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Active Ingredient: Sildenafil

Viagra is a drug designed to eliminate erectile dysfunction in men. The effect of the drug is symptomatic, it is aimed at more active work of the organs of the genital sphere, which are responsible for the development of an additional volume of the male sex hormone - testosterone, as well as filling the penile cavernous bodies with blood. The pharmacological form of release is tablets of a round form and white color without a specific smell. Consider the composition of Viagra and its action. The drug does not treat sexual disorders, but is intended solely for symptomatic therapy. During sexual intercourse with Viagra, the composition of its active ingredients ensures that the vessels of the penis are filled with a sufficient volume of blood. Due to this, a man receives an adequate response of the sexual organ to sexual arousal, as well as the opportunity to have a full sexual intercourse with a partner.

Sildenafil: The Secret Weapon Against Erectile Dysfunction

Sildenafil, also known as Viagra, is an important drug used to treat erectile dysfunction. It revolutionized the market and the pharmaceutical industry from 1998 when it was approved by the FDA in the United States.

Erectile dysfunction is one of the most common diseases in older adults. In this case, what happens is a lesion on the arteries that irrigate the penis. This endothelial damage is caused by various agents, especially important diseases such as diabetes and hypertension.

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Initially, Sildenafil was used as a drug for hypertension, but later, after several studies, experts determined that it was very useful to combat erectile dysfunction. Then Pfizer entered and decided to commercialize it to treat this disease, having tremendous success.

How does it work?

Under normal conditions, the erection of the penis is mediated by a fundamental agent: nitric oxide. This molecule is capable of vasodilating each of the arteries found in the penis. In this way, the volume of the penis will increase rapidly, and with it, the veins will be compressed, so that the blood will be trapped in the penis, and thus we will have an erection. All this is mediated by a set of messenger molecules that are released with stimuli from the parasympathetic nervous system.

In erectile dysfunction, due to the various disorders that damage the vascular endothelium, it is not possible to produce nitric oxide as in normal conditions. This is where Sildenafil comes in.

Viagra is a potent inhibitor of the phosphodiesterase 5, which is responsible for degrading those messengers that increase nitric oxide levels. Therefore, these molecules will remain longer in the penis, and powerful erections will be produced that will last much longer.

Still, everything would be useless without sexual stimulation.

Mind and Body: A Fundamental Relationship

What is the biggest problem with Sildenafil? Ourselves.

This is a drug that increases the reactions that normally occur in our body. What it does is to increase the level of nitric oxide in the blood vessels of the penis, however, it would be useless without sexual stimulation.

The causes of erectile dysfunction vary greatly. It can range from direct traumatic disorders to frequent complications such as diabetes and hypertension that injure the vascular endothelium. However, there is also another important link in this classification with psychic causes. Many people, due to problems such as anxiety, depression, sexual problems, etc., cannot achieve a satisfactory erection. For this reason, they go to Sildenafil to achieve it. The problem is that many of them have problems to reach the initial sexual stimulus so it will not be possible to get an erection.

This is one of the tests used (the Sildenafil test) to differentiate psychogenic causes from other organic ones - which are the most frequent.

Other Uses of Sildenafil

remember that we are talking about a powerful vasodilator (which in fact must be used with caution in patients with hypertension), so it can also be used in other pathologies whose development is related to these factors. Among this we have:

1. Pulmonary Hypertension

This is perhaps a rare disease, but it has similar pathophysiology and little-known treatment. Sildenafil, as mentioned above, thanks to its effect with nitrous oxide can decrease resistance and pressure in the arteries. In addition, it also increases the carrying capacity of the veins, which greatly decreases the amount of blood that reaches the heart, and the lungs. The less blood that reaches the lungs, and the walls of the arteries relax, the less pressure there will be on this vital organ.

This drug is very selective and can create vasodilation only in penis and lungs, due to the enzyme on which it acts. Therefore, it is ideal for pulmonary hypertension and erectile dysfunction.

