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Herbal Levitra

2012-01-27T10:44:00.000-08:00

Many people with erectile dysfunction (ED) are interested in "herbal Levitra" as an alternative treatment for their condition. However, at this point, no supplements or herbs have been shown to be effective at treating erectile dysfunction. If you have erectile dysfunction, see your healthcare provider for a diagnosis. He or she can recommend treatment that is right for your particular situation.

An Overview of Herbal Levitra

Because of the high cost of Levitra^®(vardenafil HCL) and the fact that the drug is "not natural," there are many people looking for alternatives to Levitra. One alternative is "herbal Levitra." If you search the Internet for "herbal Levitra," you are bound to find many people selling products that claim to have similar effects to Levitra. However, at this point, no supplements or herbs have been shown to be effective at treating erectile dysfunction (ED). If you suffer from erectile dysfunction, visit your doctor so that the problem can be diagnosed. Your doctor can recommend treatment that is right for your particular situation.

Other Things to Consider Before Using an Herbal Levitra

Before taking an herbal medicine (including herbal Levitra), it is important to be informed about that particular herb -- the same way that you would want to be informed about a licensed prescription medicine you were taking. This is especially true for people with erectile dysfunction because, in many cases, they are taking other medicines that could interact in a negative way with an herbal supplement. Here are some things to keep in mind regarding any herbal medicine:

The fact that an herbal supplement is labeled "natural" does not mean it is safe or without any harmful effects. For example, the herbs kava and comfrey have been linked to serious liver damage.
Herbal supplements can act in the same way as drugs. Therefore, they can cause medical problems if not used correctly or if taken in large amounts. In some cases, people have experienced negative effects even though they followed the instructions on a supplement's label.
If you use herbal supplements, it is best to do so under the guidance of a medical professional who has been properly trained in herbal medicine. This is especially important for herbs that are part of an alternative medical system, such as the traditional medicines of China, Japan, or India.
In the United States, herbal and other dietary supplements are regulated by the U.S. Food and Drug Administration (FDA) as foods. This means that they do not have to meet the same standards as drugs and over-the-counter medications for proof of safety, effectiveness, and what the FDA calls Good Manufacturing Practices.
The active ingredient(s) in many herbs and herbal supplements are not known. There may be dozens, even hundreds, of such compounds in an herbal supplement. In fact, some herbal supplements have been found to be contaminated with metals, unlabeled prescription drugs, microorganisms, or other substances.

Many herbs have a long history of use and claimed health benefits. However, some herbs have caused health problems for users. If you are considering taking an herbal Levitra, talk with your healthcare provider. Together you can come up with a treatment plan that works for your particular situation.

Generic Levitra

2012-01-27T07:26:00.000-08:00

There is currently no generic version of Levitra available. Levitra is protected by a patent that prevents any generic versions from being manufactured. However, it is expected that once Levitra goes off patent, several companies will start manufacturing a generic form of the drug. The first patent for Levitra currently expires in 2018.

An Overview of Generic Levitra

Levitra® (vardenafil HCL) is a prescription medicine that is licensed for treating erectile dysfunction (ED). Levitra is manufactured by Bayer Pharmaceuticals and is currently protected by a patent that prevents any generic Levitra from being manufactured. Yet, if you search the Internet for "generic Levitra," you may find a number of companies selling it. The fact is that these medicines are fake, substandard, and potentially dangerous. There may be generic Levitra available from another country, but there is really no way of knowing if you are getting genuine Levitra or not. You should not buy any generic Levitra until there is an approved generic available.

When Will There Be a Generic Version?

The first patent for Levitra currently expires in 2018. This is the earliest possible date that a generic version of Levitra could become available. However, there are other circumstances that could come up to extend the exclusivity period of Levitra beyond 2018. These circumstances could include such things as other patents for specific Levitra uses or lawsuits. Once Levitra goes off patent, there may be several companies that manufacture a generic Levitra drug.

Is Vardenafil HCL a Generic Levitra?

