Monday, May 25, 2015

What is vitamin D toxicity, and should I worry about it since I take supplements?

Vitamin D toxicity, also called hypervitaminosis D, is a rare but potentially serious condition that occurs when you have excessive amounts of vitamin D in your body.
Vitamin D toxicity is usually caused by megadoses of vitamin D supplements — not by diet or sun exposure. That's because your body regulates the amount of vitamin D produced by sun exposure, and even fortified foods don't contain large amounts of vitamin D.
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The main consequence of vitamin D toxicity is a buildup of calcium in your blood (hypercalcemia), which can cause poor appetite, nausea and vomiting. Weakness, frequent urination and kidney problems also may occur.
Treatment includes the stopping of excessive vitamin D intake. Your doctor also may prescribe intravenous fluids and medications, such as corticosteroids or bisphosphonates.
Taking 50,000 international units (IU) a day of vitamin D for several months has been shown to cause toxicity. This level is many times higher than the Recommended Dietary Allowance (RDA) for most adults of 600 IU of vitamin D a day.
Doses higher than the RDA are sometimes used to treat medical problems such as vitamin D deficiency, but these are given only under the care of a doctor for a specified time frame. Blood levels should be monitored while someone is taking high doses of vitamin D.
Although vitamin D toxicity is uncommon even among people who take supplements, you may be at greater risk if you have health problems, such as liver or kidney conditions, or if you take thiazide-type diuretics. As always, talk to your doctor before taking vitamin and mineral supplements.

Thursday, May 14, 2015

How should I use this Viagra medication?

The usual recommended dose is 50 mg taken as needed, approximately 30 to 60 minutes before sexual activity. However, the medication may be taken any time from 4 hours to half an hour before sexual activity. Based on the effectiveness and side effects of the medication, the dose may be increased to 100 mg or decreased to 25 mg.
The maximum recommended dose is 100 mg and it is not recommended to take more than one dose per day. Sildenafil may be taken with or without food, but taking it with a high-fat meal may increase the time before the medication starts working.
Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.
It is important to take this medication exactly as prescribed by your doctor. Do not take higher doses of this medication than those prescribed by your doctor. Contact your doctor if you take a greater dose of sildenafil than prescribed.
Store this medication in its original package at room temperature, protect it from moisture, and keep it out of the reach of children.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
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What form(s) does this medication come in?

25 mg
Each blue, round, diamond-shaped tablet, marked "PFIZER" on one side and "VGR 25" on the other side, contains sildenafil citrate equivalent to 25 mg of sildenafil. Nonmedicinal ingredients: anhydrous dibasic calcium phosphate, croscarmellose sodium, FD&C Blue No. 2 Aluminum Lake, hypromellose, lactose, magnesium stearate, microcrystalline cellulose, titanium dioxide, and triacetin.
50 mg
Each blue, round, diamond-shaped tablet, marked "PFIZER" on one side and "VGR 50" on the other side, contains sildenafil citrate equivalent to 50 mg of sildenafil. Nonmedicinal ingredients: anhydrous dibasic calcium phosphate, croscarmellose sodium, FD&C Blue No. 2 Aluminum Lake, hypromellose, lactose, magnesium stearate, microcrystalline cellulose, titanium dioxide, and triacetin.
100 mg
Each blue, round, diamond-shaped tablet, marked "PFIZER" on one side and "VGR 100" on the other side, contains sildenafil citrate equivalent to 100 mg of sildenafil. Nonmedicinal ingredients:anhydrous dibasic calcium phosphate, croscarmellose sodium, FD&C Blue No. 2 Aluminum Lake, hypromellose, lactose, magnesium stearate, microcrystalline cellulose, titanium dioxide, and triacetin.
Who should NOT take this medication?
Do not take sildenafil if you:
  • are allergic to sildenafil or any ingredients of this Viagra medication
  • are taking any type of nitrate medication in any form (oral, sublingual [under the tongue], skin patch, or spray). Nitrate medications include nitroglycerin and related medications that are used for the relief of chest pain or angina. They also include amyl nitrite "poppers." Use of these medications with sildenafil could cause a sudden severe drop in blood pressure that could lead to dizziness, fainting, heart attack, or stroke.
  • have been advised by your doctor not to engage in sexual activity
  • have a history of vision problems related to nerve damage to the retina caused by decreased blood flow
Nitrates are found in medications that are used to treat angina (chest pain). If you are not sure if you are taking nitrates, ask your doctor or pharmacist.
Nitrates must NOT be taken by anyone who is using sildenafil because they can cause your blood pressure to drop very low. This may cause dizziness, fainting, heart attack, or stroke.

