---------------------------------------------------------------------------- Pill could enhance a man's sexual performance ---------------------------------------------------------------------------- (September 9, 1997 01:39 a.m. EDT) -- It's the stuff that dreams are made of: A pill that you pop an hour before sex that can revive your flagging sex drive and give you back the stamina of an 18-year-old. Now, it seems, the fantasy is about to become reality.-- in the shape of sildenafil, a new drug developed by the U.S.-based company Pfizer. The discovery that sildenafil could enhance sexual performance in men with erectile problems was a lucky break: the drug was originally developed in Britain for the treatment of angina. Already doctors in the United States, where many of the clinical trials were carried out, are raving about it. "It's the kind of drug I've always dreamed about,"' says Dr. Irwin Goldstein, professor of urology at Boston University Medical School. He stresses that sildenafil is not an aphrodisiac. "It doesn't increase or enhance sexual drive -- it can only be effective when a man is sexually stimulated, but in those situations it can improve and prolong erections,"' he says. When a man becomes sexually stimulated, there is a cascade of chemical reactions in the penis which relax the muscles, allowing increased blood flow which, in turn, produces an erection. In men with erectile problems this cascade mechanism is impaired in some way and the muscle relaxation and engorgement of the penis are curtailed by the release of a further chemical. Sildenafil works by blocking this second chemical reaction, enabling the muscles to relax and increasing blood flow so the man is able to develop and maintain an erection. The drug, a single tablet, has to be taken about an hour before intercourse. "What makes it revolutionary is that it is the first oral treatment which can be used on demand before intercourse,"' says Goldstein. "It is selective to the penis, and the side-effects -- which tend to be those associated with intercourse anyway, such as nasal stuffiness and facial reddening -- are minimal."' The British reaction to sildenafil has been enthusiastic, although quieter. "The results of the trials so far are very encouraging,"' agrees Dr. Alan Riley, honorary consultant in human sexuality at St. George's Hospital Medical School in London. "There is no doubt that sildenafil will be an effective treatment for some men -- those with mild to moderate impotence -- although it's not a panacea that will work for everyone."' He emphasizes the importance of addressing relationship issues, too. "I would like to see sildenafil brought in as an adjunct to sexual therapy rather than a treatment in its own right. We mustn't forget that having the means to get an erection doesn't necessarily mean a man is going to be able to do it."' With impotence affecting an estimated one in 10 men in the developed world, anything that can offer a solution has a potentially massive application, especially when compared with such current treatments as penile implants, vacuum sheaths and self-injection of the penis with a drug that dilates the blood vessels. Although Pfizer insists the drug will be marketed only for the treatment of impotence, Goldstein is certain there will be a huge demand from other men who simply want to boost their sexual performance. "It is designed for impotence,"' he says, "but people like sexual activity and the thought of being able to take a pill to have a better sex life is a very attractive one. I can see college kids putting it in their partners' drinks."' In the long term it's not just men who will benefit. There is evidence that the drug can help women. Because sildenafil improves local blood flow, it can improve engorgement, increasing sensitivity and alleviating problems with dryness -- something that particularly affects post-menopausal women and can make sex painful and uncomfortable. Dr. Tom Lue, professor of urology at the University of California at San Francisco, says there is enormous interest in sildenafil. "It's quite possible that there could be a black market in the drug,"' he says. "We're getting phone calls from all over the U.S. from people who want to get hold of it."' Pfizer hopes to submit sildenafil to the Food and Drug Administration and to Britain's Medicines Control Agency later this year, so it will be some time before it becomes available. By ANNE MONTAGUE, The Guardian Copyright 1997 Nando.net Copyright 1997 Scripps Howard <http://www.nando.net/newsroom/ntn/health/090997/health31_14589_noframes.html> ---------------------------------------------------------------------------- [log in to unmask]