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INTRODUCTION
Advancements in the field of science have a tremendous effect in the lifestyle of people around the world. The things which we were only conceiving in our minds a long time ago came into reality after years of research and testing of the greatest minds of every century. The pursuit for the elixir of life has become a race for most developed countries so a lot of them are investing a lot of money, time and effort just to bring quality life in every household around the globe, most especially to those who can afford.

With these evident realities at hand, it is undoubtedly a fact that aside from the prolonging of life span, production of goods which are luxurious and would give immediate satisfaction is also being held as a primary consideration. In medical science, one such thing that has brought so much change in the lifestyle of people is the manufacture of Viagra, a drug that has been popular among people of all ages and races for adding more color to one of the basic needs of humanity---sex.

BRIEF HISTORY
It is safe to remember that Viagra is not for everybody. Originally, Viagra was developed by Pfizer as a drug to help men who were suffering from chest pain. However, sildenafil citrate, the active ingredient of Viagra, as a heart medication did not show progress of attaining its purpose and studies were stopped in 1992. Yet, based on published information about some properties contained in sildenafil citrate, Pfizer researchers began to look at it as a treatment for erectile dysfunction. Erectile dysfunction can also be termed as impotence or the difficulty to have an erection or maintaining it among males. Re-evaluation for its effect on the ability of men with ED to engage in sexual activity, and the ability to achieve and maintain erection sufficient for satisfactory sexual activity was taken.

Later, the clinical trials conducted by the researchers found Viagra to be so effective that the FDA approved it only six months after submission, and without consulting an advisory committee of outside experts because there were no troubling questions and no significant side effects. In furtherance to its primary uses, Viagra is being tested against pulmonary hypertension in children and infertility in women.

HOW IT WORKS
Basically Viagra’s appearance is bluish, diamond-shaped tablets with 25mg, 50mg, or 100mg strengths embossed on one side, denoting tablet strength. It works by dilating blood vessels throughout the body, allowing blood to flow more readily to the heart, lungs and other organs. Moreover, Viagra relaxes smooth muscle contractions in the penis. Around 70 percent of men using it reported some improvement in achieving and maintaining an erection. Effects normally begin within 30 minutes and last about 4 hours.

Since Viagra is only for those who have erectile dysfunctions, the drug must be taken orally once a day, one hour before the sexual activity. Viagra is not meant to be taken regularly for a prolonged period. Just take it when you need it.

An important thing to remember also is, you should not take Viagra if you are using nitrate drugs to control angina pain because the combination of the nitrate drugs and Viagra can lower your blood pressure dangerously putting your life in danger. The combinations of drugs are life-threatening for you. If it gives you an allergic reaction, do not use it again. Also, if you have severe heart problems where sexual activity can be a danger to your life, do not take Viagra.

AFTER EFFECTS
Side effects of using Viagra include headache, flushed skin, and anxiety. Its serious risks can include distorted vision and priapism -- a painful, prolonged erection that may require medical intervention. Historically, 69 deaths were linked to Viagra during its first three months on the market so the U.S. Food and Drug Administration issued a warning against using it with amyl nitrate ("poppers"), nitroglycerin, and nitrous oxide since each dilates blood vessels, thus, a dangerous drop in blood pressure can result, leading to possible heart attack or stroke.

ADDICTIVE?
Probably yes. Firstly, men who take Viagra to obtain even greater pleasure from their sex life become so much used to the drug that they find their love life uninteresting without the use of Viagra, as compared to earlier. Secondly, to some men, the effect of Viagra may decrease with time hence these men are less likely to have a non Viagra erection as compared to earlier when they did not take Viagra. Moreover, some men with no performance problems except psychologically may take even far larger doses of the drug to satisfy their own perception of a satisfactory sexual performance.

