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Why doesn’t Viagra (and Cialis or Levitra) work for everybody?

Posted on: April 9, 2012 By: drsloane

There is no question that Viagra was (and still is) a breakthrough medication. I remember hearing about Viagra before it was released and how doubtful I was that a PILL could actually work at causing  erections in men with ED.  The rest of course is history. Subsequently Cialis and Levitra became available with essentially the same effectiveness as Viagra.  As we have since learned, about 60% of men with ED respond to these medications and the remaining 40% do not.  There are also a number of men who  initially respond and then stop responding.  That’s a lot of men!

Why does this happen? Do men become immune to the medication?  Are they getting a bad batch of pills? Are they taking it properly? Well there are several reasons why this happens and there are several points to be made about taking these medications properly.

The first thing to know is that these medications often do not work the first time taken. Many men require 2 to 4 occasions to use the medication before it works-why this occurs is not entirely understood. Second, it’s important to maximize the effectiveness of these medications with proper timing (Viagra requires taking the pill one hour prior to sexual activity and preferably on an empty stomach. Cialis and Levitra 30 minutes before sex).  The maximum dose must also be used if lower dosages are not working. And as I’ve mentioned in a previous blog, normalizing a low Testosterone level will also increase the effectiveness of these meds in many men so this should be addressed.

Now if all these factors are accounted for and the medications still aren’t working, this likely represents a severe degree of ED. If the medications were working at first and are no longer effective this likely represents a worsening of the ED rather than the body “getting used to” the medications.  In order for the medications to work there has to be some normal functioning nerves and blood supply  present. So when a man stops responding to the medication it usually represents a worsening of the physical factors in the body rather than an immunity or the body becoming used to the medication.

The best way to maintain your current level of Erectile function, with or without medication, is to maintain a healthy lifestyle. This includes diet, exercise, smoking cessation and stress reduction.

For advice on maintaining normal erectile function, lifestyle changes or treatment when medications do not help your ED call 215-563-1199 to arrange a consultation with me.

 

 

 

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