No. Vardenafil HCL is the active ingredient in Levitra, not a generic version of the drug. Although people often refer to a drug's active ingredient as its "generic name," the generic name of a drug is different than a generic version of it. In order for there to be a generic version of a medicine, the original medicine must have gone off patent, and another company (besides the original manufacturer) must have made the product.

HOW DOES LEVITRA WORK?

2012-01-27T07:18:00.000-08:00

Like Viagra and Cialis, Levitra is a phosphodiesterase-5 inhibitor (PDE-5). All of these drugs function in essentially the same way. In smooth muscle cells, cGMP (cyclic guanosine monophosphate) mediates smooth muscle relaxation. The more cGMP, the more the muscles can relax, the more blood can flow in, and the better the erection. PDE-5 breaks down cGMP, so PDE-5 inhibitors like Levitra keep this from happening, helping to maintain high levels of cGMP.

Levitra's strong point is that it is very selective in attacking PDE-5 without affecting other isoenzymes. This allows a smaller dose of Levitra to have the same effect as a larger dose of Viagra (an average Levitra dose is 10mg while an average Viagra dose is 50mg), even though the two drugs essentially function the same way.

Does Levitra Work Without Stimulation?

Many men wonder if Levitra works without any stimulation. The answer is no. This is because the chemicals that cause an erection are released only when a person is aroused. Levitra has no effect on these chemicals being released. It only keeps the chemicals in the penis longer.

How Long Does It Take for Levitra to Start Working?

Many men wonder, "How long do I have to wait for Levitra to work?" The amount of time it takes will vary depending on the individual. In clinical studies, Levitra began to work in most men in under an hour. It is generally recommended that you take Levitra an hour before sexual activity.

What will the future bring for erectile dysfunction?

2012-01-17T08:05:00.000-08:00

Combination therapy for the treatment of erectile dysfunction has been under investigation. Most of these studies have been small trials, and long-term data regarding their effectiveness and safety are lacking. However, with thorough evaluation and counseling, there may be a use for combination therapy for certain individuals with ED.

Yohimbine is an older medication used for erectile dysfunction, but the data to support its effectiveness remain mixed. In practice, clinicians sometimes choose yohimbine in the setting of psychogenic erectile dysfunction.

Melanocortin receptor agonists are a new set of medications being developed in the field of erectile dysfunction. Their action is on the nervous system rather than the vascular system. PT-141 is a nasal preparation which appears to be effective alone or in combination with PDE5 inhibitors. The main side effects include flushing and nausea. These drugs are currently not approved for commercial use.

Several other medications are being studied for treating erectile dysfunction; these include IC351 (another PDE5 inhibitor), sublingual apomorphine, and the combination of yohimbine and L-arginine. Scientists also are researching gene therapy to treat erectile dysfunction.

Erectile Dysfunction At A Glance

Erectile dysfunction (ED), also known as impotence, is the inability to achieve or sustain an erection for satisfactory sexual activity.

Erectile dysfunction is common; experts have estimated that erectile dysfunction affects 30 million men in the Untied States.

The causes of erectile dysfunction include aging, high blood pressure, diabetes mellitus, cigarette smoking, atherosclerosis, depression, nerve or spinal cord damage, medication side effects, alcoholism or other substance abuse, and low testosterone levels.

Erectile dysfunction is treatable in all age groups.

Treatments include psychotherapy, adopting a healthy lifestyle, oral PDE5 inhibitors (Viagra, Levitra, and Cialis), intraurethral medications, intracavernosal injections, vacuum devices, surgery, and working with doctors to avoid medications that can impair erectile function.

New research is ongoing in the field of erectile dysfunction to find more improved and effective therapies.

Erectile Dysfunction Raises Red Flag for Heart Disease

2012-01-17T07:57:00.000-08:00

Apress releaseby the American College of Cardiology (ACC) reveals that erectile dysfunction may mean more than a troubled romance. According to two new studies of men with type-2 diabetes, erectile dysfunction is a very strong indicator of heart disease. Published in theJournal of the American College of Cardiology (JACC)in May, the research makes clear the need for men with erectile dysfunction to not only get treatment to surmount their sexual difficulties but also for the related cardiovascular issues.