CONCLUSION
With the facts given, the question now is, “Is it for you?” Think it over. Never rush.
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Kamagra (Generic Viagra) [sildenafil citrate], manufactured by Ajanta Pharma, Ltd, this drug is the first cyclic guanosine monophosphate [cGMP] specific phosphodiesterase type 5 enzyme inhibitor. This enzyme helps in regulating the blood circulation in the penile tissue. This leads to better penile erection.
Kamagra (Generic Viagra) is primarily indicated in the treatment of impotence [erectile dysfunction]

The compound sildenafil was synthesized in Pfizer’s research lab in Kent, England. Believe it or not, sildenafil was actually being studied for the treatment of hypertension and angina pectoris. Angina pectoris, or chest pain, caused by an insufficient supply of oxygen and decreased blood flow to the heart muscle. Angina is frequently the first sign of ischemic heart disease. However, during the phase 1 clinical trials, it was found that instead of having a remarkable action on angina, this drug was very effective in inducing penile erections, the main pathology behind erectile dysfunction.
The drug was patented in 1996, approved for use in erectile dysfunction by the Food and Drug Administration on March 27, 1998, becoming the first oral treatment approved to treat erectile dysfunction in the United States
Needless to say, this drug has become a household hit.

Erectile dysfunction:
Erectile dysfunction (ED) is defined as the inability of a man to achieve or maintain an erection sufficient for his sexual needs or the needs of his partner
Erection of the penis during coitus or otherwise is a result of increase in the blood flow of the arteries of the penis and simultaneous relaxation of the smooth muscle of corpora cavernosum. This whole process is due to the release of nitric oxide (NO) from nerve terminals and endothelial cells, which stimulates the synthesis of cGMP in smooth muscle cells. Cyclic GMP in turn, relaxes smooth muscle and resulting in an increase in the blood flow to the corpus cavernosum.
In erectile dysfunction, enough blood does not flow in the arteries of the penis to cause a sufficient erection.
Causes of erectile dysfunction:
With reduced libido:
- hypogonadism
- depression
With intact libido:
- psychological problems, including anxiety
- vascular insufficiency [atheroma]
- neuropathic [diabetes mellitus, alcohol excess, multiple sclerosis]
- drugs [beta blockers, thiazide diuretics]
.An organic cause can be found out in about 50% of the cases of erectile dysfunction; the rest are either psychogenic in origin or are due to a psychiatric illness such as depression which requires appropriate drug treatment. Systemic diseases like chronic liver or kidney diseases and drug addiction are important causes and should be looked for. In case of any psychogenic problem, even the partner should be actively involved in the counseling therapy
The physiologic mechanism of erection of the penis involves release of nitric oxide (NO) in the corpus cavernosum of the penile tissue during sexual stimulation. Nitric oxide then activates the enzyme guanylate cyclase, which results in increased levels of cyclic guanosine monophosphate (cGMP), producing smooth muscle relaxation in the corpus cavernosum and allowing inflow of blood. Kamagra (Generic Viagra) [sildenafil citrate] has no direct relaxant effect on isolated human corpus cavernosum, but enhances the effect of nitric oxide (NO) by inhibiting phosphodiesterase type 5 (PDE5), which is responsible for degradation of cGMP in the corpus cavernosum. When sexual stimulation causes local release of nitric oxide, inhibition of PDE5 by sildenafil causes increased levels of cGMP in the corpus cavernosum, resulting in smooth muscle relaxation and inflow of blood to the corpus cavernosum. Sildenafil at recommended doses has no effect in the absence of sexual stimulation.
There are many types of PDE, each having varied function. The plus point of Kamagra (Generic Viagra) [sildenafil citrate] is that it is PDE 5 selective, though it can also act on the other types of PDE. In fact higher doses or plasma levels of the drug is thought to be associated with defects in color vision due to its action on PDE 6.
Kamagra (Generic Viagra) [sildenafil citrate] has a 4,000-fold selectivity for PDE5 versus PDE3, which is concerned with cardiac contractility.

Indications:
- Erectile dysfunction. This is the main indication whereas for the indications given below, sildenafil is not in the first line treatment regimen.
- pulmonary arterial hypertension
- prevention of high altitude pulmonary edema associated with altitude sickness
- treatment of benign prostatic hypertrophy [BPH]-associated lower urinary tract symptoms [LUTS]
Indications under investigation:
- Relieving female sexual dysfunction. Several studies have indicated the drug may be effective in improving libido and arousal in women taking selective serotonin uptake inhibitors (SSRIs)
- Treatment of infertility. Women who have had repeated failures with in vitro fertilization (IVF) due to poor development of the endometrium [tissue that lines the uterus] may benefit from treatment with vaginal suppositories containing sildenafil.
- Esophageal motility dysfunction (achalasia), since it can enhance nitric oxide production.

