Sildenafil and Erectile dysfunction

Testosterone is essential for a healthy libido and normal sexual function, and erectile dysfunction sufferers known to have low testosterone improve when placed on prescription testosterone replacement therapy. Similarly, studies have shown that taking over-the-counter supplements containing DHEA, a hormone that the body converts to testosterone and estrogen, can help alleviate some cases of ED. Erectile dysfunction (sometimes called impotence) means that you cannot get or maintain a proper erection. There are several causes, the most common being due to a narrowing of the arteries that take blood to the penis.

Sildenafil works by preventing the action of a chemical in the body called phosphodiesterase type 5. This helps to relax (widen) blood vessels and improves the flow of blood. In erectile dysfunction, Sildenafil improves the blood flow to the penis following sexual stimulation, and this helps to maintain an erection.

Sildenafil is available on prescription. Do not take it if you do not have erectile dysfunction.

Another brand of Sildenafil tablets called Revatio is used in a completely different condition called pulmonary arterial hypertension. This is a specialist treatment and no information about this brand of Sildenafil is included in this medicine leaflet. Most men have occasional times when they cannot get an erection. For example, you may not get an erection so easily if you are tired, stressed, distracted, or have drunk too much alcohol. For most men it is only temporary, and an erection occurs most times when you are sexually aroused.

However, some men have persistent, or recurring, ED. It can occur at any age, but becomes more common with increasing age. About half of men between the ages of 40 and 70 have ED. About 7 in 10 men aged 70 and above have ED.

When you are sexually aroused, messages from your brain travel down nerves to your penis. Chemicals called neurotransmitters are then released from the ends of the nerves in the penis. Stimulation of the penis can also cause local nerve endings to release neurotransmitter chemicals.

The neurotransmitters which are released in the penis cause another chemical to be made, called cyclic guanosine monophosphate (cGMP). This chemical causes the arteries in the penis to widen (dilate). This allows extra blood to flood into the penis. The rapid inflow of blood causes the penis to swell into an erection. The swollen inner part of the penis also presses on the veins nearer to the skin surface of the penis. These veins normally drain the penis of blood. So, the flow of blood out of the penis is also restricted, which enhances the erection.

Once you stop having sex, the level of cGMP falls, the blood flow to the penis returns to normal, and the penis gradually returns to the non-erect state.

There are several causes which tend to be grouped into those that are mainly physical and those that are mainly due to mental health (psychological). About 8 in 10 cases of ED are due to a physical cause.

    Reduced blood flow to the penis. This is, by far, the most common cause of ED in men over the age of 40. Like in other parts of the body, the arteries which take blood to the penis can become narrowed. The blood flow may then not be enough to cause an erection. Risk factors can increase your chance of narrowing of the arteries. These include getting older; high blood pressure; high cholesterol; smoking.
    Diseases which affect the nerves going to the penis. For example, multiple sclerosis, a stroke, Parkinson's disease, etc.
    Diabetes. This is one of the most common causes of ED. Diabetes can affect blood vessels and nerves.
    Hormonal causes. For example, a lack of a hormone called testosterone which is made in the testes. This is uncommon. However, one cause of a lack of testosterone that is worth highlighting is a previous head injury. A head injury can sometimes affect the function of the pituitary gland in the brain. The pituitary gland makes a hormone that stimulates the testis to make testosterone. So, although it may not at first seem connected, a previous head injury can in fact lead to ED. Other symptoms of a low testosterone level include a reduced sex drive (libido) and changes in mood.
    Injury to the nerves going to the penis. For example, spinal injury, following surgery to nearby structures, fractured pelvis, radiotherapy to the genital area, etc.
    Side-effect of certain medicines. The most common are some antidepressants; beta-blockers such as propranolol, atenolol, etc; some 'water tablets' (diuretics); cimetidine. Many other less commonly used tablets sometimes cause ED.
    Alcohol and drug abuse.
    Cycling. ED after long-distance cycling is thought to be common. It is probably due to pressure on the nerves going to the penis, from sitting on the saddle for long periods. This may affect the function of the nerve after the ride.
    Excessive outflow of blood from the penis through the veins (venous leak). This is rare but can be caused by various conditions of the penis.