This is a matter to be taken seriously. "The development of erectile dysfunction should alert both patients and healthcare providers to the future risk of coronary heart disease," advised Peter Chun-Yip Tong, Ph.D., an associate professor in the Department of Medicine & Therapeutics at The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong. "Other risk factors such as poor blood glucose control, high blood pressure, high cholesterol levels, smoking and obesity should be reviewed and addressed aggressively," he added.

Men usually experience erectile dysfunction more than three years before coronary heart disease rears it head. Diabetes, erectile dysfunction, and heart disease are all related to damage of the blood vessels caused by high blood sugar levels. Men should be aware that if the blood flow required for maintaining an erection isn't happening, this could mean even more severe consequences for the heart.

In one Hong Kong-based study involving 2,306 men with type-2 diabetes, slightly more than one fourth of the subjects had erectile dysfunction at the start of the study, and none of the participants had any signs or history of heart disease, stroke or vascular disease. After four years, 123 of these men either experienced a heart attack, died from heart disease, developed chest pain caused by clogged arteries, or needed bypass surgery or a catheter procedure to restore blood flow to the heart. Men who had erectile dysfunction at the beginning of the study were much more likely to experience one of these coronary heart disease (CHD) events. A statistical analysis revealed that out of every 1,000 diabetic men with erectile dysfunction, 19.7 could be expected to experience a CHD event each year, as compared to only 9.5 of 1,000 diabetic men without erectile dysfunction. After a complete analysis of many other factors, the study concluded that erectile dysfunction is an early warning sign for heart disease and that it indicated a 58% increase in the risk for CHD.

In a second study based in Italy, researchers from four medical centers recruited 291 men who had both type-2 diabetes and silent CHD discovered by stress testing and confirmed by x-ray angiography. Of these subjects, 118 had erectile dysfunction at the beginning of the study. The study subjects were followed for four years with all instances of major adverse coronary events (MACE) documented. Results of the study indicated that those who had erectile dysfunction at the beginning of the study were twice as likely to experience a major adverse coronary event. This particular study also happened to conclude that taking a cholesterol-lowering statin drug reduced the risk for an adverse major coronary event by one third.

While many doctors may use this to try to push statins and other drugs on patients, there are many natural approaches that include dietary changes, quitting smoking, and exercise that can be tried to lower cholesterol and blood pressure and improve heart health without the awful side effects of medications. Unfortunately, guys who smoke cigarettes generally aren't "smokin' hot" in the boudoir due to the fact that smoking increases the risk of coronary heart disease and the build-up of those fatty substances in the arteries that can lead to erectile dysfunction, according to anarticleby the American Heart Association. Concerning drugs that treat erectile dysfunction, pharmacist Suzy Cohen cautions in her nationally-syndicatedcolumnthat sometimes the reason for erectile dysfunction is that men have too much estrogen in their cells which can't be solved by male enhancement pills. She jokingly compares using these pills in this situation to a guy jump-starting his car every two miles when he really needs a new battery!

Of course, there are certain side effects of traditional medications that guys should discuss with their doctors. For example, in her bookThe 24-Hour Pharmacist, an excellent read, Suzy Cohen notes that a decreased sex drive is a common side effect of many medications which include statin cholesterol drugs and almost all blood pressure medications. If the wifey is unhappy about the erectile dysfunction, she's just going to be thrilled about the lack of libido.

The good news is that there is no reason that a man in good physical condition can't enjoy sex at least into his nineties and experience passion hotter than a Pablo Nerudapoem. In anarticlecalled "An Affair to Remember" featured atSlate.comby Melinda Henneberger, it is reported that an 82-year-old woman was caught orally pleasuring her 95-year-old boyfriend at an assisted living facility. Since both people suffered from a bit of dementia, the son of the older gentleman decided to remove his father from the facility to break up the torrid love affair. Afterward, the grieving woman lost twenty one pounds, was treated for depression and was then hospitalized for dehydration. Ain't love grand?

