By Dr. Mercola
More than 35 million men around the world have been prescribed Viagra (sildenafil citrate),1 Pfizer's blockbuster drug used to treat erectile dysfunction (ED). With sales of more than $2 billion in 2012,2 it seemed this drug, with its promises of instant virility and sexual prowess, was unstoppable.
Viagra holds 49 percent of the market for sexual dysfunction treatments, which, at an average cost of $22 a pill,3 is a major income stream for Pfizer – but there are signs of trouble.
For starters, sales of ED drugs have seen slow growth (just 1 percent annually) and even declines in sales of up to 7 percent in recent years. It's also been widely observed that up to half of men who receive a first prescription for Viagra do not get it refilled.4
One theory for why not? Many men may realize that Viagra is not the miracle pill they thought it would be. It may trigger an erection, allowing for intercourse, but it will not fix relationships or build emotional connections…
The other prevailing theory? Men may get fed up with the side effects, which are high in numbers and often severe… and more potential complications are being uncovered by the day.
Viagra Use May Double Your Risk of Melanoma
Men who have ever used Viagra have nearly twice the risk of melanoma, the deadliest form of skin cancer, than men who have never used the drug, according to new research published in JAMA Internal Medicine.5 Those who had used the drug recently had an 84 percent greater melanoma risk.
While the study can't prove that Viagra causes melanoma, it did rule out a potential erectile dysfunction connection – no link was found between ED and melanoma risk. Furthermore, the researchers explained a potential reason mechanism by which Viagra might increase cancer risk.
In short, activation of the BRAF gene has been shown to downregulate the enzyme phosphodiesterase PDE5A. Low PDE5A expression is known to increase the invasiveness of melanoma cells. Another molecule NRAS has also been shown to downregulate PDE58 in melanoma cells. What does this have to do with Viagra?
Viagra belongs to a class of drugs known as PDE5A inhibitors (along with Levitra and Cialis). Viagra works by inhibiting phosphodiesterase and increasing nitric oxide production, which may help maintain erections, but this may also explain how it could increase cancer risk. The authors noted:6
"This indicates that PDE5A suppression by sildenafil [Viagra] use mimics an effect of BRAF/NRAS activation and thus may potentially function as one of the 'hits' for melanomagenesis… Two PDE5 inhibitors have been shown to promote melanin synthesis, which may stimulate melanoma development…"
What Are You Really Risking When You Take Viagra?
The potential melanoma connection is only the latest in a long list of serious Viagra side effects, which include:7
- An erection that will not go away (priapism). If not treated right away, priapism can permanently damage your penis.
- Sudden vision loss in one or both eyes, which can be a sign of a serious eye problem called non-arteritic anterior ischemic optic neuropathy (NAION).
- Sudden hearing decrease or hearing loss, ringing in your ears (tinnitus), or dizziness.
If you take other medications, be aware that Viagra interacts with many and may cause even more side effects. This includes medications such as nitrates, alpha-blockers, HIV protease inhibitors, certain antibiotics and oral anti-fungal medicines, high blood pressure drugs, and more. Other commonly reported side effects include:
Headache Flushing Upset stomach Abnormal vision, such as changes in color vision (having a blue color tinge) and blurred vision Stuffy or runny nose Back pain Muscle pain Nausea Dizziness
Beware of Buying Viagra Online
Viagra is widely available online, often for a fraction of the list price, but be aware that most of it is probably fake. Just about the only thing worse than taking actual Viagra may be taking a counterfeit version, and research shows that up to 77 percent of Viagra bought online may be just that.
Viagra is actually one of the most commonly counterfeited drugs. It's done so often that some experts estimate Pfizer could be losing hundreds of millions of dollars a year due to this online black market (which explains why the drug company also began selling Viagra online via its own Web site last year).8 Fake Viagra may obviously contain too small of a dose to be effective or, worse, may be super potent and trigger a heart attack. Other ingredients found in fake Viagra include:9
- Blue printer ink
- Speed or amphetamine
- The antibiotic Flagyl (Metronidazole)
- Drywall and plaster
The Natural Viagra Alternative
If you're seriously considering Viagra, be aware that as far as natural alternatives go, there are many options to consider including L-arginine, an amino acid that is the precursor to nitric oxide, a natural compound that helps relax your blood vessels. Nitric oxide signals the smooth muscle cells in your blood vessels to relax, so that your vessels dilate and your blood flows more freely.
This helps your arteries to regain their elasticity and stay free of plaque. L-arginine may also lead to increased microcirculation in genital tissues, which results in stronger erections and better sexual responsiveness, via this nitric oxide mechanism.
Scientific studies have shown that L-arginine can be particularly effective when used in combination with another natural agent, pycnogenol, which resulted in significant improvement in sexual function in men with ED, according to a Bulgarian study.10
Similarly, a pilot study published in the journal European Urology found six grams of L-arginine combined with six mg of yohimbine, a compound found in the herb yohimbe, was successful in treating men with ED.11 Still, even natural options like these are only temporary cover-ups to what could be an underlying issue.