In most cases due to physical causes (apart from injury or after surgery), the ED tends to develop slowly. So, you may have intermittent or partial ED for a while, which may gradually get worse. If the ED is due to a physical cause, you are likely still to have a normal sex drive apart from if the cause is due to a hormone problem. In some cases, ED causes poor self-esteem, anxiety, and even depression. These reactions to ED can make the problem worse.

Vinpocetine and Viagra (Sildenafil) for bodybuilders

Everyone knows that Viagra is taken in violation of erectile function in men. Today, however, it began to be used in the environment of bodybuilders and athletes.
However, most bodybuilders are not concerned with the question: how to increase potency?. But the drug they use for Pumping.

The fact is that the active ingredient of Viagra (Sildenafil), enhances blood flow to muscles, which increases endurance thereby to achieve good results.

Bodybuilder can lift more weight, perform more reps with and approach than usual. Thus, coefficient useful weight training increases, thanks to the more intense muscle groups. opinion that Viagra is another donor of nitrogen.However, Viagra does not affect the level of no, however vessels in the muscle expands really well.

Currently, the organization that fights against doping explores the drug Viagra on athletic performance. If in the course of the experiments will still be shown that Viagra has a great contribution to athletic performance, the drug will be banned in speed and power sports. Bodybuilding such bans probably will not be threatened, as Viagra has no adverse impact on health. With minimal adverse events Viagra also has a positive effect on the heart, improves circulation and slightly reduces blood pressure.

Favorably to steroids and anabolic steroids, Viagra has no effect on the human body is harmful. It should be noted that an erection when using the drug only appears to stimulate sexual arousal. Another very popular among bodybuilders drug – Cialis. The active substance is analogous to the Cialis (Tadalafil), Sildenafil (Viagra). Cialis Super Active 20mg also increases blood flow to the muscle fibers. Bodybuilders and athletes can take Cialis without damage to health. Cialis is different from Viagra is that the former has longer period – as many as 36 hours.

Vinpocetine has been called Viagra for the brain. Vinpocetine is a relatively unknown ingredient that not only is notable for improving symptoms of some cerebral disorders but also is a thermogenic extraordinaire.

Vinpocetine (vinca minor), when administered as little as 15-30 mg. a day, has been noted to improve visual acuity, cause significant and quick improvement in vascular disease and improvement in memory to a level of statistical significance.

Vinpocetine even works synergistically with other thermogenic compounds to increase norepinephrine (a major fat-oxidation hormone). This helps exercise to more rapidly decrease body fat levels.

 Vinpocetine comes from the periwinkle plant. Vincamine is extracted from periwinkle and an alkaloid extract of vincamine becomes Vinpocetine.

Vinpocetine is a natural substance that is effective at increasing memory, mental focus, and blood flow to the brain. In Eastern Europe (Hungary), Vinpocetine is prescribed to help treat cerebral disorders in stroke patients.

In other areas, it is used to help treat some speech impairment, depression, headaches, memory loss and tinnitus (ringing in the ears) caused by impaired blood flow to the inner ear. Vinpocetine is theorized to increase ATP production and the utilization of glucose and oxygen in the brain.

Vinpocetine's main method of action is by way of increasing cGMP production (a molecule directly responsible for endothelial nitric oxide release) and by increasing the production of norepinephrine. Vinpocetine is thought to inhibit the phosphodiesterase (PDE) enzyme, an enzyme responsible for blocking cGMP release.

PDE is also the enzyme blocked by the popular drug Sildenafil Citrate (Viagra). Blocking PDE allows for dilation of blood vessels resulting in more oxygen in the brain, (and in the case proven by Viagra, more blood in the Wang). Norepinephrine is a byproduct of dopamine and is, in part, responsible for increased vigilance, alertness, concentration and even stress capacity.

