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More doctors trust Viagra...sound like the tagline for an ad? It's true, though. In a Harris poll of almost 800 physicians, Viagra and Cialis were the most trusted drug brands. The surveyed doctors were asked questions about drugs in four categories: erectile dysfunction drugs, antidepressants, antipsychotics, and non-insulin diabetes drugs. Out of a possible 100 points, Viagra and Cialis ranked highest, tied at 82.

Since the poll asked subjective questions about familiarity with brands and the doctors' dispositions toward the manufacturers, it's arguable that the winners were just the drugs with the highest advertising profiles, or who gave out the best schwag.

It's true - Pfizer pours a lot of money into advertising, and some claim the company has recruited attractive females, including graduating college cheerleaders, to act as sales reps. But all that wouldn't be enough to hold the product up if it was truly terrible. The truth is, it delivers.

Viagra is no doubt well-regarded in part because of Pfizer's efforts in marketing and building relationships with doctors, but it's also a solid product. It works as advertised for most individuals for whom it's prescribed, and patients are satisfied with the result.

PDE-5 inhibitors are also fairly uncomplicated drugs, are predictable in their actions, and don't have serious or lasting side effects or require a lot of dose adjustment. So doctors can feel pretty confident in prescribing them.

Looks like Viagra's not the only thing that needs a warning label about four-hour erections. A man is suing BMW, claiming one of its motorcycles gave him a case of priapism that has lasted two years. After riding the cycle in May 2010 for four hours, he developed an erection that wouldn't quit - and apparently still hasn't.

He blames the design of the seat, which rather than being wide and padded, is narrow and ridge-like, concentrating pressure and vibration at a delicate juncture. The plaintiff is suing BMW and the seat manufacturer, Corbin Pacific, for damages including lost wages, hospital bills, and emotional distress. He is reportedly still unable to have normal sexual relations.

It's times like that when you need a pill that works like Viagra in reverse.

While the case is unfortunate, and no doubt uncomfortable for the poor guy, it may bring some attention to an often overlooked cause of erectile dysfunction: motorcycle and bicycle riding, especially with unpadded seats. The pressure of the seat and the vibrations of the road can indeed cause impotence, which has been confirmed by studies. One Japanese study found some degree of ED symptoms in one-quarter of their sampling of regular motorcyclists.

Just goes to show, when it comes to putting the fun between your legs, there can be too much of a good thing.

There's no way around it: Viagra is one of the most competitive keywords for search engine optimization. That's why, when Google rolled out a new algorithm meant to yield more relevant search results by penalizing over-optimization, bloggers used the V-word to test it out.

The results were not impressive. Or, at least, mixed.

This particular update went after, among other things, "exact match domains" - domains that are identical with the keyword or words. Which meant that Pfizer's official site for the drug, Viagra.com, actually dropped in the search rankings. Meanwhile, a lot of really sketchy stuff started floating to the top - unrelated sites that had obviously been hacked.

The website of Lois Lowry, children's literature author, is currently still on the page-one results for Viagra - with a warning from Google that the site "may be compromised". No kidding. Unless Ms. Lowry has switched careers and is now a pharmaceutical rep, that site has no business being in those search results anywhere.

The general consensus, among users and webmasters alike, is that this update didn't work so well, and actually worsened search results in some cases, with legitimate websites taking hits in their rankings. But Google is continually tweaking, so no doubt it will take that feedback and use it to adjust its next algorithm in the war against webspam. Unfortunately, in the battle between black hat SEO and Google, there always seems to be some collateral damage.

As expected, the FDA approved avanafil, the newest erectile dysfunction drug. No word on when it will actually go to market

It will be interesting to see if the drug catches on. Viagra is such a well established brand, it's synonymous with erectile dysfunction drugs as a class (that may actually be a synedoche, rather than a synonym, but I'm not sure -  it's been a while since Lit 101). Viagra has a loyal following, especially among older users. Not to stereotype, but with age sometimes comes a resistance to change - or an attitude of "If it ain't broke, don't fix it."

So unless guys are really unhappy with Viagra's wait time or having bad side effects, I would guess that not a lot of current users would switch. On the other hand, Stendra might appeal to younger users looking into using ED medication for the first time.

The 30 to 60-minute lead time required for Viagra works adequately for couples who have an established sexual relationship, or even a routine. Stendra's 15 to 30-minute activation time, however, fits better with the lifestyles of casual daters and more spontaneous types.

It also takes some of the guesswork out of that important decision: whether to pop the pill in the first place - and leaves less time for things to go off the rails or for your partner to lose interest before the main event begins.

In any case, at this point the drug's maker, Vivus doesn't pose much of a threat to the Viagra empire. Analysts project annual sales for Stendra to be $300 million next year, compared to the $2 billion Pfizer netted in 2011 for Viagra sales.

There may soon be a new upstart entering the ED market - in a few days, the FDA will be reviewing Avanafil, the quick-acting PDE5 inhibitor.

The drug has already been approved in Korea, and has gone through Phase III testing in the US. Chances are, it will get approved in the US.

So, will another ED drug have an impact on the market? Probably not much, given that they all do pretty much the same thing. Avanafil's benefit is that it gets things going a bit faster than Viagra or other drugs and therefore might appeal to different users:

"Men who have a pattern of sexual activity that's predictable -- every Saturday night, or something like that, don't need this." Dr. Ira Sharlip a urologist at UC San Francisco and expert in the field of sexual medicine, sees the drug appealing to those who have more casual or sporadic encounters "If you see that things are heading in that direction, you pop a pill and are ready in 15 minutes, if  correct."

On the other hand, Avanafil clears the system quicker, so while it may cut down the wait time for the fun to start , it may be over sooner too.

