Erectile Disfunction (ED) is a common problem that affects nearly 140 million men worldwide, including 30 million men in America. The incidence of this problem increases with age. It is the failure to attain and sustain an erection that will allow for sexual satisfaction, and is classified as either mild, moderate, or severe erectile disfunction. It can have devastating effects on a man’s level of self confidence and destroy an intimate relationship.

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An erection begins with stimulation to both the senses and the mind. When a man becomes sexually stimulated, his brain sends a message down the nerves in the spinal cord to the penis. The many nerve endings that exist in the penis then release neurotransmitters to signal the penis to relax and fill with blood. As the penis fills with blood, it becomes stiff, erect, and enlarged.

ED is a condition that can seriously impact the quality of life in a patient, their self esteem, and relationships with partners if left untreated. In over half of the men suffering from ED, this problem is caused by medical reasons such as diabetes, circulatory, neurological, or urological conditions. The other half experiencing ED difficulties have psychogenetic causes, or lifestyle factors.

The lifestyle factors that can contribute to ED include stress and anxiety brought on by work pressures, family pressures, relationship conflicts and fears of inability to perform. These pressures reduce the ability to focus and decrease the awareness of the senses while performing sexual acts. These factors cause an increase in catecholamine levels and increase smooth muscle tone and oppose the muscle relaxation that is needed to sustain an erection.

Clinical depression is another cause of erectile disfunction and a lower desire in sex, which in turn may cause further depression. Additionally, medications that are prescribed to treat depression such as antidepressants, lithium, monoamine, oxidase inhibitors, and serotonin reuptake inhibitors, can also have side effects that cause erectile disfunction. Substance abuse can also cause ED.

Sildenafil is a chemical that can successfully treat erective disfunction with minimal side effects. This drug inhibits phosphodiesterase type 5, so an erection can occur naturally following sexual stimulation. Clinical tests have shown the effectiveness of Sildenafil in treating men with ED due to various ailments, including diabetes, heart disease, lung disease, and spinal cord injuries.

An independent research study conducted on sildenafil to treat men with mild to moderate ED problems, found that it provided a significant improvement in the number of erections, the quality of the erections, and the level of satisfaction during intercourse.

The number of erections that occurred during sexual stimulation and the level of sexual satisfaction for both sexual partners increased greatly after using sildenafil. None of the participants in the study had adverse side effects that were significant enough to stop its use, and they were classified as mild to moderate.

The study was conducted in a natural setting rather than in a clinical environment, so the results from the participants were subject to their own interpretations. It is no wonder that sildenafil became a very popular drug shortly after its introduction to the market in 1998, as it improves the quality of life for its users and is easy and convenient to use.

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He developed two creams that are currently undergoing testing and have shown promising results. One of these creams contains sildenafil citrate, and when applied to the labia and clitoris, it resulted in better lubrication, increased arousal and more sexual pleasure. By increasing blood flow to the sexual organs, the cream increased genital sensation and assisted in the achievement of orgasm in women.

A study on the effectiveness of this cream was conducted on 27 women volunteers who reported results in achieving orgasm that ranged from disappointing to explosive.

Preliminary studies have been conducted on sildenafil cream as a treatment for postmenopausal women. Reduced hormone levels in older women cause subtle changes in the genital tissues. Some of the symptoms of menopause that inhibit sexual enjoyment include: vaginal dryness, loss of lubrication, delay in achieving orgasm, painful intercourse, soreness, burning, and irritation. Many postmenopausal women do not want to take a pill to treat FSD, so a topical cream would provide an easy solution.

Because the use of this drug as a topical cream is still in its experimental stages, all potential side effects are still unknown and further research on this topic is required. However, promising results have been shown thus far, and those participants have shown few side effects.

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A number of topical solutions are used to treat anal fissures, including local, topical nitroglycerine, diltiazem, and locally injected botulinum toxin. The recommended treatment depends on the severity of the condition and the chronic nature of the problem.

Sildenafil citrate is approved for use as a treatment for erectile disfunction as an inhibitor of phosphodiesterase 5, and its use results in increased nitric oxide induced smooth muscle relaxation. Thus, it has been suggested that it may be effective in reducing anal sphincter hyperactivity in patients with anal fissures.

In a study involving 19 male and female patients with anal fissures, a topical cream containing 75 mg sildenafil was applied topically to the fissure. The study was conducted to test the results on the maximum resting anal sphincter pressures (MRP). All patients except one experienced a reduction of MRP of approximately 18 percent.