Learn more:http://www.naturalnews.com/024116_erectile_dysfunction_disease_heart.html#ixzz1jjQ366Dm

THE TOP BLUE PILL FOR LIBIDO AND LONG SEX

2011-12-03T10:25:00.001-08:00

First of all most aphrodisiacs don’t work and I include Spanish fly as one of them. Some plants and vegetables are only thought of as aphrodisiacs because their shapes resemble genitalia. I must say with the odd exception that is pure coincidence, that is usually absolute nonsense!

For an aphrodisiac to work effectively it has to reach the groin and many people suffering with a low libido have bad circulation in that area. So the first task is to improve the circulation, particularly to the groin, it is only then that the active ingredients of an effective aphrodisiac can increase the sensory activity of the nerves in that area.

It’s important to bear in mind that no-one can take any type of Viagra, sit back and expect to feel like sex in an hour. Viagra and some herbal Viagra don’t have an aphrodisiac effect. Some do increase circulation to the groin in varying degrees, which at best can give bigger erections in varying degrees, which is an important first step, hopefully without the side effects of Viagra and some herbal Viagra.

Let’s assume you have taken a high quality aphrodisiac that also has improved circulation to the groin, the chances are, an hour later you still don’t particularly feel like sex because you still have to go through the usual foreplay to be aroused. OK, you have taken a quality aphrodisiac, the circulation to your groin has increased, you have started foreplay and you have a big erection, but are you able to sustain it?

This brings us to the most important part of the process..............relaxation. Tension can un-do all the good work that has been achieved by the Viagra/aphrodisiac combination, particularly if you suffer from premature ejaculation or erectile dysfunction.

One of the simplest and effective ways of overcoming nerves is to concentrate on your own breathing during sex. Obviously your breathing is going to increase in tempo, but try to keep it as even and deep as possible and make sure you breathe out completely and imagine that you are breathing out all your problems. It works!

Can You Smoke With Viagra?

2011-12-02T08:53:00.001-08:00

Erectile dysfunction, also commonly known as ED, is described as the inability to achieve or maintain an erection during the act of sexual intercourse. In the United States, ED affects one in five men, and more and more research is being published today identifying key causes in ED. Traditionally, ED was thought to be an issue of the metabolic system, and was linked to the cardiovascular system. As more research comes to light however, studies are showing consistently that lifestyle factors such as smoking and substance abuse are the leading causes in more than 25% of cases involving erectile dysfunction.

When it comes to the main problem of ED, getting or maintaining an erection, a healthy blood flow is crucial. In order for the penis to even become erect, blood flow through its major arteries is necessary. Any process or experience that interferes with blood flow in your body then, will also interfere with blood flow to the penis, and you may experience some issues with ED. While it is fairly common knowledge that smoking is an unhealthy lifestyle choice, that it creates obvious harm to your lungs and respiratory system, you may not be aware of its effect on your cardiovascular system.

Chemicals like carbon monoxide found in cigarettes can be extremely detrimental to your cardiovascular system. When you smoke a cigarette, the carbon monoxide in your cigarette will bind with the hemoglobin in your blood. Hemoglobin is an essential blood component that is responsible for oxygenating your blood to full capacity. With lower hemoglobin counts, your blood is not oxygenated properly, and can not function properly. Thus, blood flow slows down, and in some areas of your body, may stop all together, at least temporarily.

When you factor in the arteries in your penis that need to be filled with healthy oxygenated blood in order to function properly, smoking creates a problem. When your blood is not oxygenated properly, your arteries will weaken by hardening and this will immediately reduce blood flow in all necessary areas, particularly in the genital region. Thus you can see how smoking could directly contribute to erectile dysfunction. If you are also thinking about building or extending your family, smoking will be one of the first things you want to eliminate from your life, as smoking will also contribute to low sperm motility, increased mortality of your sperm, and even lower sperm counts.

