed.