reasons why viagra may not work

reasons why viagra may not work




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Urological Services, P.C.
Michael J. Macksood, D.O. F.A.C.S.

WHAT DO I DO WHEN VIAGRA DOES NOT WORK?

By Michael Macksood, DO, FACS

The oral medications that are available today for impotence, including Viagra, Cialis and LEVITRA, have a very high patient satisfaction rate. These medications work in approximately 50% to 80% of men, depending on the etiology of their impotence. They are very safe medications in the vast majority of patients, as long as the patient has good cardiovascular status and is not taking any medications that contain nitroglycerin.

However, the question often comes up; What we do with those patients that do not respond to these oral medications? It is important that men are informed that impotence is always a treatable condition.

If oral medications do not work, the next step for most men would be a trial of intraurethral prostaglandin. This is a suppository that is about a third the size of a grain of rice. It is inserted by the patient into the urethral meatus, approximately 30 minutes before intercourse is anticipated. It is easy for most men to learn how to use the medication and it works well with a good result in 30% to 60% of patients who fail oral medications. The medication is safe and it does not have systemic effects. The main side effects would be the possibility of priapism or, more frequently, urethral discomfort after insertion of the medication.

If prostaglandin intraurethrally is not effective, various vacuum suction devices are available. The vacuum suction devices work by inserting the penis into a plastic tube and then there is some sort of a pump mechanism to create a negative pressure within the tube, which will help draw blood into the penis. A constricting band is then placed at the base of the penis to help hold the erection. This works in a small percentage of patients who have the manual dexterity to operate the device and do not find the necessary equipment too cumbersome.

Penile prosthesis surgery is still a very effective treatment for the impotent man who does not respond to conservative measures and still desires treatment for his impotence. The penile prosthesis has been around for many years. It has a success rate of well over 95% and it has a low complication rate. It is now performed almost exclusively as an outpatient surgery with a very low complication rate. The two major devices available are a malleable device and an inflatable device.

It is important that men with erectile dysfunction be informed that when oral medication does not work to treat their problem, they still have other options available to them. For more information please call the number below for an appointment.

Urological Services, P.C.
1121 West Hill Road
Flint, MI 48507
Tel: 810.232.8888
Fax: 810.232.9190
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Viagra Failure

Viagra. Cialis. Levitra. These are a miracle in a bottle, right? Well, not for a huge percentage - around a third - of middle-aged and beyond men. These drugs fail and fail miserably for them - they simply do not work. (And sometimes failure occurs with these PDE5 Inhibitors due to nasty side effects including headaches and hearing, vision and stomach disturbances.)

I have already documented many reasons for their lack of effectiveness in my link on Why Viagra Doesn't Work. However, I want to cover another important reason for Viagra failure here: lack of baseline nitric oxide production in men that are 40+.

This point was emphasized in a Recent Interview with Nathan Bryan. one of the world's foremost experts on nitric oxide. In this interview, Dr. Bryan explained how PDE5 Inhibitors work, which is by inhibiting the activity of an enzyme that breaks down nitric oxide. In other words, and as I have explained often on this site, Viagra and other similar drugs do not actually directly increase NO, they merely allow it to stay in your system longer. This is only effective if you have sufficient baseline nitric oxide production in the first place. As Dr. Bryan put it, "Without production of NO, this pathway does not and cannot work. In fact, this is why Viagra and Cialis do not work in 100% of the population."

Need to boost your Nitric Oxide naturally through food, drink and supplements? Check out Lee Myer's book here: The Peak Erectile Strength Diet

Or do you need the most comprehensive testosterone book in Amazon? Here it is: Natural Versus Testosterone Therapy

And Dr. Bryan himself has pointed out that most 40-year-old men will only produce half of the nitric oxide that they did when they were 20. [1] This is a drastic reduction! It's a wonder us old timers can even have an erection, eh?

Now imagine what happens when a man has "endothelial dysfunction." His arteries and veins have been damaged, inflamed and coated with extra plaque after years of lifestyle abuse. His nitric oxide is will be in even worse shape. The reduction in blood flow will affect almost every system in his body, including those affect his sex life. And for him taking Viagra, Cialis or Levitra is doomed to failure.

