© SasinParaksa / fotolia.de

On 27 March 1998, the first erectile dysfunction drug was approved in the United Kingdom. It has fundamentally transformed the sex lives of many men. An expert explains who can benefit and who should be cautious.

Viagra was supposed to alleviate heart problems. But in the drug trials, many subjects discovered a pleasant side effect: The medicine improved and prolonged erectile ability. "For the first time in human history, there was a pill that could really help affected men," says Dr. Christian Leiber, head of the Andrology Section in the Department of Urology at the Medical Center - University of Freiburg. Meanwhile there are now other medicines with similar functional principles. In an interview, the expert answers frequently asked questions.

Dr. Leiber, how do Viagra and similar drugs work?

Sildenafil - the active ingredient in the original blue pill - and most similar drugs inhibit a specific enzyme responsible for the regression of the natural erection. The medicine makes the penile vessels dilate further and longer, so that more blood flows into the erectile tissue and a better erection is thus achieved. But nevertheless, sexual stimulus is still needed. Otherwise nothing happens.

Whom do the medicines help?

Men who have erectile problems for psychological reasons almost always benefit from taking them. That's the majority of those affected. But if high blood pressure or diabetes are the cause of the disorder, then these medicines only help about one patient in three. Those affected should talk to a cardiologist about the treatment, especially as erectile problems can also be a warning sign of an impending heart attack. If nerve injuries are the cause, for example after a prostate cancer surgery, the medicine usually does not help at all.

What does erectile dysfunction mean for the men affected?

For most men, erectile dysfunction is a serious burden. It can also jeopardize a partnership if the man conceals the issue and the partner misinterprets it as lack of interest. Incidentally, it is often partners who ensure that men finally see a doctor.

What should the men affected do?

First, they should go to the doctor. Because for one thing, these drugs only help a specific group of patients. For another, in a worst-case scenario, life-threatening interactions with heart medications can occur.

Many men order the medicine online, mostly out of shame. What do you make of that?

I must strongly advise against the online purchase of low-quality products without a prescription. It is often impossible to tell what ingredients are in the pills. And because the patent protection on three of the four available medicines has expired, many cheap generic preparations are now also available in the pharmacy. Fortunately, this makes counterfeit versions much less attractive.