For many men, the easiest answer to curing ED is to start treatment such as Viagra. While these medications are very effective in dealing with ED, the simple answer is that ED that is caused by smoking may not always be cured with Viagra. The situation is further complicated if you have extraneous conditions such as heart disease or diabetes. Thus, if you are a smoker, and struggling with ED, your best bet for ED treatment is to first quit smoking, and then try medication like Viagra. While this may seem like a great sacrifice to you at first, when you consider the sacrifice you will alternatively make with a less than stellar sex life, it is up to you to decide which is more important to maintaining a healthy and satisfactory quality of life. Is smoking really worth it?

Erectile Dysfunction-Destroying

2011-11-29T07:51:00.000-08:00

The meg of relationship have been ruined by erectile disfunction or ED. This is the most mutual intimate upset touching 1000000 of workforce in the cosmos. The block of gaining hard-on in sire generative ovipositor i.e. phallus or previous interjection is termed as an erectile disfunction or ED. Most of the clip peoples get confound between erectile disfunction and impotency. One should cognize that ED and powerlessness are not the same. ED is one of the cause of impotency in workforce and other cause creditworthy for powerlessness in workforce comprise previous interjection, anxiousness, emphasis about routine in berth, want of privateness etc. Erectile disfunction or ED certainly takes away the harmoniousness from the partnership. The loving enactment becomes like a ho-hum occupation to be finished very presently or sometimes it only doesn’t happens for a recollective clip.

The sire generative ovipositor is consists of two erectile bodies named as corpus cavernosum which are done up of bland musculus and humor vessel. When an Adam is sexually aroused the encephalon sends the signaling to the member via nerve. This intimate galvanisation could be from forcible or genial galvanisation. This can too because of intimate thought or dreaming. According to the rubdown direct by the encephalon the suave musculus of the humour vessel and helps them to unfastened wider. Because of this the humor flows in a greater positiveness and fills the corpus cavernosum. Simultaneously the vena that carried humor off from the phallus get closed and antecedent a growth in the humor force in the member. Thus the humour that is filled in the corpus cavernosum makes the phallus upright and harder. This neurophysiology of penile hard-on is upset in the workforce enduring from ED or erectile disfunction.

The symptom of erectile disfunction or ED are the block to increase or keep the penile hard-on even if the context for adoration making is favourable. If the individual is perpetually neglected to accomplish or keep the penile hard-on then this status can termed into erectile disfunction or ED. This could be the most trying status for every Adam. There are several other factor which add to ED or erectile disfunction. These factor are deficiency of clip, modification in spot, deficiency of seclusion, communicating spread, fright of maternity, no unvarying mate, genial emphasis etc. If you are seeing erectile disfunction on a veritable footing even if the factor depict above are abstracted then you should handle ED or erectile disfunction earnestly and be unfastened to your doctor so that he can propose you the efficacious tending about it.

There are several treatment uncommitted for erectile disfunction or ED efficaciously. Though it is not potential to therapeutic ed but you can sure handle it and makes your worship doing a memorable familiarisation. There are several anti powerlessness pill are uncommitted in the marketplace to handle ED or erectile disfunction. The allopathic medicine for ed contain anti powerlessness drug amongst which Blue thing has go the first selection of anti powerlessness aborticide. The combat-ready component of wine cialis . It is because vino cialis offer a penile hard-on for about 36 hours. Because of this unique property of generic cialis is also known as “the weekend pill”. Generic cialis assistance to enhance the daub flow to the smooth muscle of the penis and aid to get an erection. But for generic cialis to wash a sexual galvanisation is needful. It is advisable to take generic cialis one hr superior to sexual activity and its upshot lasts for 36 hours. This amazing place of generic cialis makes it a selection of millions for the treatment of erectile dysfunction. Generic cialis has literature up a furniture of desired in the life of many couples.

Herbal Viagra - Herbal Viagra can Rescue Relationships

2011-11-20T13:28:00.001-08:00

Herbal Viagra - Herbal Viagra can Rescue Relationships

Sex is a vital ingredient for a healthy, happy relationship. If you're married, or in a partnership, the chances are you've gone through rocky periods and ups and downs. There are many stresses from being in a couple such as financial pressures, petit arguments, or having a child – all these factors can impact drastically on your sex life. These stresses could even lead to a loss of libido or even erectile dysfunction or erection problems. If you're unable to satisfy your partner you might be worried she or he will end up having an affair and seeking satisfaction elsewhere. So you should never ignore erectile dysfunction or erection problems if you want to save the future health of your relationship.