2. Pulmonary Edema

Pulmonary edema is a complicated condition, which can have many causes. However, Sildenafil is approved for use in only one type: altitude pulmonary edema. Although it is not completely clear what the effect is on this pathology, its action is attributed to the ability to vasodilate the venous vessels, increasing the return, encouraging water to pass from the lung to the blood vessels. It is a disease suffered by many mountaineers.


Although there are many different versions of Sildenafil, for the treatment of erectile dysfunction only 100mg are needed that should be used at least 30 minutes before sexual relations.

If it is your first time or you are just beginning to adapt to Sildenafil, it is recommended that you consult your doctor to create an appropriate scheme for you, in which you gradually begin to use this drug. Remember that it is a potent drug capable of lowering blood pressure, so its use is delicate. Initially, it is normal to prescribe small doses of 50mg or less 30 minutes before receiving sexual stimulation.

There are several types of pills, they can be solid, capsular or chewable. The last one is much faster and can have an effect in just 15 minutes, especially if the stomach is empty.

On the other hand, for the treatment of hypertension, there are other drugs such as Revatio, whose dose of Sildenafil is lower, up to about 20 mg that should be used 3 times a day in conjunction with other drugs to enhance its effect.

Side Effects

Most of the side effects are attributed to vasodilatation caused by nitric oxide. However, it is important to mention that other unwanted effects are caused by the activation of the sympathetic nervous system, which is secondary to the vasodilation caused by Sildenafil. Some of these effects are:

  • Headache
  • Intestinal disorders
  • Blurred vision
  • Palpitations
  • Rebound hypertension
  • Photophobia
  • Sensitive alterations

With headache, for example, the decrease in blood pressure in the head or the large vasodilatation of the blood vessels causes alterations in the state of consciousness or lack of supply to the brain, causing pain. However, as part of the sympathetic response, our body increases the heart rate and the intensity of the beats to increase blood flow, which has decreased by the same vasodilation.

This can be potentially dangerous in some states. Important side effects such as priapism (erection maintained for many hours), myocardial and cerebral infarctions, severe hypotension and even cardiac arrhythmias have rarely occurred. It is usually due to secondary basal disorders of the patient, such as high blood pressure or the presence of atheroma in the arteries. For this reason, it is important that you see your doctor to find out if you can take this medicine.

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Other side effects of using Sildenafil is a blue coloring in the vision called cyanopsia. This is a disorder that has been reported by the FDA, but it is quite rare.

Sildenafil and the Elderly

Most people link erectile dysfunction to age, so they believe that if they reach their golden years, they will not have satisfactory erections that allow them to enjoy their sexual relations. Nothing is further from the truth.

The problem, as mentioned at the beginning, does not lie in events related to aging, but is vascular damage caused by many diseases. Most of the time there is no problem with a HEALTHY adult using this medicine. But the most frequent thing is that there are other basal pathologies that are a product of normal aging. These include diabetes and hypertension, the most important causes of erectile dysfunction in the elderly.

In addition, another point to note is that, in fact, perhaps these diseases are not the cause, despite being present. Sometimes it is due to the medications that are used to treat the various conditions that affect older adults.

For this reason, it is quite likely that any older adult who is in good condition will be able to have a satisfactory erection on his or her own, where the use of this medication is not necessary. However, many times it will be necessary to use Viagra but ALWAYS considering the relationship that exists between the rest of the diseases that affect the patient and the medications that are consuming. It is probably best, in some cases, to reduce or adjust the doses of certain drugs or even change them, to use them in conjunction with low doses of Sildenafil.