The cream was fast acting, and showed results in less than 3 minutes. On women, the drug acted more rapidly, showing results in about 80 seconds. Maximum relaxation of the sphincter muscle occurred within about one minute after application.

The topical sildenafil solution was well tolerated in all patients, with the most common side effects being mild or moderate itching and burning. Although more studies are required to prove the effectiveness of this cream, these results are promising.

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This disease is often fatal, since it causes additional strain on the heart and can lead to heart attacks. When the heart fails, the lungs fail to provide enough oxygen to the rest of the body. The method of treating this disease is to widen the blood vessels in the lungs and making it easier for the heart to pump blood through these vessels.

One way to accomplish the widening of blood vessels is to inhale a mist called iloprost, which is a form of epoprostenol. However, its effects last for about 60 minutes so numerous inhalations are required throughout the day. Sildenafil was tested to learn if it could prolong the effects of iloprost.

Another treatment for pulmonary hypertension is a continuous inhalation of nitric oxide gas, which also widens blood vessels in the lungs.

In a study group, thirty patients with severe pulmonary hypertension volunteered to participate. The blood pressure and blood flow in the lungs were measured during treatments at 3 hour intervals.

All patients first received an inhalation of nitric oxide. They were then divided into four groups. The first group received a low dose of sildenafil, the second had a low dose of sildenafil followed by inhaled iloprost, the third received a high dose of sildenafil, and the fourth group received a high dose of sildenafil followed by inhaled iloprost.

The researchers discovered that the most effective treatment for severe pulmonary hypertension was a high dose of sildenafil followed by inhaled iloprost. The next most effective treatment was a low dose of sildenafil followed by inhaled iloprost. Thus, a combination of therapies was most effective, and the patients suffered no serious negative side effects from the treatments.

The usefulness of the results of this study were limited due to the low number of participants and the short time span of the test. However, it has shown that sildenafil may help to control this fatal disease when combined with other treatments.

Sildenafil has few side effects, is easy to administer, and is relatively inexpensive in comparison to alternative treatments.

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When Sildenafil was tested on mice, it had the effect of reversing the long term damage to the heart caused by chronic hypertension. The way that Sildenafil citrate works to maintain an erection is to expand genital blood vessels that carry the blood supply to the penis when aroused. In the same way, Sildenafil can benefit the heart to treat pulmonary hypertension.

By dilating the blood vessels, Sildenafil causes a drop in blood pressure required to pump blood through the body.

While conducting experiments on mice, researchers realized that sildenafil was able to stop the short term effects of hormonal stress and reverse the long term damage on the heart muscle. The effects of heart failure and cardiac hypertrophy were also improved by sildenafil in mouse experiments, although this effect was not tested on human subjects.

To prove its effectiveness in humans, thirty five men and women participated in the John Hopkins study. In this test, volunteer participants took an injection of dobutamine, a chemical that increases the heart rate and contraction of the heart muscle. The heart rates of the participants increased by 150%. The volunteers were divided into two groups, where one group took sildenafil and the second group took a placebo. Then a second dose of dobutamine was administered to both groups. The first group taking sildenafil experienced a drop of 50% in heart rate and heart contraction, while the second group had an increase of 150% more.
Because this study was so successful, it sparked greater interest in researching the short term and long term effects of sildenafil on the heart and additional benefits to using this medication. Although research on this drug is still being conducted, researchers have learned that sildenafil stops the action of the enzyme phosphodiesterase 5 (PDE5A) from breaking down cyclic GMP, which helps to control stress and hypertrophy in the heart.

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Blue Steel is sold in containers of 10 capsules or in blister packs holding 2 capsules. Hero is sold in blister packs of 2 capsules.

Consumers may be misled into believing they are not harmful because these products are called all natural dietary supplements. However, caution must be taken if the patient has other medical conditions and is taking medications, such as nitrates, that interact negatively with these chemicals. Certain ingredients are not listed on the product, and these components could be potentially harmful to the unsuspecting consumer.

Some prescription drugs contain nitrates that are used for the treatment of angina and heart failure. Nitrates relax a muscle in the blood vessels and allow the vessels to widen. As a result, the heart does not have to pump as hard to circulate the blood, and allows for greater physical activity. Some of the ingredients in Blue Steel and Hero that are not listed, interfere with nitrates and can lower blood pressure to a dangerous level.

