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May 24, 2000 (San Francisco) — Don’t expect to see Elizabeth Dole in an ad
for Viagra. Once again, when the miracle drug was tested in women with sexual
dysfunction it failed the test proving, according to some critics, that what is
good for the gander will never fly in the goose.

Nonetheless, Pfizer Pharmaceuticals, the maker of the drug, is not throwing
in the towel. Pfizer tells WebMD that it is forging ahead with a new study that
will test the drug in postmenopausal women on hormone replacement therapy whose
main complaint is the inability to become sexually aroused.

Michael T. Sweeney, MD, medical director of the Viagra team at Pfizer, tells
WebMD that the new study is recruiting 150 women who will either receive a
sugar pill or one of three Viagra doses: 10 mg, 50 mg, or 100 mg.

But Viagra has had some success among women, because if the mass media is
any indication, sexual dysfunction in women is news and much of the credit for
that goes to Viagra, the drug that made it possible to take sexual dysfunction
public. With the remarkable success of Viagra for men with impotence,
researchers hoped that the drug could do the same for women.

But once again, gender makes a difference, says Rosemary Basson, MBBS, MRCP.
Basson was lead researcher of a Canadian and European study of almost 600 women
with sexual dysfunction disorders.

In this latest study, released at a meeting of obstetricians and
gynecologists here this week, the placebo performed better than Viagra
regardless of the dose. Additionally, more than a third of women taking higher
doses of Viagra — 50 mg and 100 mg — reported side effects, such as headache
and flushing. Basson says that “is much higher than the rate in men, which
is only about 14% or 15%.” She is associate professor in both obstetrics
and psychiatry at the University of British Columbia and Vancouver
Hospital.

Basson, who says she has been treating sexual dysfunction in women for
decades, says it is difficult to determine if Viagra will ever have a
therapeutic role for women. “Among women, sexual dysfunction is not so
easily divided into different areas as it is with men. In women, it is more of
a continuum in which women may have low desire, female sexual arousal disorder,
or female orgasmic disorder. It is not such a simple thing as blood
supply,” she says.

Picking up that theme, Winnifred Cutler, PhD, president of the Athena
Institute for Women’s Wellness Inc. in Chester Springs, Penn., says sexual
response in women is actually even more complicated than a mixing of the
emotional and physical.

In another discount generic levitra online viagra
at the same meeting, Cutler presented findings that
also suggest hysterectomy may have a negative impact on sexual response in
women. Researchers looked at women who had hysterectomies, women who had not
had hysterectomies, and women who were diagnosed as having fibroid tumors in
the uterus, a common condition. A majority of women in all three groups report
a high rate of sexual erectile dysfunction pill
, she says.

However, says Cutler, more than half of the women “report frequent
orgasm,” but frequency of orgasm declines when a hysterectomy is scheduled.
She says other studies have noted lower levels of orgasm at the time
hysterectomy is scheduled and higher levels at two years after surgery. Those
studies claim, she says, that hysterectomy improves sexual function and
satisfaction.

“Our data suggest that sexual satisfaction is suppressed at the time a
hysterectomy is scheduled,” she says. “The claim that hysterectomy
improves a woman’s sex life is wrong.”

Basson says that Cutler’s theory is interesting, but has some skepticism.
“I think if this were true, I would be getting great numbers of
posthysterectomy referrals,” she says. “That is not the case. I am not
treating great numbers of women who say that hysterectomy made them sexually
drug dysfunction erectile
.”

Vital Information:

• Viagra has suffered some recent setbacks in studies testing the drug in
  women who have sexual dysfunction.
• A therapist who works with female patients with sexual dysfunction says
  unlike men, women’s conditions don’t focus on blood flow, but rather, are
  affected by multiple factors.
• Another factor that can contribute to a woman’s sexual dissatisfaction is a
  plan for hysterectomy. While studies have found those who have had this surgery
  often have a satisfying sex life, intimacy often suffers during the time the
  procedure is planned, but gradually recovers.

Aug. 6, 2004 — Men with low testosterone levels who suffer from erectile dysfunction and have tried Viagra without success may benefit from adding a testosterone gel to their impotence treatment plan.

Nearly 30% to 50% of men with erectile dysfunction who take Viagra don’t respond adequately to treatment. The reason could be low levels of the sex hormone testosterone, according to a new study published in the Journal of Urology.

Low levels of the hormone could lead to a low sex drive and erectile dysfunction, erectile dysfunction drugs
, fatigue, and osteoporosis in men.

The study tracked 75 men aged 18-80 years old with low levels of testosterone and erectile dysfunction. All the men were in stable, heterosexual relationships and had failed to respond to treatment with 100 milligrams of Viagra.

For 12 weeks, the men took Viagra in viagra vs levitra
with either the testosterone gel (AndroGel) or a placebo gel. The gel is applied to the skin and is absorbed slowly resulting in an increased blood level of testosterone. Viagra improves erectile dysfunction without causing an increase in testosterone levels.

Researchers gauged the men’s sexual function, quality of life, and testosterone levels at the start of the survey and every four weeks throughout the study.

The men using the testosterone gel along with Viagra improved in every category. Men receiving testosterone gel reported a 34% improvement in impotence compared with a 17% improvement seen in men taking the placebo gel. They also reported a 28% improvement in orgasmic function compared with only a 4% improvement reported in men taking the placebo.

Overall satisfaction also improved, with men receiving AndroGel reporting a 32% improvement compared with a 10% improvement in overall satisfaction in men on placebo.

The benefits were noted about four weeks into the study.

The erectile dysfunction pills
conclude that men seeking treatment for erectile dysfunction should be screened for low testosterone before beginning therapy and using testosterone gel along with Viagra may be better for men with erectile dysfunction and low testosterone levels than just taking Viagra alone.