Under certain criteria, which should be analyzed by your doctor, it is not possible to use Sildenafil despite the existence of erectile dysfunction. Some diseases and drugs in combination with Viagra can lead to fatal results. For this reason, it should always be purchased under prescription. Some of them include:

  1. Nitrates: One of the mainstays for the treatment of hypertension are nitrates. There are many, the most used are nitroglycerin, nifedipine, or poppers, such as nitrate or amyl butyl nitrite. All these drugs can increase the concentration of nitric oxide in our blood (which also increases with Sildenafil) so it would enhance the effect of Viagra, leading to very severe states of hypotension, which can cause strokes or heart attacks.
  2. Cardiovascular: those patients with a poor cardiovascular condition, who do not tolerate simple exercise, may not be good candidates to consume this drug. In addition, patients with high cholesterol levels are prone to atheroma's formation, which can cause secondary complications with Viagra use.
  3. Hypotension: Sildenafil by itself can cause a slight decrease in blood pressure; in fact, this is what activates the regulatory response on the part of the sympathetic system to increase heart rate. If there is already a base state where there is hypotension, as in some infections, it is best not to use this drug.
  4. Recent heart attacks: Not only cardiac but also cerebral. If in the previous three months you had an important ischemic event, the use of Viagra is discouraged.
  5. Allergies or Hypersensitivity Reactions to the compound

Interactions: Alcohol and Food

It is important to know all aspects surrounding the use of sildenafil. As mentioned above, Viagra is best absorbed when the stomach is empty. This is because this drug is absorbed through the gastric walls, with ideal levels of acidity that you may not have when you are eating. The more food there is, the less medicine is absorbed, so it is recommended not to eat at least 3 hours before use. As for alcohol, most studies report that it is possible to consume it in moderation, however, excess levels can diminish its potency and effect. Some studies also mention that, because of alcohol's ability to lower blood pressure, there are likely to be significant adverse effects such as severe hypotension, so it is best to avoid using Viagra when considering alcohol or drunkenness.


Another special case has to do with our ability to drive. This medicine can cause drowsiness, so it is not recommended to drive until at least 6 hours after use. In this way, major complications are avoided.

Women and children should not take this medicine. It can cause serious adverse effects and has not been shown to have any benefit except for the treatment of pulmonary hypertension. Sildenafil is not a teratogen but should not be taken during pregnancy. It has no effect on it or facilitates conception, despite what many people with medical judgment claim.

Viagra and Legal Problems

As we have pointed out, Sildenafil is a drug that must be prescribed by a doctor. Unfortunately, there is a large black market that traffics in this type of drug. Many people do not understand the seriousness of the complications that can arise with the use of Sildenafil, so they seek to acquire it "quickly" through the black market, just to enjoy its benefits. The reality is that this is a dangerous practice.

Many international organizations have devoted their efforts to prevent the illicit sale of this drug, but especially to inform people about the possible complications of Viagra. If you are thinking of using the "blue pill", you should consult your doctor.

Tomorrow's Healthy Men: Overcoming Erectile Dysfunction

It is no secret to anyone that our society is moving by leaps and bounds. Today, the average man has a life of lesser impact than our great predecessors, where we are less physically burdened, but more emotionally burdened. We quickly get used to routines, with repetitive movements, full of bad habits and unhealthy behaviors, but not everything is dark.

Science has also come a long way in recent decades to make it easier for conventional society to work. Today we can find special nutrients in small capsules, as well as physical activity without even leaving home. However, what doesn't stop changing is human behavior and the way we want to lead our lives, even though we know how dangerous many of our habits are.

We are a supernumerary set of cells that are constantly working to get everything up and running. From the small changes in your hair that make it longer each day to the complicated chemical reactions that allow your metabolism to function; the human body is a complex system that requires special care.

With youth, energy tends to overflow and give us a slight feeling of "superpower", where we believe we can with everything and do not measure the consequences of our actions. We usually enjoy acts that we know as harmful but ignoring the magnitude of our error. A short and simple example is smoking, at first - being young - we allow ourselves to inhale thousands of cigarettes a year, but it is not until middle age when we feel the lethal effect of nicotine in our body.

Many things change with aging and the best way to treat those conditions is to prevent them from happening with prevention. Let us know some key points that we must cover to enjoy good health.