Erectile disfunction is common in men who suffer from diabetes, high blood pressure, high cholesterol, and heart disease. These patients often take nitrates to treat their disease, and doctors advise them not to take erectile disfunction treatments. As a result, they may seek alternative, all natural medications such as Blue Steel and Hero. However, these medications may cause serious harmful health problems.

These products are not federally approved and are currently illegal. If using either of supplements, the FDA advises discontinuing their use and speak with a doctor if experiencing any adverse side effects.

If experiencing erectile disfunction, the patient should consult with their medical practitioner for treatments that have been approved by the FDA.

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Some of these medications include nitrates, which are frequently prescribed to treat chest pain and angina, as sildenafil may cause a rapid and risky decrease in blood pressure and can lead to fainting, heart attack or stroke. If you have taken sildenafil, then you need to wait at least 24 hours for the drug to leave your system before nitrates can be used.

Another medication that sildenafil interferes with are beta blockers, which are used to treat high blood pressure or prostate difficulties. Your doctor may recommend a lower dose of sildenafil. Protease inhibitors, that are used to treat HIV, may also be affected by sildenafil, so your doctor may limit the dose to a maximum of 25 mg every 48 hours.

Approximately 15 percent of people taking sildenafil experience side effects. These side effects are usually mild and do not last more than a few hours. They include fever, headaches, flushing, muscle aches, nasal infection or stuffiness, vision problems, nosebleeds, sleeplessness, dizziness or light headedness, fainting, shortness of breath, stomach upset, diarrhea, or heartburn. Some cases of sudden hearing loss and tinnitus have also been reported, and this reaction has caused labeling to be revised and list this side effect under Precautions and Adverse Reactions.

Vision problems are also seen in a limited number of patients taking this drug, and include sensitivity to light, blurred vision, impaired blue/green color distinction, and a decrease or loss of sight. The cause of these problems is attributed to a decrease in blood flow to the optic nerve. You should contact your doctor immediately if any of these side effects persist.

During sexual activity, if you experience dizziness or nausea, develop pain or tingling in your chest, arms, neck or jaw, you need to contact your doctor immediately as you may be experiencing serious side effects from sildenafil citrate.

You need to let your doctor know if you have any drug allergies, or any of the following conditions that may affect your tolerance of sildenafil.

1. Heart disease or heart rhythm problems
2. A recent history of heart attack, stroke, or heart rhythm disorder
3. Congestive heart failure
4. High or low blood pressure
5. Coronary artery disease
6. Liver or kidney disease
7. A blood cell disorder such as leukemia, multiple myeloma, or sickle cell anemia
8. A bleeding disorder such as hemophilia
9. A stomach ulcer
10. A physical deformity of the penis
11. Retinitis pigmentosa
12. If you have been advised to avoid sexual intercourse for health reasons
13. You are pregnant or planning on becoming pregnant during treatment, or if you are breast feeding a baby
    If you think you may have overdosed on Sildenafil citrate, seek emergency medical attention. Symptoms include chest pain, nausea, irregular heartbeat, feeling lightheaded, or fainting.

Allergic reactions to sildenafil include skin rashes, difficulty breathing, or swelling of the face, lips, tongue, or throat. If you experience these reactions, you should immediately seek emergency medical help.

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Clinical trials were conducted on the effectiveness of sildenafil in treating women with FSD caused by spinal cord injuries in the year 2000. The spinal cord injuries affected the sacral cord and spinal segments S2 through S5. Nineteen premenopausal women were recruited to participate in the study, and each received either 50 mg of sildenafil citrate or a placebo on one day and the other medication the following day.

One hour after receiving the drug or placebo, the participants were subjected to two 12 minute sessions of audiovisual stimulation, followed by a 6 minute time period of no stimulation. They then were exposed to a second period of two 12 minute sessions of both manual and audiovisual stimulation.

During these sessions, vaginal pulse amplitude (VPA) was measured using vaginal photoplethysmography. Heart rate and blood pressure were also measured.

During both the visual and manual sessions, the group who took sildenafil had a greater level of VPA than those who took the placebo. Subjective arousal, heart rate, and systolic and diastolic blood pressure readings were also greater among the group who took sildenafil. This study was the first to test how effective sildenafil citrate is for women who are being sexually stimulated. Because the study group was small, additional research is required.

In a following study in 2001, 53 premenopausal women who being treated for sexual arousal disorders participated. None of the women in the group were taking hormone therapy or oral contraceptives and they all reported no problems with sexual desire.

The participants were divided into six groups, and each group took either 25 mg of sildenafil citrate, 50 mg of sildenafil citrate, or a placebo. The medications were administered in different sequences.

