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Dr Dean Peterson , aka Dr. Dean.
Dr Dean Peterson has had wide experience in Public Health, Family Medicine, Hypnotherapy, and Prison Medicine. He has been associated with lifestyles organizations in one form or another for thirty five years, and is well known in the Las Vegas area.
Lust and Found
The internet, E- mail, TV, and magazines are full of conflicting advice and ads these days. What is a boy or girl to do when faced with this blizzard of information and ads for various products to enhance the sex life?
We will boil this jumble of information down to the basics of what is known for sure, and we will simplify what is known for sure for the sake of brevity.
In the 60s, the advent of a safe and effective birth control pill for women changed the character of their sex lives forever. In the late 90's another revolution occurred, this time for men. At last we had an effective treatment for erectile dysfunction, and the diagnosis became very popular for men of all ages.
A whole panopoly of nostrums and wannabes for sexual enhancement are now widely advertised. Most are worthless, at best and some can be dangerous, and nearly all are a waste of money. The exception here would be a product purchased by the ten to twenty percent who are very suggestible. For them, anything they believe in would be somewhat effective for a short while.
For now, I would like to discuss only the effective FDA approved remedies and discuss how they work; and they really can work. These are Viagra, Levitra and Cialis. All three have a similar mechanism of action, but there are subtle differences.
All erections must, at some point in time, go away, that is, detumence, when the sex is over and it is time to go home. These medications essentially work by slowing down the chemical in the body responsible for softening the erection, called PDE. The new wonder drugs do absolutely nothing in the absence of sexual stimulation, which causes the erection in the first place.
Follow along with this train of events. The brain, under appropriate circumstances, produces sexual desire, which, if the blood vessels in the penis are healthy, causes them to release nitric oxide, which is produced by the blood vessels. The nitric acid causes these same blood vessels to relax allowing them to dilate and fill the penis, causing an erection. As mentioned above, the PDE relaxes the erection by getting rid of nitric oxide. If the PDE is inhibited by one of our three new friends, the erection will stay around much longer and build on itself. Now we have a happy man and woman. Since these medications can work only by inhibiting the softening of the penis, we must first do the proper head work to get the sexual stimulation and thus the erection in the first place.
As mentioned above, all three of these new medications, work in a similar fashion, but there are subtle differences between them. The old reliable, Viagra, should be taken on a fairly empty stomach, and probably will be slowly absorbed and ineffective if taken soon after a fatty meal. Both Levitra and Cialis can be taken with food, but a large recent meal before sex is still ill-advised. Viagra usually starts working in about thirty minutes and will last for several hours only. This can sometimes be a problem in a lifestyles situation. Levitra is probably effective longer and can be taken with food. Now to complete the picture, we have had Cialis since the first of the year. Cialis, like Viagra and Levitra, is relatively quick acting, and, like Levitra, can be taken with food. It differs somewhat from the other two, in that it works on a slight variation of PDE-5, called PDE-11. This enables it to last considerably longer in the body. Although the effects can last throughout the night and into the next day, it would appear that claims of being effective for up to thirty six hours are overblown.
All three have a similar side effect profile, and taking either with nitrate heart medication, or recreational poppers is contraindicated and could be lethal. Also a prostate medication, called Hytrin, is contraindicated. Headache, flushing, and nasal stuffiness, and minor temporary vision changes are the most reported minor side effects for all three.
The cost for all three is usually eight to ten dollars per pill. The best deals can usually be found at Wallmart or Cosco Pharmacies, and buying them on line usually costs as much or more when all the fees are counted in, and you are taking a chance with what you end up with. Most men purchase the one hundred milligram dose of Viagra, and split it with a pill splitter, to receive two fifty milligram doses, each at half price. Fifty milligrams of Viagra is effective for most men. Levitra and Cialis are designed by the manufacturer to be more difficult to split. Nevertheless since the cost is the same for any strength pill, it is worth a try.
Drug companies are working on an anti-impotence gum and nose spray. They are feverishly developing treatment for the estimated forty three percent of women who suffer some degree of sexual dysfunction. Stay tuned in. More to follow.
[More to come, so to speak].
Dean G. Peterson M. D.