June 8, 2005 — The FDA has approved Viagra’s active ingredient to treat pulmonary hypertension, a rare, life-shortening lung disorder that causes high blood pressure in the lungs.

Viagra’s maker, Pfizer, a WebMD sponsor, announced the approval in a news release. Pfizer will repackage Viagra’s key ingredient (erectile dysfunction
) and market it as Revatio.

Revatio would be used to improve exercise ability in patients with pulmonary hypertension, says Pfizer. The approved dose is limited to 20 milligrams three times daily. The white, round pills will look different from Viagra’s blue diamonds and should be available by mid-July, says Pfizer.

Rare Condition

Pulmonary hypertension involves dangerously high pressure in the blood vessels that lead from the heart to the lungs. It affects an estimated 100,000 people worldwide, says Pfizer.

Most cases of pulmonary hypertension are due to some underlying condition, such as chronic lung or heart disease. Nearly 300 cases, mostly women in their 30s, are diagnosed per year, says the National Heart, Lung, and Blood Institute (NHLBI). There is no known cause.

Symptoms include difficulty breathing, dizziness, and fatigue. Without treatment, patients live less than three years from the time of diagnosis, on average, says Pfizer.

Another oral drug, Tracleer, is also used to treat the condition. Revatio’s tadalafil alternative
hasn’t been evaluated in patients taking Tracleer, says Pfizer. The drug company says Revatio is the first oral treatment approved for patients with an early stage of the progressive condition.

Study’s Results

The FDA’s approval was based on a study of 277 people with pulmonary hypertension, says Pfizer. Patients were randomly assigned to get a placebo or 20, 40, or 80 milligrams of Revatio three times daily.

After 12 weeks, all three Revatio groups showed “highly significant improvements” in the distance they could walk in six minutes, compared with the placebo group, says Pfizer. Average pressure in the lung arteries and other heart functions also improved with Revatio, and in a year-long trial, 94% of patients taking Revatio were still alive, says Pfizer.

No particular dose had an advantage, and the lowest dose was approved.

Side Effects

Pfizer says Revatio was generally well tolerated, with side effects similar to those seen with Viagra.

The most common side effects for Revatio were headache, citrate sildenafil ups, flushing, insomnia, and nosebleeds. Viagra’s most common side effects are headache, facial flushing, and upset stomach; less common (and brief) side effects are bluish vision, blurred vision, or sensitivity to light, says Pfizer.

Pfizer also recently said it is talking with the FDA about possible label changes to Viagra regarding extremely rare reports of vision loss.rare reports of vision loss. The drug company says there is no evidence that those rare cases occurred more often in men taking Viagra. Pfizer says no such problems were seen in clinical trials of Viagra, and no cases were noted in the Revatio news release.

Ongoing Care Needed

It’s important to get ongoing medical care for pulmonary hypertension, says the NHLBI. The NHBLI also recommends walking for patients who can do so, as well as eating healthfully, getting enough rest, and not smoking. Relaxation exercises, stress reduction, and a positive attitude may also help patients stay active for as long as possible, says the NHLBI.

May 5, 2003 (New Orleans) — Depression takes all the joy out of life, even the joy of sex. Fortunately for many people, many symptoms of depression diminish once they begin treatment with best price for generic viagra
drugs such as Prozac. But for many women, when the depression leaves the sexual dysfunction remains, says H. George Nurnberg, MD, professor of psychiatry at the University of New Mexico.

For these women, he says that Viagra can change their lives.

In fact, he tells WebMD that Viagra is just as good at reversing antidepressant-related sexual dysfunction in women as it is in reversing similar symptoms in men.

And he presented his evidence at the 51st annual clinical meeting of the American College of Impotence vacuum therapy
and Gynecologists.

Nurnberg, who has already published a study in the Journal of the American Medical Association about the efficacy of Viagra in men who have sexual dysfunction associated with treatment for depression, says that 84% of women in his study had a return of sexual enjoyment after treatment with Viagra.

The study enrolled 42 women who had no history of sexual dysfunction before treatment for depression. All of the women were treated with one of the SSRI type of antidepressants such as Prozac or Zoloft, which often have sexual dysfunction as a side effect. All the women were “no longer depressed after being treated with those drugs for six to eight weeks,” he says. But all the women “reported sexual dysfunction related to the SSRI treatment.”

The women are randomly selected to take either Viagra or dummy pills for eight weeks. Neither the women nor the doctors knew which pills the women were getting.

Nurnberg and his colleagues assessed response using a standard psychiatric test designed to measure sexual function. The test, called the Clinical Global Sildenafil citrate 100mg Function or CGI-SF, scores responses about arousal or sexual satisfaction, using a 1 to 7 rating system, with lower scores indicating better functioning.

At the end of the study, “84% of women had a score of 2 or less,” he says. Moreover, he says that Viagra can be given at the same time as the antidepressant, which might make women “less likely to citrate medication sildenafil antidepressant treatment, which is a real problem since only about 20% of women are willing to stick with a full course of antidepressant therapy.” He says that often this reluctance to stay the course with treatment is related to the sexual dysfunction side effect.

Gerald F. Joseph Jr., MD, medical director of women’s services at St. John’s Health System in Springfield, Mo., tells WebMD that Nurnberg’s results are interesting but he is not entirely sold on Viagra. He says, for example, that “placebo effect is very powerful in studies of sexual dysfunction, and I’m not sure these findings are not really just a placebo effect.”

Joseph, who wasn’t involved in the study, says that as a surgeon he thinks the only way that Viagra could work in women is if the women have sexual dysfunction that is “associated with an abnormality in the erectile tissue present in the genitals. Otherwise, it just doesn’t make sense.”