The three sex pills

I wrote an article in 1998 about Viagra, a headliner around the world then when it was first introduced that year. Two decades next year, Viagra and its competitors, Cialis and Levitra, still arouse interest worldwide.

Levitra from $1.05

Sildenafil (Viagra), the wonder pill for the treatment of erectile dysfunction (ED) in men, was approved by the US Food and Drug Administration on March 27, 1998 and sold as hot cakes that same year . More than 400 million dollars were sold in the first quarter, 10,000 recipes a day. This blue pill was found to be very effective and safe. It increases marriages and relationships. Surgical procedures for ED have been drastically reduced since this pill was introduced.

Then came the competitors! Vardenafil (Levitra) was approved in September 2003, and on November 21, 2003, Tadalafil (Cialis) was released. To date, these 3 ED pills are the most popular, dominant and effective regimens in the management of erectile dysfunction and have been found to be also very helpful in improving erection even among those without ED. More than 20 percent of failed marriages and broken relationships are due to erectile dysfunction.

Although its mode of action is basically the same: they are a class of drugs called PDE-5 inhibitors. They block an enzyme called phosphodiesterase type 5, boosting a chemical in our body called nitric oxide, which relaxes the muscles of the penis and opens the veins, allowing more blood to enter and fill the veins of the penis, causing engorgement and maintaining the erection.

Original research: Serendipity

The original laboratory studies on these PE-5 inhibitors focused on their vasodilatory effects as potential drugs in the treatment of coronary heart disease and hypertension. However, the researchers observed that experimental male mice that received the PDE-5 inhibitor developed erection and chased the female mice. This discovery would serendipity that the side effect of the PDE-5 inhibitor was even a larger and more welcome discovery than the original intention to develop a new vasodilator for cardiovascular diseases. The side effect (erection) in this case far exceeded the “original intent” for drug use. This is an incident where the side effect is most useful and beneficial.

Other uses

These ED pills (PDE-5 inhibitors) are also prescribed for other medical conditions, such as myocardial infarction, pulmonary hypertension (including among children), preeclampsia, Crohn’s disease, and infertility.


Some people think that Viagra, Cialis and Levitra are aphrodisiacs. No, they are not, because none of them increases libido (sexual desire). These 3 just improve erection and keep it for a successful sex. When taken, man develops a sense of certainty, security and confidence, which could incidentally increase desire in both partners.

Directions for use

Those who could benefit from any of these 3 PDE-5 inhibitors are those who are unable to initiate and maintain erection for a successful sexual relationship, regardless of age, including those age 20, where stress and psychological condition Affect their sex life negatively. One does not have to have a complete erectile dysfunction to benefit from these pills as they have been found effective and save since they were introduced almost 20 years ago.

ED Statistics

Cleveland Clinic reports that 52 percent of men have erectile dysfunction, “which affects 40 percent of men in their 40s, and 70 percent of men in their 70s.” Men who are on high pressure pills, beta blockers, etc., from ED development. Urology Care Foundation says that 30 million American men have occasional problems (mild to moderate) when they get or keep an erection.


These three drugs for ED belong to a class of medication and have similar pharmacological action: PDE-5 inhibitors. All three react with nitrates (heart medicines that open the arteries), which could cause a drop in blood pressure and shock, even death. Those taking nitrates SHOULD NOT take any of these drugs for ED. These three are in oral form and there is a generic version of this drug ED still, and it takes about 30 before planned sex. Any of these 3 medical consultation needs before use to rule out any contraindication and danger, since each individual reacts differently to medications. You need a prescription to buy ED pills. They all cost almost the same. Your security logs are also similar.


While their action, use and effectiveness are basically the same, there is difference between these three pills for ED. Viagra and Levitra remain in the bloodstream for about 4-6 hours; Cialis, 17-18 hours, longer lasting. Other differences are its side effects.

Side effects

The following side effects are common among the three: nasal congestion, headache, upset stomach, priapism (erection, painful, persisting), sudden cardiac arrest, death (which are very rare). The differences: temporary change in vision and redness are more in Viagra and Levitra. Back pain and muscle aches are more with Cialis. The alcoholic beverage reacts more with Cialis, causing dizziness, less with Viagra and Levitra. But, as Shakespeare wrote: “Alcohol increases desire but decreases performance.”


Any of these three ED drugs react dangerously with nitrates, drugs that dilate (open) the coronary arteries used in the management of coronary heart disease. A person taking a nitrate medication (such as nitroglycerin, isldil, imdur, peritrate, nitrostate, nitroderm, nitrolingue, nitrocide, etc.) should NEVER take any of these three ED pills because the combination will lead to severe Blood pressure, shock and possibly death. Consult your doctor if the erection does not go away in 4 hours, a condition called priapism, where the penis is so engorged causing pain, one that needs urgent medical attention.


Deaths related to the use of any of these three ED pills are suspected due to the inadvertent concomitant use of nitrates. New studies have shown that these PDE-5 inhibitors may also increase platelet aggregation in diseased coronary arteries causing blood clots, and heart attack in some individuals.

“It is comforting that … in general, for most patients, even those with existing coronary [heart] disease … resumption of sexual activity is very unlikely to trigger a [coronary] event,” according to Murray A. Mittleman, MD, researcher and cardiologist at Beth Israel Deaconess Medical Center in Boston.

All evidence-based clinical information around the world today shows that these three PDE-5 inhibitors are effective and safe when used according to the standard medical advice and under the supervision of an attending physician.

Dr. Philip S. Chua, MD, FACS, FPCS, Emeritus Cardiac Surgeon in Northwest Indiana and President of Cardiac Surgery from 1997 to 2010 at Cebu Doctors University Hospital, where he holds the title of emeritus physician in surgery, is headquartered in Las Vegas , Nevada.