Is Erectile Dysfunction Destroying your Life?

It may sound crazy that erection problems could lead to a breakdown of your life, especially when erectile dysfunction is so easily cured using online herbal Viagra for instance. But a failed relationship can leave you emotionally broken, financially bankrupt and unconfident to find a new partner – especially if the break-up was blamed on your erectile dysfunction or erection problems. If you're letting embarrassment stand in the way of a healthy, happy love life, you're risking your relationship and family life. It's possible to buy herbal Viagra online discreetly so you don't have to feel anxious or embarrassed – it's only a few clicks of the mouse away.

Don't Let Erection Problems Ruin Your Relationship

The first thing you should acknowledge if you are experiencing difficulties in the bedroom is that one in ten men experience erectile dysfunction and erection problems. It is not uncommon or unusual. It doesn't help to blame your partner or ignore the problem entirely. Like any sexual problem, leaving it only makes it worse. Facing erectile dysfunction and erection problems by having frank discussions and investigating herbal Viagra or other sex stimulants readily available could make all the difference.

Sex Matters

It doesn't help sweeping erectile dysfunction under the carpet or assuming that your partner will love you regardless of your erection problems. The harsh fact is that sex matters. And although your partner will undoubtedly help you overcome your erection problems with the aid of herbal Viagra, sex therapy or other treatments, you are running the risk of ruining the relationship if you don't seek treatment or help. A happy, healthy and active sex life could be waiting just around the corner – just go online and try out the herbal Viagra and other stimulants readily available and see how you can transform your sex life.

For a guaranteed result from herbal Viagra for erectile dysfunction, male impotence and premature ejaculation, visitwww.ultimate-herbal.com. They specialise in sexual enhancement products for both men and women. They are so confident that their version of herbal Viagra, HORN, will work for you that they offer you your money back should you not be completely

Herbal Viagra - Kick start your libido

2011-11-20T13:19:00.001-08:00

Ironically it was Freud who originally coined the word libido as personal energy that goes against what we consider to be civilized behavior. However, it is the alternative meaning of libido that is more commonly referred to in modern day society: the urge to engage in sexual activity.

The science behind it

Despite libido and sex drive being based on historic theory, there is in fact a science behind it. The hormone, testosterone is what kick starts the feeling of passion and desire in men and despite the female body producing many forms of the female hormone, estrogen; it is only one, natural progesterone that is the source of women's libido.

Why can our libidos sometimes take a nose dive?

There is a multitude of reasons why our libidos can sometimes not be as active as we would like which can ultimately lead to tension between us and our partners. The most common psychological reasons include:

Depression

Stress

Low self esteem

Loss of intimacy

However, there are also a number of physical factors that can how strong our libido is, which tend to get over looked as it is not as well known that environment can affect your sex drive. These physical reasons include:

Unhealthy lifestyle

Underweight

Overweight

Certain medications can have an effect

Studies have been done that show the libido of people who lead healthy lifestyles by eating the right and participating in regular exercise is considerably higher than those who lead unhealthy lifestyles.

How to improve our libido

There are a number of ways in which we can take personal action to improve our libidos and get back on top so to speak. The most obvious and easy one to do is change our lifestyle. By changing diet by incorporating vitamins and minerals as well as balancing protein and carbohydrates we can improve not only libido but sexual stamina. Coupled with regular exercise, we can improve sexual drive all round.

Herbal alternatives

There are also a number of herbal products that are on the market that claim to help overcome erectile dysfunction, impotence and at the same time increase libido. One of these products is known as HORN, types of herbal Viagra, due to the fact that HORN is an herbal Viagra, the side effects that are often linked to the conventional Viagra are eradicated.

Viagra talk - impotence drug - includes related articles - Interview

2011-09-13T09:17:00.001-07:00

After months of media hype, what's the real dope on this wonder drug? A doctor gives you the hard facts.

