Viagra May Not Cure All Sex Problems, but May Save Lives by Helping Heart
Two new studies take interesting looks at erectile dysfunction drugs
A study by a psychologist finds oral drugs like Viagra improve sexual performance but not a man’s ‘sexual health’. Not to worry, another new study finds Viagra can improve heart function and potentially save the lives of people with specific heart problems. The net results imply a longer life with poor sexual health but good ‘sexual function’.
The study finding medications are not quite a magic pill to improve the sex lives of men with erectile problems comes from a Deakin University. Hayley Matic conducted the study for her Doctor of Psychology (Health) with Deakin’s School of Psychology under the supervision of Professor Marita McCabe.
She found that while oral medications phosphodiesterase type 5 inhibitors, known as PDE5 inhibitors, may restore a man’s ‘sexual function’ they don’t necessarily restore a man’s ‘sexual health’. PDE5 inhibitors include Viagra, Cialis and Levitra.
“As well as the obvious physiological aspects, men with erectile dysfunction (ED) suffer a range of problems such as significantly poorer self esteem, sense of masculinity, sexual satisfaction and relationship satisfaction,” Dr Matic said.
“This study found that overall well being was not improved in the men who had used medical interventions for their ED.”
Dr Matic’s study explored the psychological and relationship impact of ED on the lives of Australian men and their partners. It also looked at men’s help-seeking behaviour and experiences with oral medication as treatments for their ED. It involved 410 men with ED and 242 men without ED.
“ED affects up to 50 per cent of men at some point in their lives and is generally treated with the use of oral medications,” Dr Matic said.
“The focus on the medical and biological elements of ED has led to a relative dismissal of the role of psychological and relationship aspects of men’s sexual experiences. As a result many men stop using the medications and continue to suffer ED as well as the associated problems with their masculinity, self-esteem and quality of life.
“Hopefully the results of this study will open up current mainstream treatments for this sexual dysfunction to include greater awareness of the psychological and relationship factors inherent in a man’s sexual health.”
Dr Matic suggests that improvements could come from:
● Ensuring GPs and specialists who assess and treat sexual dysfunction are educated in the potential broad ranging impact of ED on a man’s life
● Ensuring that those prescribing ED medications are able to talk to their patients about their expectations for the use of the drugs
● Increased development of and referral to non-medical treatments for ED, either in conjunction with medication treatment or as a stand-alone
● Increased inclusion of a man’s partner in the assessment and treatment for ED in both medical and other settings.
“As medications are only potentially able to address the biological/physiological aspects of sexual arousal, there is a clear need to consider broader application of a biopsychosocial model of health to our understanding and treatment of ED,” Dr Matic said.
Viagra boosts heart performance and may save lives
Researchers at the University of Alberta have shown that Viagra, the popular drug prescribed for erectile dysfunction, can improve heart function and potentially save the lives of people with specific heart problems.
Viagra’s unexpected benefit has led the U of A researchers to encourage doctors to consider the drug when a patient has a failing right ventricle of the heart, a dire condition for which there are currently no treatments available.
The research will appear next week in Circulation, a journal of the American Heart Association.
“There are a number of medical conditions in both children and adults for which there is a need to boost the performance of the right ventricle, and this drug can be clinically and immediately relevant to help these patients,” said Dr. Jayan Nagendran, a cardiac surgery resident at the U of A and the first author of the paper.
“Sometimes the right ventricle can fail rapidly and even result in death, like in lung transplant surgery, for example. In such a case, Viagra may increase the right ventricle’s performance and save the patient.” Nagendran added.
“We have a number of drugs and therapies available to treat the left ventricle of the heart to prevent it from failing or to treat it after it has failed, but we don’t have anything for the right ventricle.
The phosphodiesterase type 5 inhibitors, which include Viagra, Cialis and Levitra, may offer some important benefits in this case,” said Dr. Evangelos Michelakis, a U of A cardiologist, the Canada Research Chair in Pulmonary Hypertension and the senior author of the paper.
In a healthy person, phosphodiesterase type 5 constricts arteries in two places in the body—the lungs and the penis. In the lungs, it prevents excessively low blood pressure. In the penis, it prevents excessive engorgement.
However, undue phosphodiesterase type 5 can constrict these arteries too much and cause problems, as it does in the case of pulmonary hypertension, where lung arteries constrict and put a strain on the right ventricle of the heart. Phosphodiesterase type 5 inhibitors allow the arteries to relax so that blood can flow more easily.
In 2002, a U of A research team led by Michelakis published the first evidence that Viagra may improve pulmonary hypertension in humans. This work was later conformed by larger trials and Viagra—sold under the name Revatio—is now approved all over the world for pulmonary hypertension.
Researchers assumed Viagra’s benefit in pulmonary hypertension is restricted to its ability to relax the lung arteries. In fact, there was evidence phosphodiesterase type 5 was not expressed in the normal ventricles, explaining the lack of Viagra effects on the normal heart.
However, the U of A researchers, acting on a hunch, studied human hearts and showed that phosphodiesterase type 5 is expressed in large amounts in thickened (hypertrophied) right ventricles, but not in healthy hearts. They replicated their results in animal models and also showed that Viagra enhanced the output of hypertrophied right ventricles.
Michelakis noted that this might be the first example of a drug that can improve the function of the right ventricle (which is diseased in pulmonary hypertension), without affecting the left ventricle (which is normal in pulmonary hypertension).
“This selectivity is important and has direct clinical implications,” Michelakis added. “Relaxing the lung arteries alone may not be sufficient to help the patient, if the right ventricle is too weak to push blood through them. A drug such as Viagra, with a combined beneficial effect both in the lung arteries and the right ventricle of the heart, offers a significant advantage.”
“Viagra is a drug that millions of people take every year, and we’ve just learned something new and essential about how it works,” Nagendran said.
Michelakis agreed, adding, “This drug can have an immediate and direct clinical application, so we’re pretty excited about these findings.”
The study was funded by CIHR, AHFMR, CFI and the Heart and Stroke Foundation.
Source: www.seniorjournal.com
