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Timing, food can be important with Viagra

DEAR DR. ROACH: My husband and I have had a happy relationship for many years. Our lovemaking has been a pleasure. Now, we have to add Viagra. Sometimes it works; sometimes not. Is there anything we can do to enhance its effectiveness? Or is there something else you can recommend that would work consistently? — Anon.

ANSWER: Sildenafil (Viagra) and similar medicines have been effective for many who have difficulty achieving and maintaining adequate erections. They are not effective for all, and many have a misunderstand about how they work.

Viagra does not increase libido, the desire for sexual contact, in men or women. It changes the way blood flows in and out of the penis. Erectile dysfunction can be caused by circulation problems such as blockages in the arteries; neurological problems; endocrine problems, especially low testosterone; and relationship issues. Viagra helps to some extent, but reconsider whether there is an underlying medical issue, both before prescribing it and periodically while taking it, especially if it isn’t working as well.

Oftentimes the problem with Viagra working intermittently is that it is affected by food. Food slows down absorption of the medication, making the optimal time of administration more difficult. I have repeated the advice I heard from a urologist: “Take Viagra at 6, have dinner at 7, and you are good until midnight.” Viagra does become progressively less effective in some, requiring higher doses to have the same results. Or, switch to another Viagra-like drugs, which have greater flexibility with timing and food.

DEAR DR. ROACH: I am a 69-year-old male in good health except for a low testosterone count of 109. I wonder about the benefits, risks of therapy. I read that injection can lead to very high and then very low counts, but the patch can be potentially dangerous to my spouse. Can you clarify? — A.D.

ANSWER: Testosterone is an important hormone for men and women, although men have much higher levels. It has critical functions including promoting bone and muscle strength, and favorable effects on blood cholesterol types and levels. Plus, it is necessary for healthy sexual function.

Although very high levels of testosterone are have significant risks, replacement suggests an overall benefit. There are oral forms, injection and transdermal (patch and gel). Most men now prefer the gels or patches, which tend to be consistent

Women and children should not handle the medication. Your spouse is at low risk if you wash your hands carefully after application and avoid skin contact until it has dried. Avoid getting the area of application wet for five hours after application.

(Roach is a columnist for the North American Press Syndicate. Write to him at 628 Virginia Drive, Orlando, FL 32803.)

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