It’s Valentine's Day, Yeah Baby! Smashing News for Missing Mojos

by Darline Turner Lee, Physician Assistant, ACSM Exercise Specialist

Article Last Reviewed: Sept. 9, 2006

Valentine’s Day is coming and along with it the commercialized versions of love and intimacy. There are “Little Hershey’s Kisses with big chocolate taste”. “Say it with flowers”. “Tell her you love her with diamonds.” Make restaurant reservations weeks in advance to ensure the right spot and the right mood. Stop by Victoria’s Secret or Forbidden Fruit for that special something after the lights go down low.

When all is said and done, dinner is over, the flowers are set aside and even the chocolate has lost its charm what’s left?? Sex!!! Yep, you got it (or are hoping to in the foreseeable future!). Valentine’s Day is the day of the year when we are encouraged to express our love in the form of sexual intimacy. We couch it in cute little hearts and romantic settings but the underlying message is, “Snuggle up with the one you love (or like a whole lot) and get your groove on!”

What if your groove is gone? In the words of Austin Powers, “What if you’ve lost your mojo?” For women the solutions are still sketchy and complex. But men now have three little pills from which to choose, Viagra, Levitra and Cialis. As competition steams up this already hot market here is a brief summary of the drugs so that men, along with their physicians, can make the best choices for their situation.

Erectile dysfunction (ED), the medical term for “lost mojo”, is the inconsistent ability to achieve or maintain an erection that is sufficient to complete intercourse to the satisfaction of both partners. It affects fifteen to thirty million men and its occurrence increases with age. It is estimated that by the age of forty, most men will have experienced at least one episode of Erectile Dsyfunction. Five percent of men will be affected in their forties while up to fifty percent of men will experience transient Erectile Dsyfunction between the ages of forty and seventy.

Erectile Dsyfunction is sometimes referred to as impotence and the two terms are often used interchangeably. However the two conditions differ because impotence is complete, chronic erectile dysfunction i.e. no erections, at all, under any circumstances. Men with Erectile Dsyfunction do experience sporadic or brief erections.

In 1985, the National Ambulatory Medical Care Survey found that seven out of every thousand men had made inquiries about treatment for erectile dysfunction. At that time, the options for treating Erectile Dsyfunction were penile implants, vacuum devices, penile injections, urethral suppositories and surgery. Most men found these treatments unacceptable. But in 1998 the US Food and Drug Administration (FDA) approved the use of Viagra, the first oral medication for treatment of Erectile Dsyfunction. Levitra received FDA approval for the treatment of Erectile Dsyfunction in the summer of 2003 and Cialis was approved in November. For many men, this has revolutionized the treatment of Erectile Dsyfunction, increased awareness about its prevalence and decreased the stigma associated with Erectile Dsyfunction. These men no longer have to contemplate a bulky contraption or painful treatments to have intercourse. If their condition is amenable, they can ask for and take a pill. By 1999, talk amongst men and their physicians skyrocketed to twenty-two men per thousand inquiring about Erectile Dsyfunction and its treatments in 1999 and the numbers continue to increase.

All three drugs relax the blood vessels of the penis allowing increased blood flow in while constricting the veins that take blood away from the penis. The increased blood flow causes enlargement and subsequent erection. All have been successful in men with diabetes, spinal cord injury and following prostate removal. However, none of them creates or increases sexual desire. An individual must have innate sexual desire for the drugs to be effective. Since it must be taken thirty to sixty minutes prior to intercourse, Viagra removes the spontaneity from sexual encounters and works for up to four hours. Tablets can only be taken once daily and don’t protect against sexually transmitted diseases. Levitra and Cialis however, are absorbed in fifteen to thirty minutes. Cialis lasts up to thirty-six hours earning it the nickname “the weekend sex pill”.

Results vary. One drug may work well for one individual but have no effect on another. Underlying conditions such as high blood pressure, high cholesterol and stress should be addressed prior to treatment. In some cases, management of these conditions restores potency and avoids the unnecessary use and cost of the pills.

Medications containing nitrites, such as those in nitroglycerin and other medications used for the treatment of chest pain, can cause heart attack, stroke or death if used at the same time as these drugs. Men are cautioned against using the pills if also taking alpha-blocking medications for enlarged prostates. Men should not take any of the drugs if they have allergies to their active ingredients or medical conditions prohibiting sexual activity. Side effects may include headache, nasal congestion nausea, facial flushing, blurred vision and backache. The effects are usually transient and spontaneously resolve. In rare instances, a man may experience a prolonged, painful erection called priapism. This is a serious medical condition requiring immediate treatment to avoid permanent damage and loss of erectile ability.

Valentine’s Day, yeah baby! If you can get your mojo back with one little pill- Smashing!