Contraindications:
- patients on nitric oxide drugs since sildenafil potentiate the hypotensive effects of nitrates, and its administration to patients who are using organic nitrates, either regularly and/or intermittently, in any form is therefore contraindicated.
- There is a degree of cardiac risk associated with sexual activity, especially in elderly people above the age of 60 years. There is increase incidence of mortality and morbidity with KAMAGRA (GENERIC VIAGRA) [sildenafil]
- Severe hepatic impairment (decreased liver function)
- Severe impairment in renal function
- Hypotension (low blood pressure)
- History of stroke or heart attack
- Hereditary degenerative retinal disorders (including genetic disorders of retinal phosphodiesterases)
Side effects:
The most commonly reported side effects of KAMAGRA (GENERIC VIAGRA) are headache, flushing of the face, upset stomach, and nasal congestion.
Other less common side effects include, but are not limited to:
• vision problems, including sensitivity to light, blurred vision, and a color tinge to vision
• urinary tract infection
• diarrhea
• dizziness
• rash
Dosage:
Administered in the dose of 50 mg one hour before the intended sexual activity. Based on effectiveness and toleration, it can be increased to 100 mg or decreased to 25 mg.

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Generic Propecia, also called finasteride, is a drug that is used to treat male pattern hair loss. It is only approved for use in adult men. Finasteride is a type of drug known as an enzyme inhibitor, and is also known as an anti-androgen. It was first used to treat benign prostate enlargement. It blocks an enzyme called 5-alpha-reductase, which is necessary to change testosterone into another hormone called dihydrotestosterone, or DHT. High levels of DHT are associated with male pattern baldness, so reducing levels of DHT sometimes has the effect of slowing, stopping, or reversing male pattern baldness.


In male pattern baldness, DHT is critical to the process of follicular miniaturization and eventual destruction of hair follicles. Like testosterone, DHT is a steroid, but DHT has a greater affinity for locking onto androgen receptors. When this happens, the combination receptor-DHT molecule enters the nucleus of follicular cells, altering the rate of protein synthesis in men predisposed to baldness.


In 1992, finasteride was introduced under the brand name Proscar, which is a treatment for prostate enlargement. Drug studies of the 1 mg dose of Proscar showed that it had the effect of slowing, stopping, or reversing male pattern hair loss. In 1997 the US Food and Drug Administration approved Finasteride for the treatment of male pattern baldness.


Finasteride, the generic version of Proscar, can be manufactured and sold inexpensively by manufacturers in India because Indian law only protects the process by which drugs are made, and not the actual drug. This means that if a drug company in India finds a new way to manufacture an existing drug that is still under patent, it can do so legally.


It is important to know that finasteride does not treat other types of baldness, such as baldness due to diseases like lupus. The effects of finasteride on baldness only last as long as the medicine is taken. If you stop taking finasteride, any hair gained from using it will eventually fall out. It usually takes at least three months of taking finasteride every day to find out if it will stop or reverse male pattern baldness. It is important not to miss any doses, because it only works if taken every day.


Side effects of finasteride :

Side effects that are possible, but rare include impotence, decreased sex drive, breast enlargement, testicular pain, or decrease in quantity of ejaculate. If these occur, you should contact your doctor.


In some patients, a decline in DHT is associated with depression. If you have symptoms of depression, contact your doctor for advice.


Who should not take finasteride :

Women and children should not take finasteride, and should not even handle finasteride tablets. The drug has been found to cause birth defects, and it can be absorbed through the skin. Therefore, it must not be handled by children, or women who are pregnant, breastfeeding, or of childbearing age.


Before prescribing you finasteride, your doctor also needs to know if you have a history of liver disease, prostate cancer, urinary tract disease, and drug allergies.


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Category: Men’s Health