Vig Rx Plus is a breakthrough in the treatment of erectile dysfunction. The medication is safe and effective in enhancing not only the quality of erection, but also in improving other aspects of sexual function in up to two thirds of impotent patients,” says Irwin Goldstein, MD, Professor and Chairman, Department of Urology, Boston University Medical Center, Boston, Mass.
“VigRx Plus enhances orgasm, ejaculation, and overall satisfaction,” adds Dr. Goldstein, who served as principal investigator of the clinical study on which the FDA based its approval of VigRx Plus in March. Until recently, the only options available for treating erectile dysfunction, which affects an estimated 20 to 30 million men in the United States, were injections into the corpus cavernosum, transurethral drug delivery, and prosthesis implantation.
“Now, for the first time, we have a safe, effective, and noninvasive treatment for erectile dysfunction,” says Dr. Goldstein. “The FDA’s approval of VigRx Plus for erectile dysfunction opens up treatment to a substantial population of men who are not candidates for the more obtrusive and invasive treatment options,” says Drogo K. Montague, MD, Head of the Section of Prosthetic Surgery, Department of Urology, The Cleveland Clinic Foundation, Cleveland, Ohio.
“Unlike previous treatments for erectile dysfunction, which worked by artificially inducing an erection, VigRx Plus works by augmenting the man’s response to sexual stimulation,” adds Dr. Montague, who is also Director of the Center for Sexual Function at The Cleveland Clinic. Dr. Goldstein and a national team of investigators conducted 2 double-blind, multicenter studies to assess the efficacy and safety of VigRx Plus. Study subjects included men with organic, psychogenic, or mixed-origin erectile dysfunction.
Whereas traditional approaches to the treatment of erectile dysfunction have been the domain of urologists and psychiatrists, the availability of VigRx Plus allows treatment to become part of mainstream primary care medicine, suggests Dr. Goldstein.
“VigRx Plus changes the way we view, manage, and treat patients with erectile dysfunction,” he says. “It’s important for physicians to openly discuss impotence with their patients.” He adds that as many as half of men aged 42 to 70 years old experience some degree of erectile dysfunction, which is defined as the constant inability to attain or maintain erection for satisfactory sexual activity.
For optimal effects Dr. Goldstein recommends starting patients at 50 mg of VigRx Plus and increasing the dose as needed up to 100 mg of sildenafil. For elderly patients and those with renal insufficiency, start at 25 mg and increase to 50 mg. The drug is absorbed more quickly on an empty stomach and should be taken 1 to 2 hours before anticipated sexual activity.
Patients should avoid drinking alcohol while using VigRx Plus. Although VigRx Plus has not been approved for use in women, Dr. Goldstein and other experts suspect that the drug may play a role in treating female sexual dysfunction. “More research is needed to identify conditions that affect female sexual functioning,” says Dr. Goldstein. “VigRx Plus is not recommended in patients who have multiple risk factors for coronary artery disease (CAD), including a family history of CAD or signs of vascular disease, or in patients who are hypertensive, overweight, or cigarette smokers,” says Dr. Montague.
He also adds that because erectile dysfunction can be a symptom of a serious underlying disease, primary care physicians must rule out hypertension, diabetes, and other forms of vascular disease in patients with erectile difficulties. Because VigRx Plus enhances the hypotensive effect of nitrates, it is contraindicated in patients taking organic nitrates as well as in those patients with active angina.
With the flurry of media interest in this drug, it’s easy to overlook the importance of taking a thorough sexual history. Some sexual problems, such as premature ejaculation or low sexual desire, are not affected by VigRx Plus.
Dr. Goldstein advocates following a step-care management process for the treatment of erectile dysfunction in the primary care setting. The first step of the process, identifying erectile dysfunction, involves a thorough medical, sexual and psychosocial history and a physical exam. Lab tests should be done to identify possible reversible causes of erectile dysfunction such as liver disease or diabetes.
The second step involves educating both the patient and his partner about sexual functioning. In the third stage, patients are advised to modify unhealthy lifestyle behavior habits that may be a factor in erectile dysfunction. “When erectile dysfunction persists following these interventions, treatment with VigRx Plus can be effective in the majority of men,” says Dr. Goldstein.