Sedentarism and Physical Activity

This is perhaps one of the most talked about points in any post about health, but do you really know why you need to stay active and how to do it?

Maintaining a certain level of physical activity goes beyond just jogging 30 minutes a day, it implies constancy, confidence, and a lot of self-esteem. As we age, our ability to form atheromas - large fat-filled plaques in our arteries - increases very rapidly, so we must act without thinking about it. These plaques are the cause of strokes and heart attacks, emboli, thrombus and many other injuries in our body. In addition, as we approach our golden years, our arteries harden and calcify so they cannot expand as easily as in our youth, we may suffer from high blood pressure and other complications, and the only way to improve our condition is by conditioning our body. Women have benefits that we don't; their high estrogen content protects them for many years until menopause, so our cardiovascular system is weaker and needs our help.

What is really indicated by most international regulations, especially the WHO, is to have at least 30 minutes of physical activity dedicated to improving your health. You can run, jog, walk, dance, practice a sport, etc. The important thing is that you dedicate that time to an activity contrary to your daily routine, which does not imply the same stress with which you normally take part but, on the contrary, it helps you to unload.

Alcohol, Smoking, and Other Drugs

Unfortunately, men have higher rates of alcoholism and tobacco addiction than women. In fact, large studies and pollsters claim that the male sex has greater complications from substance abuse, so many measures and programs related to these illegal products are geared entirely toward men.

Let's try to be a little more specific just so you start worrying a little more about your body.

When they talk about Alcohol, the first thing that comes to your mind for sure is the liver. Liver problems are very important when you talk about alcohol and that's not something you can put aside. However, it's not the only thing.

Alcohol and smoking have one thing in common: endothelial damage. Our blood vessels are very complex structures that have an intricate system of homeostasis (balance) that can be very delicate. When we abuse any of these substances, we cause irreparable damage to the inner wall of our arteries, where the cells that produce the vascular relaxation factors are located. In short, by consuming these illicit substances, we damage our blood vessels and prevent them from functioning properly.

All this can be summed up in -at least- the appearance of a classic disease: arterial hypertension. The increase of blood pressure in our body is never good, it can lead us to other secondary complications such as acute pulmonary edema, cerebral or cardiac infarction, renal insufficiency, etc. Maybe we lead a crazy life, full of alcohol and cigarettes for many years, but worth it?

The best solution: quit smoking and reduce alcohol consumption to a maximum of one drink a day.

Giving Your Body What It Needs

For years there was a bad concept about diets, most people thought it was about "restricting the amount of food and calories we ate. Today, thanks to advances in health systems and the medical-scientific community, we can affirm that this concept is quite far from reality.

Healthy eating is not about eating less, but about eating better. Learning to choose our food for balance, away from sausages and fast food, is the best thing we can do. Today we're not talking about trading your good burger for a random set of vegetables, but about giving your body what it needs.

You can try to start by eliminating junk food, soft drinks and cold meats at least 5 days a week (leaving Saturday and Sunday for you to eat what you want). You must get your body out of the bad habit of eating processed foods, to give it more natural nutrients that are easy to digest and that allow you a better internal functioning.

Changes can be seen within a few weeks. The performance and energy needed to digest and absorb all those natural foods are lower, plus they provide healthy calories, so you'll feel full of life and strength, which you may not have had before.

In addition, you can supplement this diet with some necessary supplements that are not obtained from conventional foods (or that are normally in low amounts) such as vitamins -especially the B complex-, zinc, iron, omega 3, omega 6, etc.

And by the way, don't forget the water! giving your body what it needs also includes consuming the necessary amount of water, keeping your body hydrated and helping to eliminate all the toxins that normally inhabit your body as a result of normal metabolism. At least drink 2 liters of water a day if you have a conventional physical activity, if you practice any sport or are exposed to tasks under hot climates perhaps you should consume more.