Viagra and hormonal causes of ED

Viagra (Sildenafil) relaxes muscles and increases blood flow to particular areas of the body. Viagra is used to treat erectile dysfunction (impotence) in men. Another brand of sildenafil is Revatio, which is used to treat pulmonary arterial hypertension and improve exercise capacity in men and women. Erectile Dysfunction is highly prevalent, is age related and can be progressive. At least 50 percent of all men ages 40 to 70 years old have some degree of E.D. Effects on physical and emotional health can be profound. The usual body builder will likely use some anabolic hormonal augmentation to achieve desired physical “cosmetic effects”.

The most common anabolic pharmacologic agents used are:
1.Testosterone of different kinds (injectibles, testosterone mixtures etc.); sometimes topical testosterone also.
2.Nandrolone anabolic agents, which are more anabolic than androgenic, which may include Nandrolone Undecanoate (Deca), Oxandrolone, Stanazalol, Oxymethalone and many others.

When you look at the chemical structures of the nandrolones you will see that many look like the synthetic progestin (progesterone) family of hormones. That is why many of the nandrolone anabolic agents have central nervous system depressing effects like the progestins. Some years ago male sex offenders were given injections of methyl provera acetate (a potent synthetic progestin) to suppress deviant sexual behaviors. The progesterone / progestin sex hormones are central nervous system and sexual depressants.


The nandrolones since they do not convert (aromatize) to estrogen have negative (depressing) sexual effects in the brain with loss of sexual desire and erectile dysfunction. The estrogen component of natural T is necessary to relax blood vessels and facilitate sexual desire in the brain.
Other agents used by body builders may include:
a) Cytomel (T3)-the potent form of thyroid to increase metabolism and burn fat. T3 can cause excitement and can decrease penile blood flow.
b) Diuretics – used before contests to remove fluid to enhance muscle vein prominence.
c) Stimulants before training or to lose weight. All stimulants decrease penile blood flow.

Post Cycle Therapy (PCT) includes agents like Clomid, Tomoxifen, HCG (human chorionic gonadotropin), and Arimidex. Except for HCG all the others either lower or block estrogen levels and can sometimes be anti-sexual.

However when HCG is used estradiol levels go up in a natural proportion to testosterone and many body builders report enhanced sexuality and function. Their testes also may increase in size with HCG.
Male sexual behavior is an interaction between the intra psychic (mind), biology (the body) and relationship (the couple). E.D. can occur from some abnormality in either one of these areas or a mixture. A shift of these domains can affect the other. The results are variable and need to be looked at a case-by-case basis.

Testosterone modulates nitric oxide expression in the penis, which is necessary for erections. Those men who have very low testosterone levels often experience poor results to the erectile drugs like Sildenafil (Viagra) and the others. They also lose morning erections. It is necessary for testosterone to be present to convert (aromatize) to estrogen to have a positive sexual effect in the brain and other tissues (penis).

The goal of most bodybuilding is to achieve a maximum cosmetically aesthetic physical appearance rather than athletic performance goals. Most body builders are not involved in professional competitions, but often follow competitive body building principals in order to achieve the best look cosmetically. This is a big problem.

Body builders can run into problems by sacrificing their cosmetic look goals over their natural internal health. One of the biggest issues is that body builders do cycles of “stack “of multiple androgens and other anabolic agents including many anabolic steroids, insulin, growth hormone etc. Those who start at a young age on various “cycles” may later develop androgen induced hypogonadism or AIH.  A basic rule is that the longer the “cycles” and the older the body builder that more problems will occur over time with erectile function and lowered natural T production. Some get to point later where they cannot make enough of their own natural internal testosterone to have normal erectile function.

