Around 20 years ago, Viagra and two other erectile dysfunction agents hit the medical market, becoming one of the most widely used pharmaceutical drug agents across the globe. These drugs, known as phosphodiesterase inhibitors (PDE-5 inhibitors) were initially trialled as cardiac drugs because they open up arteries. 

When middle-aged males with heart disease in the initial trials asked the researchers for more of these wonder drugs, it was clear they were more than just a tonic for the heart. Once the researchers discovered the increase in sexual performance for middle-aged and older men, where erectile dysfunction is commonplace, a blockbuster drug for Pfizer hit the public and the rest is history. 

The PDE-5 inhibitors work by opening up the arteries to what many males consider the most important organ and thus give (for many men), much stronger erections. But, soon after their release around 20 years ago, with the widespread use of these agents, there were a few deaths reported, raising the concern that there may be some hitherto unknown side-effects from these drugs which could be lethal. 

But, with further research, it was concluded that the handful of reported deaths were the result of the excess physical activity that Viagra, Cialis and Levitra encourage and not the drug itself. There is no doubt that people with serious heart disease should not be engaging in sexual activity unless they have been given full clearance by their cardiologist. Men with heart disease also suffer erectile dysfunction, which in some cases may be the presenting symptom of a heart problem. That is precisely why any person over the age of 50 who wants to engage in vigorous activity of any kind, whether it be sexual or standard exercise, should have some form of cardiovascular assessment. I would suggest a coronary calcium score and stress echocardiogram. 

But, now for the good news. A study released in 2017 reviewed the records 43,000 men, 80 years and younger following a hospital admission for heart attack. They were followed for just over three years after their hospital admission. Those patients who were prescribed one of the three PDE-5 inhibitors, Viagra, Cialis and Levitra, were a third less likely to die and 40% less likely to be hospitalised with heart failure. The study clearly showed that these drugs are not only beneficial for enhancing erectile function but are also good for the heart. There has also been some work showing benefits in a less common condition known as primary pulmonary hypertension. 

The most recent trial, released by Augusta University in Georgia in America has suggested that Viagra reduces colorectal cancer in a mouse model of colon cancer. This study suggested a 50% reduction in the formation of colonic tumours. Whilst the study was only performed in mice, it adds to the body of evidence that whilst enhancing male sexual performance, PDE-5 inhibitors may also be beneficial in a number of other conditions. 

So, the next time you swallow your Viagra, don’t see it as a naughty indulgence, see it as therapy.