We've all heard news stories, rumors and even jokes about Viagra, the infamous impotence drug. HMOs are battling over whether to pay for it, and over how many pills constitutes a month's supply. Men are pounding on doctors' and pharmacists' doors nationwide, clamoring for prescriptions. Even women are sampling the pills in an attempt to improve their sex lives.

But what about the facts, medically speaking? Does it work for everyone? And how safe is this stuff, anyway? We asked Dudley Danoff, MD, a Los Angeles urologist and the author of Superpotency (Warner Books, $11), for the real lowdown on the drug that's taken the country by storm.

After years of treating male sexual dysfunction, have you ever seen anything like Viagra before?

There's no question that the magic blue pill is a phenomenon no urologist has ever seen before. Nothing has come down the urological turnpike to equal the attention, the excitement, the hope that Viagra has generated.

What do guys tell you when they come to you for a Viagra prescription?

Well, I listen to what they don't say as much as what they do say. They'll come in complaining of another thing - "It hurts when I urinate," or, "There's an abrasion on my penis." Then the moment they're ready to walk out, they say, "By the way, doctor, I have trouble with erections. I can't get it up."

What kinds of men actually need to use Viagra?

Most are at least 50, older guys who really have erectile dysfunction. They can't get an erection, or they have an erection inadequate to penetrate, or they feel it's not as firm as it once was. We also see [younger] guys who get hard-ons twice a day but want six a day. But we're very cautious in giving it to them. If my patients under 40 ask for Viagra, I'm suspicious, and I'm reluctant to give them a prescription unless they have a bona fide erectile problem.

What kinds of stories do these younger men tell you?

Most are very candid and, in a way, naive. They think Viagra is a magic bullet, which it isn't. I tell them that if they're getting erections good enough for penetration, it can be downright dangerous. The result can be an erection that can't quit or lasts more than two hours; that can be very damaging to all the veins and channels in the penis.

Can't these men get any tangible benefit from Viagra?

They're mostly psychogenic. If I were to give a blue-colored placebo to 100 guys under 50 years old, 30 of them would call in the morning and say, "That pill was like magic."

If a man gets nocturnal erections, he doesn't need Viagra. Viagra will probably work, but it is probably more psychological than because of any metabolic mechanism. The men who really need Viagra are those who are medically impotent for reasons of vascular deficiency, inadequate blood flow or neurological damage.

So how do you decide which guys to prescribe it to?

I would be reluctant to write a Viagra prescription for a guy who I didn't think had erectile dysfunction, and I would advise him that it's probably not a good idea to take it. And then I have to make a clinical judgment. I like to keep patients happy, and if a guy absolutely insists on it, and I have the feeling he's going to go and get it someplace else from someone who might give Viagra in a less responsible way, I'll say, "Let me give you a small dose. Try it - don't abuse it - and let me know how you make out."

Are there also guys who come to you because they want sex all day long?

I've run into all sorts. But most people find it's hard to have sex all day - you have to work and sleep, and you have to find a willing partner.

We're hearing that Viagra helps women achieve orgasm, too. What's the story there?

There are some women asking for it, and many doctors are giving it to them. It may increase blood flow to the clitoris, which could help them have an orgasm.

We've seen news reports about older men leaving their wives for younger women because of Viagra. Is that really happening?

You can find a case to back up anything, but let's be practical. For a guy married many years, there's no question that if you're with the same woman, the edge is off. But what guy with a sane mind is going to get a hard-on, screw somebody and then leave a long-standing relationship unless there's already something seriously wrong with that relationship in the first place? It doesn't make any sense. So, in my experience, the answer is no, that doesn't happen.

For guys who need Viagra, does the effect of potency spill over into the rest of their lives? Do they feel better about themselves in general?

A guy with an erection is like the quarterback who throws the winning touchdown, the guy who hits a grand slam. A guy with an erection is the king of the world. And a man with an inadequate erection - and I don't care who he is - unless he's very psychologically stable, he feels like he's half a man.

We all worry about that day when it won't go up. We all have performance anxiety, and that's the reality. So we all feel better if we can get an erection - that's the nature of man.