For a period of 4 weeks, every participant took the medication one hour prior to sexual intercourse. After 4 weeks, they had a one week break before beginning the next medication. Following the treatment, each participant completed a Personal Experience Questionnaire to evaluate their level of interest, enjoyment, and satisfaction in sex.

Both groups taking sildenafil (either 25 mg or 50 mg) reported an improved overall quality of sex life. They had higher levels of arousal, greater frequency of coitus and orgasm, and a higher level of enjoyment than the group taking the placebo. They also reported an increase in the frequency of arousal, higher levels of satisfaction with coitus, and more sexual fantasies than those taking the placebo.

A further study was conducted in 2002, where 12 premenopausal women in good health participated. None of the women reported problems with FSD. They received either 50 mg of sildenafil citrate or a placebo for one week, and then they received the alternate medication the following week. During the test period, the participants viewed 60 minutes of neutral video, then 30 minutes of erotic video, followed by 15 minutes of neutral video.

The results showed no difference in arousal or vaginal wetness in either group, but those taking the sildenafil had an increase in VPA compared with those taking the placebo. VPA was measured continuously using vaginal photoplethysmography and began 15 minutes before the drug was administered. Vaginal wetness and subjective sexual arousal were measured following each session using a scale of 0 to 4. Because this sample size was small and the women did not have FSD, the usefulness of this study is limited.

In 2003, another study was conducted on 68 premenopausal women with no history of FSD. The study was random, double blind, and placebo-controlled. A questionnaire was given before treatment, after treatments, and after a 2 week period where no medication was given. Each participant received either a 50 mg dose of sildenafil citrate or a placebo, with a two week wash out period between treatments.

The women reported a substantial improvement in arousal, orgasm, and overall enjoyment of sexual intercourse, although they had no increase in desire.

A similar study in 2003 was conducted on 34 postmenopausal women taking estrogen replacement therapy for a minimum period of six months, and had reported a loss, delay or decrease in intensity of orgasm. The women were given either 50 mg sildenafil citrate or a placebo one hour before vibratory stimulation and viewing erotic stimulation. The subjects tested the amount of time required from exposure to erotic materials to completion of orgasm, the intensity of orgasm on a scale of one to seven, and VPA was measured using vaginal photoplethysmography. A questionnaire was given prior to and after viewing the erotic video. The results showed no overall effect on orgasm latency, although women who were had low VPA response showed significant improvement after taking sildenafil.

In a test in 2004, nineteen premenopausal women with Multiple Sclerosis and FSD (experiencing arousal and orgasm difficulties) were given either a dose of 50 mg of sildenafil citrate or a placebo for 12 weeks, and then they were given the alternative drug for the following 12 week period. The women receiving the sildenafil reported an improvement in lubrication and sensation, but no change in orgasm, desire, or quality of life.

In 2006, a study was conducted on 32 premenopausal women suffering from Type 1 diabetes and FSD. The participants received either 100 mg of sildenafil citrate or a placebo for a period of 8 weeks, followed by a 1 week wash out period, and then a further 8 week period on the alternate medication. A questionnaire was administered at the start of each session and during the eight week treatment period. The results showed an improvement in arousal and orgasm, and increased clitoral blood flow.

In 2008, a study was done on the effectiveness of sildenafil in treating FSD problems in women taking antidepressants. Ninety-eight premenopausal women participated in the study, who reported FSD for a minimum of four weeks. They had no previous problems with FSD prior to taking the antidepressants.

They received either 50 mg of sildenafil citrate or a placebo for an 8 week trial period. The women were tested prior to treatment, after 2 weeks, 4 weeks, and at the end of the treatment period. All test scales showed a significant improvement in orgasm with the group who took sildenafil citrate over the group taking the placebo.

In all of these studies, the patients reported mild to moderate side effects. The most frequent negative effects were headaches, flushing, nausea, rhinitis, and visual problems.

Although these studies showed an improvement in clitoral blood flow, further study is required to show which patients will benefit most from sildenafil treatment. The results are inconclusive, as female sexual pleasure is derived from a complex set of biological and psychological factors.

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FSD is classified as a disorder associated with decrease in sexual desire, arousal, orgasm, and painful intercourse. It is the recurring inability to achieve or maintain enough lubrication and genital swelling to complete sexual activity. Many women who are taking antidepressants experience these sexual problems. Although once thought to be a psychological problem, doctors are now focusing on physical reasons for lack of desire for sexual intercourse and researching possible treatments.