Men and Erectile Dysfunction

Perhaps one of the most sensitive points in man's health has to do with erectile dysfunction. This is a very uncomfortable disease where we cannot achieve an effective erection that allows us to enjoy sexual relations, an unsatisfactory erection. It affects not only the physical side but also the mind; self-esteem can fall quickly when it comes to male genitals.

Many people have the false belief that this is a disease that comes with age, but it is not. The truth is, man cannot blame aging for the inability to get an erection, but the same carelessness he has had with his body all his life. Erectile dysfunction is a secondary complication of our indifference to our organism, our bad habits, and our little interest in improving.

The Science Behind Dysfunction

Erections have their origin in the correct blood flow of our body. The penis has a normal flow which, although flaccid, constantly nourishes it. Initially, after sexual stimulation (which will always be necessary to achieve an erection) several signals are created in our body that ends up reaching the endothelial cells of the arteries in the penis, which will begin the production of a molecule called Nitric Oxide (NO), the true secret of male erection.

This mediator can create a state of "vasodilation", where the caliber of the arteries increases to carry more blood to the penis. What happens, in short, is that the blood begins to accumulate in the arteries of the penis, increasing its volume, secondarily compressing the veins, creating a vicious circle that only ends with the trapping of blood in the male sexual organ. Thanks to the great capacity of the vascular system to adapt to these changes, a great increase in volume is achieved.

The problem lies mainly in the production of this mediator. Many men, due to the great disarrangements and bad habits that they have had throughout their lives, end up having important endothelial disorders that directly affect the vascularization of the penis. All of this leads to a decrease in the production of nitric oxide, and with it, the vasodilatation of the penis that allows erection.

Sometimes we want to blame age, but the truth is that for a long time we had undue behavior that led us to that point. Healthy living is necessary, even to be able to enjoy sexual relations.

What's Stopping Me from Enjoying Sex?

As mentioned earlier, erectile dysfunction is a disorder that arises directly from the inability to produce the right amount of nitric oxide to allow vasodilation. However, the correct question would be "why doesn't NO occur anymore?"

Undoubtedly, endothelial damage is the most important thing. This is due to some secondary disorders such as smoking and alcoholism, which end up creating free radicals and other measuring molecules that directly affect the internal walls of our arteries at the level of the male sexual organ. In the same way that it occurs with the consumption of these illicit substances, it happens with diabetes; however, in this case what exists is an increase in the amount of glucose in our blood that has a direct effect on the endothelium, damaging it, preventing the development of the cells responsible for the formation of NO.

There is also hypertension. The increase in arterial blood pressure has an important and well-known secondary complication: endothelial damage. So it all boils down to the fact that there are more diseases and disorders that can end up with the cells that produce NO, which is responsible for erection.


Taking care of your health sounds more important now, doesn't it?

Still, that's not all. There are many other causes of erectile dysfunction that involve direct traumatic injuries, use of other drugs, even psychogenic causes where there is a disorder in sexual performance that does not allow erection.

Finally, there are the drugs. The real problem during aging is that we end up taking a conglomerate of infinite pills in order to treat each of the diseases that affect us at that stage of our lives. This is one of the most important causes of erectile dysfunction; these same drugs can have important side effects that end up diminishing the intrinsic production of nitric oxide, thus altering the vasodilatation process and, therefore, the erection of the penis. The important thing is that many times there are other alternatives to all drugs, you should consult your doctor to explore the possibilities.

Treatment - Is there a solution?

The most important thing is that you learn to take care of yourself from a young age, however, any age is good for starting to change your bad habits.

Despite this, there are many treatments currently available to overcome erectile dysfunction. Depending on the cause, and after a visit with your doctor, you can use Sildenafil -the blue pill or Viagra-, the world's most accepted medication for erectile dysfunction.

In addition, there are other variants of Sildenafil that can also be used as Cialis, or other invasive and non-invasive therapeutic measures.

By: Benjamin Peng, MD


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