Erectile dysfunction among men, 40 years and over, has been a major concern for both sexes. Many have found some comfort by using pills to facilitate an erection while others have resorted to hormone replacement or erection devices to stimulate a flow of blood to the penis, but a leading urologist and authority on erectile dysfunction said that the use of Viagra can only be effective if it is accompanied by stimulation from the right partner.
"You need stimulation and the right partner. You cannot take a Viagra pill and in five minutes to be ready to go. You still need sexual stimulation because the pill merely reinforces an erection," said Dr Culley C Carson III, a Rhodes scholar and Chief of Urology at the University of North Carolina.
"The pill by itself will only facilitate an erection, but it will not produce an erection," said Carson.
Erectile Dysfunction: A marker of Men's Health in the 21st century" was the theme of a lecture held at the Muscovado Restaurant, Lowlands, Tobago, on March 6.
Carson said men suffering with erectile dysfunction (ED) are generally candidates for vascular diseases such as strokes, heart attacks and other ailments associated with insufficient flow of blood to the heart muscle.
Men with ED should have a thorough medical investigation because, as Carson indicated, "Whenever there is evidence of ED, it is the first sign of a vascular disease affecting the circulatory system."
"ED is not life- threatening," he continued, "but it is usually a message as the first step to a heart attack."
Carson said, "Although erectile dysfunction is not a disease; it is the earliest manifestation and the first sign of a vascular disease. The condition could be treated if it occurs early in the life of the patient, because the penis, like other organs of the body, is a carrier of blood."
When asked whether Viagra is the answer to men with ED, Carson recommended the use of Viagra in cases where the patient is healthy, but it would be dangerous to use the pill if a patient is suffering from diabetes, high blood pressure or any similar ailments connected with the flow of blood to the tissues. Viagra can help to relax the muscles in the coronary system," he said.
Viagra was developed as the answer to ED.
Carson said, "Contrary to popular belief, Viagra was not manufactured to improve erection of the penis. It was first designed for treatment of angina, but it did not work well with angina
patients. Instead patients using it found that they were getting better erections."
Angina, according to Carson is a tight strangling o,r pain which occurs on exertion, owing to insufficient supply of blood to the heart muscle. He defined erectile dysfunction as the inability for men to reach and maintain an erection sufficient to allow for a satisfactory sexual performance, adding that this has been the cause of several social problems that ultimately affected wives and families.
Carson classified ED as a condition and not a disease". "ED is associated with cardiovascular disease, high blood pressure, obesity, smoking and a manifestation of a vascular disease , but if it is treated in the early stages through change in lifestyle and exercise, chances are patients could recover from ED."
He said the condition associated with ED is depression, loss of self-esteem and self-reliance, and a deterioration of the quality of life of the patient. He said it is also associated with the patient's inability to have a good sexual relation and the possibility of having prostate problems.
Carson said research done by the World Health Organisation within the last five to ten years has found that ED is not confined to old age, but also patients below the age of 40. "Generally, what we found in the past was patients with ED in the 40- year range and upwards, but now we are having patients below age 40." He said ED starts with anything that would interfere with the flow of blood such as smoking, diabetes, lack of exercise, high blood pressure and obesity.
Carson said there are three stages that men can follow if they are suffering from ED. Patients can use Viagra if they are healthy. But if a patient has a chronic heart complaint Viagra could be harmful. The second stage could be the use of hormones, the third will be injection to the penis to facilitate the flow of blood and the fourth the use of an artificial penis.
"In some cases the use of erection devices that bring a flow of blood into the penis does not bring immediate results.
The lecture at which Carson made the disclosures was organised by the Society of Surgeons and sponsored by Pfizer Pharmaceuticals.