Sildenafil citrate is a phosphodiesterase type-5 (PDE5) inhibitor, and has been successful in treating erectile disfunction in males, although few studies have been conducted in the treatment of female sexual disorders. However, PDE5 was found to be involved in the smooth muscle tissue of the vagina, clitoris, and labia, and it plays an important role in female genital arousal. The presence of PDE5 is much lower in female sexual organs than in the male penis.

Women that are taking sildenafil for FSD report increased vaginal vascular engorgement, improved clitoral responsiveness, and greater vaginal lubrication. The results of studies are inconclusive, but have shown that about 20 percent of women having difficulties with vaginal lubrication responded positively to sildenafil treatment, with increased blood flow to the vagina and clitoris causing greater female arousal.

In placebo-controlled studies, women suffering from Female Sexual Arousal Disorder (FSAD) experienced significant benefits from taking sildenafil. These women suffered from physical problems associated with sexual arousal such as lack of blood flow to the genitals and lack of natural lubrication. Those women suffering from Hypoactive Sexual Desire Disorder (HSDD) had minimal effects from taking sildenafil. These problems are characterized by a lack of desire for sexual activity, and are likely to be caused by underlying emotional and psychological problems.

Sildenafil Feminine is an oral medication that is effective 45 minutes after it is taken, and remains in effect for up to six hours. This drug increases vaginal blood flow and enhances the pleasure of sexual intercourse. It improves the sensitivity of the vaginal region and naturally increases lubrication.

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It is also used to treat pulmonary arterial hypertension (PAH), a disease that leads to dangerously high levels of blood pressure in the pulmonary artery, a main vessel that carries blood from the heart to the lungs. This disease mostly affects women between the ages of 20 and 40 years. Symptoms include dizziness, shortness of breath, fatigue, and fainting as a result of exertion and can cause heart failure.

As a treatment for pulmonary arterial hypertension (PAH), which is a rare and incurable vascular disease; sildenafil citrate is used to improve the ability to exercise. When this disease is treated early, sildenafil improves the quality of life in patients and delays the onset of further development of the disease. Later stages of PAH are characterized by the inability to perform routine tasks without experiencing extreme fatigue and chest pain.

Sildenafil acts to relax the pulmonary muscles and improve blood flow from the heart to the lungs. The most common side effects patients experience include nosebleeds, headaches, stomach upset, flushing, and sleep irregularity. It is an excellent treatment option for these patients, as it is less expensive and has fewer side effects than other available treatments.

When sildenafil is prescribed to treat PAH, the typical dose is a 20 mg oral pill that is taken three times a day. The drug should be taken six to eight hours apart each day and can be taken either with or without food.

As a treatment for ED, which is its most popular use, sildenafil works by increasing the flow of blood to the penis and results in harder, longer lasting erections. The blood is pressurized in two tube like structures called corpora cavernosa, which exist inside the penis. When the man is sexually aroused, the arteries going into the penis fill with enough blood to create an erection and the arteries that control the blood flowing out of the penis contract. The erection goes away after sex is finished. Sildenafil does not immediately cause an erection. You need to be sexually aroused for an erection to occur.

The usual dose prescribed by a physician is 50 mg, taken once daily as required, although the dose may be altered to 25 mg or 100 mg depending on side effects experienced and the effectiveness of the medication. The maximum dose allowed is 100 mg per day. Sildenafil is available in a tablet form that should be taken with a glass of water. The shelf life of sildenafil is 2 years from the date of manufacture.

Sildenafil is fast acting and should be taken about one hour prior to sexual activity. In studies, it was shown to be effective in as short a time as fourteen minutes, and its effects remain for up to four hours. If an erection lasts for more than 4 hours, or the patient experiences priapism (painful erections lasting more than 6 hours in duration), then a doctor should be consulted as a prolonged erection can cause irreversible damage to the erectile tissue in the penis.

Most men can safely take this drug once a day. Sildenafil has been effective in 80 percent of men suffering from erectile disfunction; although it may need to be taken for 3 or 4 times before it starts to work.
Sildenafil has no effect on the libido in men, and it is not used to treat the desire to perform sexual intercourse.

It can be taken with or without food, but fatty foods can slow the body’s absorption of sildenafil, slowing its effectiveness. Large quantities of alcohol consumption can also reduce the effectiveness of producing and maintaining an erection. Alcohol can also increase some of the side effects of sildenafil and should be avoided.

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