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As we've talked about many times, some men report that Viagra helps with premature ejaculation. It can decrease sensation, and it can also help in "rebound time," getting you back in the action very quickly even if you jump the gun a bit.

Also as we've mentioned, a new drug, Priligy (dapoxetine) has come out. Designed initially as an antidepressant, it promises to help with premature ejaculation. It's available now in parts of Europe but it failed to gain US approval a few years ago and it's not clear if it will ever hit the US market.

These two solutions are pills you pop. However, a new study just came out showing that a spray-on anesthetic is effective as well:

The first U.S. trials of a spray-on anesthetic for the penis showed that it increased the time to ejaculation nearly five-fold, providing the first good solution for premature ejaculation, researchers reported today.

There's really nothing new here. Ejaculation delay creams and even condoms have been available over-the-counter for years. Time will tell whether men will find this spray-on worth the trouble - the study reports that it increases average time from .6 minutes to 2.6 minutes. No reports on how it feels to have a slightly numbed penis, though...

It's worth noting that premature ejaculation is often treatable through exercises where men can learn to delay ejaculation themselves. It's quite different from erectile dysfunction which, in many men, has a physical basis and can only be treated with medication.

We already have Levitra, Cialis, and, of course, Viagra. Do we really need another PDE5 inhibitor? The company Vivus thinks we do. Their new drug Avanafil appears to work, and they are hoping to push it as a drug that works faster than the competitors:

"Patients want on-demand therapy because when the mood is right, the mood is right," Wilson said in a telephone interview. "We've shown efficacy in 30 minutes, and no one else has done that."

The company hopes to bring the product to market in 2011. With generic Viagra looming large in this market as Pfizer's drug goes off-patent, it's hard to imagine this new drug achieving too much success. They'll need a stronger selling point than fast action, since Levitra is supposed to work fast, and many users report to us that Viagra works for them within half an hour too, especially on an empty stomach.

Detailed new study shows that Viagra, Cialis, and Levitra do, in fact, work better than hormone treatments for treating erectile dysfunction:

Published in the Annals of Internal Medicine, the new clinical practice guideline finds that for most men who complain of erectile dysfunction, one of the phosphodiesterase type 5 inhibitors -- sildenafil, tadalafil and vardenafil -- is a more effective treatment than pills, creams, gels or patches containing testosterone.

This isn't very surprising, of course. These drugs (so-called PDE5 inhibitors) really work at the plumbing level. They enhance the mechanism the body uses to produce an erection, and so are very effective in producing that result.

Another case of beverages super-powered with Viagra has been uncovered in Malaysia. First it was coffee and now it's fruit juice.

The motivation behind this is obvious. "Generic Viagra" is cheap and easy to produce. Mix it with whatever, and you have a tonic of undeniable effectiveness - a veritable potion of youth. Similarly, "Herbal Viagra" is often nothing more than a few traditional herbs spiked with real Vitamin V.

The main problem with all these concoctions, of course, is that you don't know precisely what dose you're getting. That's why it's best to go with the pharmaceutical-grade varieties. It's important to know exactly what you're taking so you can minimize side effects and maximize effectiveness. 

The blogosphere is abuzz with talk of a "Viagra effect" in Brazil, where older men are marrying much younger woman. This is a problem for the pension system, since the women continue receiving benefits after the man dies.

Of course, as the all of the news articles about this issue make plain, this trend started way before the advent of Viagra.

Fact is, a very young woman looking for sex is going to look to someone about her age. Viagra doesn't turn a 50 year-old man into a 19 year-old man; it only gives him a strong erection. That's a benefit, to be sure, but it isn't some magical love potion. Women marrying much older men are doing so for economic reasons, not carnal ones.

Viagra isn't likely to have demographic effects in this way. Its effects are more small-scale. They are psychological, giving men confidence and removing strain from marriages.

Health officials have called off a promising trial that used Viagra to treat a complication of sickle cell anemia. The study, known as "walk-PHaSST" (Treatment of Pulmonary Hypertension and Sickle Cell Disease with Sildenafil Treatment), was stopped dead in its tracks this month. The drug was making some patients worse instead of better; 38 percent of the subjects experienced serious side effects, compared to 8 percent of those taking the placebo.

The study seemed like a good idea on paper. Sildenafil is approved under the name Revatio to treat pulmonary hypertension, one of the major killers of sickle cell patients.