ED and Bodybuilders health

Where the arteries supplying blood to the penis do not bring in enough blood to cause an erection. This can occur because of a narrowing of the arteries such as occurs in the elderly, diabetics and those with high blood pressure or because of injury to the genital region which causes a block in the artery to the penis. The last is very common in the young. The injury can be major and sudden as after a vehicular accident causing a fracture of the pelvis or pubic bones, or low grade and gradual, as in bicycle and other riders and occurs because sustained friction in that region causes a clot-like substance (thrombus) to develop in the artery to the penis. This clot gradually grows and ultimately blocks the blood supply to the penis completely.

Arteriogenic impotence resulting from injuries is very common but often unsuspected because of ignorance of the causative conditions. Many such patients are to be found in orthopedic and urology wards. The impotence is often discovered much later, after the more obvious wounds and fractures have healed. Ironically, it is most often discovered by the patient himself and not by the doctor.

Venogenic: Where the veins of the penis leak blood and prevent the development of a rigid erection. In a normal man during full erection the veins close down almost completely and practically no blood flows out from the penis. This allows blood to accumulate in the sinusoid of the penis, thus raising pressure and allowing for the development of rigidity or hardness. Venogenic impotence is extremely common. It is said to account for as much as 30-70 percent of all impotence. Some men have venogenic impotence from birth (primary). Such men have never had a rigid erection all their lives. Others develop venogenic impotence suddenly after years of normal sexuality (secondary).

Neurogenic: The nerve supply to the penis is very delicate and complicated. A proper conduction of impulses along these is basic for the initiation and maintenance of an erection. It is these nerves that activate the arteries and the veins and alter the dynamics of blood flow within them.

Many things can go wrong with the nerve supply to the penis. Injuries to the back, especially if they involve the vertebral column and the spinal cord can cause impotence. So also can injury to other nerves supplying the penis such as occurs after pelvic or perineal trauma. A wide variety of operations performed for other conditions can cause incidental injury to the nerves of the penis and cause impotence. These include operations on the rectum, prostate, urethra, spine, retro peritoneum, urinary bladder etc. Of course, disorders of the nervous system such as multiple sclerosis, myelitis, tumour etc. are wont to cause impotence if they involve the nerve supply to the penis.

Another disease affecting the nerves to the penis is diabetes mellitus. Impotence is extremely common among diabetics. In fact, as many as 50 per cent of all diabetics are impotent. Impotence in diabetics is almost always organic in origin. Appropriate therapy for diabetes can never restore erectile function because the basic diabetic process can never be reversed. Only the blood sugar levels and the complications of diabetes are controlled. Modern andrology, however, can offer a cure to nearly all patients with diabetes-related impotence. This is another fact that is, unfortunately, not known to most people. Few diabetologists address erectile dysfunction (ED, impotence) in their patients.
Many doctors recommend use Sildenafil. Viagra is used to treat impotence in men. Viagra increases the body's ability to achieve and maintain an erection during sexual stimulation. Before taking Viagra, tell your doctor if you have had a heart attack, stroke, or life-threatening irregular heartbeats within the last six months; have a history of heart failure,  have coronary artery disease; have angina; have high or low blood pressure, have liver problems; have kidney problems; have ever had blood problems, including sickle cell anemia or leukemia; have a bleeding disorder; have a stomach ulcer; have retinitis pigmentosa (an inherited condition of the eye),  have a physical deformity of the penis such as Peyronie's disease, have a condition that could lead to prolonged and painful erections, such as a tumor of the bone marrow, sickle cell anemia, or leukemia; or are taking another medicine to treat impotence. You may not be able to take Viagra, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above. Although Viagra is not indicated for use by women, it is in the FDA pregnancy category B. This means that Viagra is not expected to be harmful to an unborn baby. Women should not take Viagra. It is not known whether Viagra passes into breast milk. If you are over 65 years of age, you may be more likely to experience side effects from Viagra. Your doctor may prescribe a lower dose of this medication.