June 2015 Archives

Thumbnail image for news-icon.jpgThis last week we've seen a good object lesson in that scientific adage: Correlation does not equal causation. 

In 2014, researchers released a study associating sildenafil use with melanoma in U.S. men. The scientists were cautious about drawing any direct causal relationship between the drug and the occurance of skin cancer, but the report was enough to stir up a bit of a scare. Some men undoubtedly stopped taking or decreased their use of Viagra because of it (and some probably reduced their sun exposure instead).  

Now it seems to have been debunked by a doctor who decided to slice and dice the data a little differently.

Urologist Stacy Loeb of New York University took it on herself to look further into the data and the study, in part so she could know how to advise her own patients about the use of ED drugs. She was able to find comparable data about ED drug users from Sweden, which at first seemed to confirm the results of the U.S. study. The data from Sweden also included users of Levitra and Cialis. 

However, when Loeb dug deeper, she found that the relationship between use of ED drugs and melanoma was not as simple as it appeared. When analyzing the data further, Loeb found that rates of melanoma did not increase with the amount or frequency of ED drug use, how many years patients had used them, or the half-life of the drugs (the amount of time they stay in the body). So if ED drugs weren't contributing melanoma, what was?

The apparent answer: socioeconomic status. Call it Lifestyles of the Rich and Virile. Men who can afford Viagra and other ED drugs have more disposable income and have lifestyles that in general put them at higher risk for developing melanoma -- Caribbean vacations, weekends on the golf course, you get the idea. (True, Sweden's healthcare system does cover ED drugs, but it uses a rationing system similar to other countries with national healthcare, so a steady supply would come out of pocket.)

This theory was reinforced when Loeb found similar rates of basal cell carcinoma (a sun-related skin cancer) in the patients with melanoma, indicating there were likely behavioral factors at play. 

So what's the upshot of all this? Loeb says she now focuses on the well-established side effects and health risks of Viagra when counseling patients, since the link to skin cancer seems questionable, but does advise men to take standard precautions such as wearing sunscreen and getting moles checked. Good advice for anyone, regardless of whether you use an ED drug. 

Columbus, OH: Viagra Users -- Don't Drink the Water

Thumbnail image for news-icon.jpgIt's not uncommon for tests of residential drinking water to turn up levels of Viagra and other prescription drugs. We addressed this in another post, explaining how it gets there (what goes in comes out, basically).

But here's a new one: Officials in Columbus, Ohio, are warning Viagra users (along with pregnant women and babies) not to drink city tap water.

The reason? Elevated nitrate levels. And the source is ubiquitous in the heartland: fertilizer. "Elevated nitrate levels are primarily a result of fertilizer and agricultural runoff within the 1,000 square mile Scioto River watershed--80% of which is agricultural," explains the warning on the city's website.

While nitrates can cause a number of serious health problems, from birth defects to ovarian and thyroid cancers, the danger for Viagra users is the way sildenafil interacts with nitrates, possibly causing an unsafe drop in blood pressure. That's why amyl nitrate (used to treat heart conditions, and recreationally as "poppers") is contraindicated with Viagra.

However, it's unlikely that ERs will be swamped with Viagra users who missed the memo: "There's a limited risk; it's a cautionary event," said Henry Spiller, director of the Central Ohio Poison Center of Nationwide Children's Hospital. "These levels are very low -- these levels are less than if you eat a hot dog. ... That said, I want them to take caution."

So, fellas in Columbus, when you knock back that blue pill, be sure to wash it down with bottled water, not tap.

news-icon.jpgViagra now has another outstanding celebrity endorsement! In a recent podcast, WWE legend Stone Cold Steve Austin went public with his use of the little blue pill.

Like some other celebs who have copped to using Viagra, the fifty-year-old Austin stopped short of saying that he actually needed the pill to do the deed: "I can f*ck without Viagra or Cialis, but I f*ck better with Viagra than if I don't take Viagra. So, at 50 years of age, I'm into reality, and the reality is -- at 50 -- I've got more years behind me than I do in front of me. So, I wanna enjoy these next few motherf*cking years to the maximum enjoyment that I can enjoy."

Steve raises a good point: You don't have to be having complete sexual dysfunction to benefit from using Viagra. But sexual function does decline with age, and many men in mid-life simply find that they perform better and more consistently when using the drug. 

Austin mentioned that while he has used both Viagra and Cialis, he wouldn't consider mixing the medications: "[I] take Viagra. I also take Cialis, but you never take those things at the same time. If you're gonna take Viagra, you stick with the Viagra. If you're gonna take Cialis, stick with the Cialis. You can't flip-flop back-and-forth [because] it's bad for you medically." 

Well, Austin's obviously not a doctor, and neither are we, but that seems like sound advice. 

So if you've been on the fence about whether to use Viagra, consider Stone Cold's words of wisdom: "[I]t makes me f*ck better, and when I f*ck, I'm pretty goddamn happy."

"Pink Pill" for Women Moves Closer to Approval

Thumbnail image for research_icon.jpgThe long-awaited "female Viagra" could be on its way soon thanks to an important decision last week by an FDA advisory committee. The committee voted 18-6 to recommend that the FDA approve the drug flibanserin for the treatment of sexual dysfunction in premenopausal women.

The approval is a major victory for the drug's maker, Sprout Pharmaceuticals. In 2010 the FDA committee unanimously vetoed its approval, and Sprout filed an appeal. 

Sprout is not the only pharmaceutical company benefiting from the decision; shares of Palatin Technologies, which is working on a drug similar to flibanserin, also skyrocketed. 

The search for the elusive "pink pill" has been a long one -- because women's sexual response is governed by different physiological and psychological mechanisms than men's, treatment for female sexual dysfunction is much more complex. Unlike Viagra, whose primary effects are focused on blood circulation in the genitalia, flibanserin affects the nervous system and causes changes in the balance of the neurotransmitters dopamine and norepinephrine. In fact, it was originally investigated as an antidepressant. 

Unlike past contenders for the "female Viagra" title, flibanserin seems like it could be the real deal, and the vote for its approval is being hailed as a milestone by advocates of women's sexual health equity, such as Even the Score. Supporters say that the FDA has had a double standard for sexual dysfunction treatments for men and women, and the vote for the drug's approval represents major progress.