However, a high number of the patients on Revatio experienced painful "sickle cell crises", in which sickle-shaped blood cells become backed up in blood vessels.

Interestingly, Viagra has had mixed results with regard to another sickle cell complication: priapism. While Viagra has been known to precipitate priapism in men with sickle cell anemia, the drug has also been shown to relieve the condition in other sickle cell patients when given in a steady low dose.

Ultimately, Viagra may prove to have some benefit for certain patients with sickle cell anemia, perhaps when combined with other treatments, but the failure of this study is a major setback.

Interestingly, Cialis sales appear to be growing much faster than Viagra:

One bright spot: Cialis sales in the U.S. were up 16 percent to $149.4 million. Pfizer's Viagra was up only 4 percent at $207 million. Looks like that once-a-day positioning is starting to pay off.

Viagra's been around much longer and has the name recognition, but Cialis has some advantages that shouldn't be overlooked. For one thing, it's much longer-lasting than Viagra (the Cialis folks claim 36 hours). You don't have to time taking the drug so closely to when you expect to have sex; that makes Cialis much more convenient for many men.

As the article alludes to, they are also suggesting that people take a lower dose of Cialis on a daily basis. That way, you'll be ready for whatever comes whenever.

Picking Viagra, Cialis, or Levitra depends on a lot of factors. First of all, some drugs may work better for some men than others. Secondly, how you use the drug, whether you take it with alcohol or how spontaneous your sex life is likely to be, can make a difference. Someone who has sex once a week on a regular schedule might be better off with a dose of Viagra as needed, while someone more active might find daily Cialis a better fit.

Billionaire investor, Midwestern mogul, Friend-of-Bill (Gates). He's known by many monikers, but should we add Viagra aficionado? Warren Buffett opines:

"Our first stimulus bill ... was sort of like taking half a tablet of Viagra and having also a bunch of candy mixed in... as if everybody was putting in enough for their own constituents.  It doesn't really quite have the wallop that might have been anticipated there."

First, note, half a tablet of Viagra is more than enough for most men, if we are talking about a 100mg pill. We even recommend starting with a quarter pill, and we provide a guide to pill splitters to help you make that cut.

We hesitate to offer advice on macroeconomic policy, though we will note that metaphors don't come from nowhere. Might it be that 78 year-old Mr. Buffett is no stranger to the stimulating power of the magic blue pill? If so, he earns mad props, and we wish him many happy returns!.

UK pharmacy chain Boots has been given the go-ahead to dispense Viagra without a doctor's prescription:

Patients will complete a pre-screening questionnaire before having a 30-minute consultation with a pharmacist. The service costs 55 pounds ($90.20) for the initial screening and supply of four tablets and then from 26.59 for four tablets for further supply.

Being forced to complete a detailed questionnaire and having a 30 minute consultation... These patients are going to be much better informed and much better screened than the ones who have to suffer through the process of making, and keeping, an appointment at a doctor's office. This is an obvious case where patient convenience will be matched by better, more thorough health care. It's a true win/win.

Reputable online pharmacies also require detailed questionnaires. The fact is, the average doctor isn't going to do a standardized and detailed inventory of possible risk factors, so even there, you may be getting a more thorough check than doing it in-person.

Pfizer, of course, tried to get Viagra approved as a true OTC drug in Europe but gave up in 2008. This seems like a reasonable compromise. We can only hope it will spread, but I can't imagine them ever making progress in the US. Our puritanical spirit requires us to suffer if we want to have sex. The process has to be difficult, time consuming, and expensive.  Otherwise, we might actually get to have satisfying sex unhindered. And that just can't be allowed, people might enjoy their lives too much.

The disingenuous folks at PETA have a new billboard claiming that "eating meat can cause impotence."

As we've opined before, this is just opportunism with no basis in fact. The funny thing is, their press release mentions meat, eggs, and dairy products as the culprits. So they aren't suggesting people adopt a vegetarian diet, they are suggesting a vegan diet.

We're also informed that "Meat is also murder on animals." Don't get us started on that one.

Even if it is true that a high fat diet isn't healthful, there are plenty of meat-based alternatives that are low in fat. Lean cuts of beef, fish, poultry, skim milk, etc. can (and should) be part of a healthful diet.

Most distasteful is their effort to blame men for erectile dysfunction. Lifestyle choices may, in some cases, be responsible for erectile problems, but most men suffer through no fault of their own. Suggesting otherwise is outrageous.