So is there any hope? Are there any natural ways to boost nitric oxide for a man with nitric oxide insufficiency?

Yes! I hope that you've already found many of these ways as you've searched around my site, but let me summarize some of the key ways that you can get your nitric oxide levels back in shape:

1. Diet. One of the ways you can increase baseline nitric oxide production is through consumption of nitrates. I discuss many of these in my book on book Peak Erectile Strength Diet. but spinach and beetroot juice are classic examples. Nitrates are converted to nitrites by bacteria on your tongue and to NO in your stomach and gut. In addition, many of these foods will also enhance and protect your nitric oxide, thus effectively raising nitric oxide levels farther downstream.

CAUTION: Avoid amines when consuming nitrates in the diet. Certain cheeses and meats may combine with nitrates and create carcinogenic compounds called nitrosamines. In addition, avoid consuming supplemental Vitamin C with any fat in the stomach for a similar reason.

2. Neo40. This new supplement works via not allowing supplying baseline nitrates, but also by adding an enzyme that helps the body convert the nitrates more easily to nitric oxide. [1]

NOTE: You can boost the power of all of these through exercise. Exercise is a potent booster of nitric oxide and researchers believe it works primarily by increasing the bioavailability of the same enzyme that Viagra works on. So then does it really increase baseline nitric oxide production? Well, exercise gets you to the same point through a different route: it increases the number of new capillaries and veins throughout the body, a fact I cover in my link on Exercise and Erectile Dysfunction. This has a similar net effect as #1 and #2 above - more blood flow to more tissues. See my link on Sexercise for a dozen other reasons to exercise as well.

Erectile Dysfunction Health Center

WebMD archives content after 2 years to ensure our readers can easily find the most timely content.

To find the most current information, please enter your topic of interest into our search box.

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April 10, 2000 (Mill Valley, Calif.) -- In his early 40s, Ron Hanson was too young to be having trouble getting and sustaining erections. But like many men, he was too embarrassed at first to talk about the problem. Hanson (not his real name) waited seven years to see a urologist. By the time he spoke up, erectile dysfunction had become a household word, thanks to the popularity of the drug Viagra. But the widely touted drug, Hanson soon learned, doesn't work for everyone.

When Viagra (sildenafil) hit the market in 1998, some men thought it was the long-awaited answer to their problems. Many rushed to doctor's offices to give it a try. According to the Grey Clinic in Indianapolis, which specializes in erectile dysfunction. 17% of men between 18 and 55 experience occasional impotence, while 6% have regular erectile difficulties. For men over 55, that number jumps to about one in three. Some common causes of impotence are diabetes. heart disease. and psychological problems. It also frequently occurs after prostate cancer surgery.

Because Viagra works in a way that's similar to drugs that contain nitrates, however, it isn't recommended for men who take nitrates for heart disease or those with certain other heart conditions. In some men, it causes bad headaches. In others, it just plain doesn't work. In some instances, men may notice they have trouble telling blue and green colors apart when they start taking the drug.

During an erection, blood flows quickly into the penis. which increases its length, width, and firmness. If the "in" vessels (arteries ) are too narrow or if blood drains too quickly through the "out" vessels (veins), men may have trouble achieving or maintaining an erection, says Arnold Aigen, MD, a urologist with Camino Medical Group in Sunnyvale, Calif. Viagra, which increases inflow, may not be strong enough to work its magic if the arteries are too narrow.

Hanson tried Viagra, but he couldn't tolerate the headaches it caused. Luckily, when Viagra fails, he discovered, there are several alternatives.

Alprostadil to the Rescue

A drug called Alprostadil. either alone or sometimes in conjunction with others such as papaverine and/or phentolamine, can be injected directly into the penis to dilate the arteries, experts say. The drug produces an erection in about 10 minutes that can last up to an hour. But there are several disadvantages, says Teresa Beam, MD, a urologist with the Grey Clinic. Some patients are averse to using a needle, which is why many men abandon the therapy. Those who give it a try may experience pain at the injection site or priapism (a painful erection lasting too long).

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