It's Important to Get to the Bottom of Erectile Dysfunction
If you're struggling with erectile dysfunction, really, the last thing you should do is attempt to cover it up with a drug. Even slight problems maintaining an erection can be a sign of serious health problems elsewhere in your body, namely in your heart. You may be aware that the inability of the inner lining of your arteries (endothelium) to dilate fully leads to damage and to subsequent hardening, also known as atherosclerosis, and is a major cause of heart disease and can lead to stroke, heart attack, and sudden death.
As the disease process unfolds the smaller arteries in your body, such as those in your penis, often get blocked first or receive less of the available blood flow, before the larger arteries leading to your heart. The lack of blood flow to your penis results in erectile dysfunction, and this is why ED has been called the "canary in the trousers" for future heart problems.
Men with ED have an increased risk of many heart-related problems, including heart failure, stroke, and heart disease.12 So if you have any type of erection difficulty, it's a good idea to see a qualified health care practitioner who can give your heart health a thorough check-up and help you develop a plan to fix the underlying causes of both issues.
Even Viagra Won't Always Work if You're Not Sexually Stimulated
…And as you're probably aware, this typically involves an emotional component. If you're stressed out, angry, or at emotional odds with your partner, an erection is unlikely with or without drugs, as for men every erection begins in the brain. Your brain stem emits nerve impulses that control erectile function. These nerve impulses navigate through the erection center of your spinal column to the erectile tissue of your penis, where they trigger a chain reaction in the membranes of your vascular muscle cells. This sophisticated chain reaction is dependent on a messenger molecule called cyclic guanosine monophosphate, or cGMP.
Even the Viagra website states "VIAGRA works only when you are sexually stimulated,"13 so the pills may not create an erection in and of themselves. Initial erection may still have to be triggered psychologically. Because sexual dysfunction can worsen due to stress, relationship troubles, and anxiety, taking control of your emotions by learning the Emotional Freedom Technique (EFT) can really help. EFT is a psychological acupressure technique that can help you effectively address your stress-related thoughts and leave you feeling calmer and more able to face your challenges, whatever they may be.
Is Your ED Actually Low Libido?
For some men, what they believe to be a physical problem achieving an erection may actually be the result of a low libido. To increase your libido, a more comprehensive program is recommended. For starters, you'll want to ensure that your hormone levels (including testosterone and human growth hormone (HGH)) are balanced and optimized. I've discussed many strategies for optimizing these hormones before, including high-intensity exercise. When it comes to an exercise plan that will complement testosterone function and production (along with overall health), I recommend including both high-intensity interval training and strength training.
Another effective strategy for enhancing both testosterone and HGH release is daily intermittent fasting. Intermittent fasting helps boost testosterone by improving the expression of satiety hormones, like insulin, leptin, adiponectin, glucagon-like peptide-1 (GLP-1), cholecystokinin (CKK), and melanocortins, which are linked to healthy testosterone function, increased libido, and the prevention of age-induced testosterone decline. Vitamin D also increases levels of testosterone, which may boost libido. In one study, overweight men who were given vitamin D supplements had a significant increase in testosterone levels after one year.14
A Healthy Sex Life Is the Result of a Healthy Lifestyle
It's difficult to separate your sexual health from your overall health, as the two are intricately connected. Not only does a healthy lifestyle lead to a healthy sex life, but the opposite also holds true in that physical intimacy benefits your health in numerous ways. If you're in a committed relationship and find your sex life leaves much to be desired – and stress and relationship troubles aren't the problem -- it could be that your lifestyle is getting in the way. To boost your libido naturally and help restore harmony to your intimate life, use the strategies that follow:
- Reduce, with the plan of eliminating, grains and sugars in your diet. It is vitally important to eliminate sugars, especially fructose. High levels of sugar in your bloodstream can actually turn off the gene that controls your sex hormones.
- Eat a healthy diet, like the one described in my nutrition plan, which will help to normalize your insulin levels. This simple measure has a profound influence on every area of your health, including your sex life.
- Optimize your vitamin D levels, ideally through appropriate sun exposure, as this will allow your body to also create vitamin D sulfate — a factor that may play a crucial role in preventing the formation of arterial plaque that is linked to erectile dysfunction.
- Exercise regularly. Make sure you incorporate high-intensity interval training exercises, which also optimize your human growth hormone (HGH) production.
- Avoid smoking or drinking alcohol excessively.
- Be sure to get plenty of high-quality, restorative sleep.
- Consider choline and vitamin B5 supplements.The neurotransmitter that triggers the sexual message, in both men and women, is acetylcholine (ACH). With too little ACH, sexual activity goes down. One way to safely and effectively enhance ACH levels in your body is to take choline supplements (1,000-3,000 mg) and vitamin B5 (500-1,500 mg).