Sildenafil (also known under the brand name Viagra) is an oral erectile dysfunction (ED) drug. Sildenafil was first developed as a drug to treat high blood pressure but was found to have been more effective in helping men get more erections in clinical trials.
Sildenafil was first approved by the United States Food and Drug Administration in 1998 as the first oral drug of its kind to treat ED. Sildenafil, besides Viagra, is also available under the brand name Revatio as a treatment for pulmonary arterial hypertension (PAH), an uncommon type of hypertension affecting the lungs.
Sildenafil 101: How it Works
Erections seem like a cut-and-dried process, but they actually require a slew of complex bodily processes involving your heart, circulatory system, hormones, nervous system, and mood to work in lockstep with each other.
When you get an erection, chemicals in the body relax penile tissue, causing blood flow to get trapped within the penis. This is why you’ll notice more blood in the penis when it’s erect compared to when it’s in a flaccid state. Then, when the blood flow subsides and gets released from penile tissue, your erection diminishes and your penis returns to its normal flaccid state.
Sildenafil, like other PDE5 inhibitor drugs of its kind, works by blocking an enzyme known as phosphodiesterase type 5, which breaks down substances that cause erections. When PDE5 is inhibited, these chemicals that cause erections aren’t metabolized, which allows penile tissue to remain relaxed and filled with blood to maintain a fully-erect penis. Other drugs in the PDE5 inhibitor category include tadalafil (Cialis), vardenafil (Levitra), and avanafil (Stendra), all of which work in a similar fashion.
It’s important to keep in mind that sildenafil, like other PDE5 inhibitors, is very effective in treating ED, but it’s not a silver bullet that magically produces an erection when you take it –– you need to be in a state of sexual arousal for it to actually work.
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Erectile Dysfunction (ED): What is it?
A bunch of symptoms is categorized under ED, such as softer, less frequent erections, or a complete and total inability to produce one.
ED isn’t just a matter of being unable to produce an erection—it also involves you and your partner’s feelings about your sex life.
ED can be an extremely frustrating medical condition, but it’s quite common. It is estimated that over 50 million men in the United States alone experience some form of ED, and many men will experience it at one point in their lifetimes. That said, ED is something that needs to be addressed soon because it can be an indicator of more serious underlying medical conditions such as the following:
- Cardiovascular disease
- Hypertension (high blood pressure)
- Diabetes
- Low testosterone level
- High cholesterol levels
- Depression
- Sleep apnea
- Nerve damage
How long do Sildenafil’s effects last?
Sildenafil kicks in within 30 minutes to an hour of taking it, so you should take it at least around that time before you engage in sexual activity. Other men may find that it kicks in sooner.
Sildenafil’s window of effectiveness lasts for around 4-6 hours. Your mileage will vary depending on factors such as your overall health, age, sildenafil dosage, and any other medicines you might be taking.
What are the common side effects of Sildenafil?
Common PDE5 inhibitor side effects include:
- Flushing
- Headaches
- Gastrointestinal discomfort
- Lower back pain
- Dizziness or lightheadedness
- Rashes
- Nasal congestion
Rarer side effects include temporary distortion in vision or loss thereof, shortness of breath, chest pain, fainting, and low blood pressure.
Another rare but serious side effect of sildenafil is known as priapism, a painful condition where an erection fails to subside after 4 hours. Erections that last longer than a few hours can cause irreversible damage to the penile tissue. Seek immediate medical attention if you experience priapism or any other rare side effects.
Sildenafil on its own can reduce blood pressure. If you already have low blood pressure or if you are already taking anti-hypertensive drugs to reduce blood pressure, consult your doctor before taking sildenafil or other PDE5 inhibitors.
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What are the risks of taking Sildenafil?
Despite their sterling safety record, PDE5 inhibitors are not for everyone. Individuals taking drugs for heart ailments such as nitrates should avoid using sildenafil.
That’s because nitrates boost nitric oxide levels in the body. Nitric oxide triggers erections, and problems may occur when taking ED drugs with nitrates. Taking PDE5 inhibitors like sildenafil with nitrates can cause excessive vasodilation that may lead to a potentially serious (or fatal) reduction in blood pressure.
Men with existing heart conditions or chest pain, or a medical history of heart attacks or strokes should consult a healthcare professional before taking sildenafil. Do NOT under any circumstances use sildenafil if you’ve experienced allergies to it.
Fortunately, PDE5 inhibitors like sildenafil aren’t the only treatment for ED. Lifestyle changes such as managing stress, consuming a balanced diet, and getting regular aerobic exercise may do wonders for your erectile function.
It’s easy to feel embarrassed about seeking treatment for ED, but remember that ED is a very common ailment, and you owe it to yourself and your partner to talk to an expert about your erectile dysfunction concerns.