One thing Avanafil has in its favor is that the side effects seem to be milder, especially the more serious cardiac symptoms. The headaches and stuffy nose just seem to come with the territory, but most users tolerate them.

Sharlip had an interesting take on some of Viagra's other supposed side-effects. "Despite what the FDA says, I have never seen priapism from any PDE5 inhibitor drug. Priapism is just not a clinical problem. Blue vision with Viagra is uncommon and at worst annoying. Most men who get the blue vision with Viagra don't care about it," he said.

Huh. I'd think that would be a little disturbing, but who knows - maybe some people like looking at the world through Viagra tinted"glasses.

Somebody at small-to-midsized pharma company Teva Pharmaceuticals must  have a real David-and-Goliath complex, or a chip on their shoulder the size of a Subaru. After doubling down on their previous patent challenges to Pfizer - and getting hit with some hefty penalties - Teva is taking another run at the Viagra empire in their bid to win rights to pump out a generic version of the drug. But this time they're attacking from the north, as Teva Canada Limited leads the charge, taking their case to the Supreme Court of Canada.

Their last angle didn't fly with the courts, so they're trying a new tack - claiming Pfizer's patent should be invalid because the drugmaker didn't provide enough information about Viagra's active ingredient. According to Teva, Pfizer's application gave a laundry list of ingredients, but didn't single out sildenafil as the active compound. Little late to be bringing that up now, don't you think?

That's maybe not as extreme as Teva's previous claim that Pfizer committed fraud when it filed it's initial patent for Viagra. Apparently the court doesn't find it frivolous, since it agreed to hear the case - but maybe the court is planning to make Teva an example of what not to do.. 

On the other hand, if they win, the payoff for Teva could be huge - they could sue for years of lost sales.

Counterfeit Viagra smugglers are finding more creative ways of getting their products to market. Last month, Canadian border patrols intercepted a March 12 shipment of rice cookers from China that were filled with bogus Viagra and Levitra. The innocent looking appliances, covered with floral decals, concealed the contraband under their lids and inside their electrical works.

The pills came in authentic-looking blister packs, marked with expiration dates. Officials say some of the pills contained no pharmaceuticals at all, while some contained four times the amount of a real tablet. The 2,400 pills had an estimated value of almost 50K.

While we certainly don't condone counterfeit Viagra, we have to say, this has got to be the most perfect cooking accessory if you're planning on making any of our Viagra recipes. Or if you like to have sex in the kitchen frequently.

Here's a good case for never being caught without your Viagra: a 43-year-old German man found himself unexpectedly on a one-night stand gone wild. After meeting his partner, an apparently insatiable cougar four years his senior, in a Munich bar, the two repaired back to her apartment. There she put him through his paces...again, and again, and again.

She persisted even after the poor guy was exhausted, but "because he saw no other alternative, he complied with the woman's wishes another few times so he could finally leave the apartment," a police spokesman said.

So, that would be - what? seven, eight, ten times they got it on by then? Even after that, she still wouldn't let him go and blocked his exit from the apartment. Eventually he fled onto a balcony, where he took refuge and called for police. And when they arrived? - she tried to seduce them too.

Come to think of it, maybe Viagra was to blame for getting the guy into this mess to begin with. I mean, how could he physically perform that many times without some help? But even though Viagra might have raised her expectations of his stamina, there are reasonable limits to what it can do.

As for the woman, she's facing possible charges of assault and illegal restraint - and will probably be hearing from a few drug companies looking to harness the secret of her unstoppable libido for a female Viagra drug.

In entertainment news, our favorite drug plays a supporting role in Stand Up Guys, a gangster dramedy in the works, starring Al Pacino, Alan Arkin, and Christopher Walken.

Stand Up Guys already sounds like a Viagra joke just from the title, especially when you find out it's not about comedians doing club routines, but about geriatric hitmen out for one night of living it up before one of them has to take the big sleep.

Apparently the evening's adventures include Viagra, because Al Pacino ends up in the emergency room after OD'ing on it. Cue Julianna Margulies. Yes! Nurse Carol Hathaway from ER. No typecasting here.

Margulies character treats Pacino's "condition", but before you get any ideas, remember that the treatment for priapism usually involves inserting shunts or using syringes to draw off excess blood from the engorged organ. If that's not enough to make you cringe, how about Pacino in a hospital gown?

Rumor has it that female senators in Ohio pushing for legislation that will require men to take a cardiac stress test and watch Stand Up Guys before obtaining a Viagra prescription.

Having trouble getting it up? Maybe you just need a hug.

The latest news from the erectile dysfunction front is a recently published case study is that  the "cuddle hormone" oxytocin, which is  linked to emotional bonding between sexual partners and mothers and infants, has been found to have dramatic effects on male libido and erectile capability, at least in some individuals.

Same as Viagra, the discovery of oxytocin's effect on male performance was accidental. The subject described in the case study was given the hormone in a nasal spray to help with social phobia and social difficulties related to Aspberger's syndrome. It helped some with that, but the unexpected payoff was in the bedroom.

His libido improved, going from "very weak" to strong, and his erections and orgasms were better - 46% better, going by a assessment scale someone dreamed up to quantify these things.

However, the  treatment was not without its side effects. The man "also hugged a work colleague in a 'very out of character' way." 

Since this is only one case, there are still a lot of unanswered questions. Will the hormone work similarly for men without Asperger's? Other research on oxytocin indicates it might, as over 25% of men in an unrelated study experienced improved erections when given oxytocin. Viagra also stimulates oxytocin production, which may account for part of its effect.

Only time will tell how this will pan out, but one of the scientists involved with the discovery and development of Viagra predicts that an oxytocin-based treatment could have 'blockbuster potential'.