Monday, May 11, 2015

Erectile dysfunction

Erectile dysfunction: Viagra and other oral medications

By Mayo Clinic Staff
Viagra, Levitra or Cialis is often the first oral medication tried for erectile dysfunction. For most men who have trouble keeping an erection firm enough for sex (erectile dysfunction), these medications work well and cause few side effects.
Sildenafil (Viagra), vardenafil (Levitra or Staxyn) and tadalafil (Cialis) are all medications that reverse erectile dysfunction by increasing nitric oxide, a chemical naturally produced by your body. Nitric oxide opens and relaxes blood vessels in the penis, helping you get and keep an erection. These erectile dysfunction medications don't increase your sex drive and only cause erections when you are sexually stimulated.
 
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Viagra, Levitra and Cialis — How they're different

Although they work in similar ways, each of these medications has a slightly different chemical makeup. These minor differences affect the way each medication works, such as how quickly it takes effect and wears off, and the potential side effects. Your doctor will consider these factors when deciding if one of these medications is a good choice for you. Your doctor will also consider any health problems you have and possible interactions with other medications you take.
 Viagra, LevitraCialis (small dose daily)Cialis (36-hour)
How to take itWithout food, no more than once a dayWith or without food, once a dayWith or without food, no more than once a day
When to take itAbout 30-60 minutes before sexAnytimeAbout 30 minutes before sex
How long it's effectiveUp to 5 hoursAnytime between dosesUp to 36 hours
Vardenafil (Levitra) can also be prescribed in a tablet that dissolves on the tongue (Staxyn).
A new medication, avanafil (Stendra), was approved in April 2012 by the Food and Drug Administration for treating erectile dysfunction. Stendra works similarly to Viagra, Levitra and Cialis.

When these medications may not be safe

Not all men can safely take erectile dysfunction medications. They can be dangerous if you have certain health problems or you're taking particular medications. Erectile dysfunction medications may not be safe if you have:
  • Heart problems, including reduced blood flow (aortic stenosis or left ventricular outflow obstruction), heart pain (angina), abnormal heart rhythms (arrhythmia) or a recent heart attack
  • High or low blood pressure that isn't controlled
  • A history of stroke within the last six months
  • Eye problems, such as retinitis pigmentosa, or if you have a family history of certain eye problems
  • Severe liver disease, including cirrhosis
  • Kidney disease that requires dialysis
Never take Viagra, Levitra or Cialis if you take nitrate drugs to treat heart pain (angina). Like Viagra, Levitra and Cialis, nitrate drugs dilate blood vessels. Their combined effects can cause dangerously low blood pressure and loss of consciousness. Medications that contain nitrates include:
  • Nitroglycerin (Nitro-Bid, Minitran, others)
  • Isosorbide (Dilatrate-SR, Isordil, Monoket, others)
  • Illegal drugs such as amyl nitrite or "poppers"
Tell your doctor about any medications you're taking. A number of other drugs can also interact with Viagra, Levitra or Cialis. They include:
  • Alpha blockers
  • Antibiotics
  • Anti-seizure medications
  • Blood thinners
  • Anti-arrhythmic heart medications

Side effects

Most men who take Viagra, Levitra and Cialis aren't bothered by side effects. When side effects do occur, they can include:
  • Headache
  • Flushing (with Viagra and Levitra)
  • Indigestion
  • Stuffy or runny nose
  • Back pain and muscle aches (with Cialis)
  • Temporary vision changes, including "blue vision" (with Viagra and Levitra)
  • Dizziness or fainting (rare)
In a small number of cases, men taking Viagra, Levitra or Cialis have reported more serious side effects:
  • Hearing loss or vision loss. Some men have had sudden loss of hearing or loss of vision after taking one of these medications. However, it isn't clear whether vision or hearing loss was directly caused by taking the medication or by a pre-existing condition. If you're taking one of these medications for erectile dysfunction and have sudden loss of hearing or vision, seek medical help right away.
  • An erection that doesn't go away on its own. Called priapism, this rare condition can be painful and requires medical treatment to avoid damage to your penis. If you have an erection that lasts more than four hours, seek medical attention.

Blindness Noted in Men Using Impotence Drugs

Federal health officials are probing reports of blindness among dozens of men who used Viagra and other impotence drugs — but at the same time cautioning that the vision loss can be linked to the same illnesses that lead to impotence.
The Food and Drug Administration disclosed Friday that it was in discussions with the makers of Viagra, Cialis and Levitra about what the labels of those drugs should say about the rare cases of varying degrees of vision loss, including blindness. The maker of Cialis already has voluntarily added a one-line mention to its label.
At issue is sudden vision loss when blood flow to the optic nerve is blocked, a condition called NAION or non-arteritic anterior ischemic optic neuropathy.
The FDA has 43 reports of NAION among the impotence drug users: 38 for Viagra, four for Cialis and one for Levitra, said spokeswoman Susan Cruzan.
Those are rare numbers, given that Viagra alone has been used by 23 million men worldwide since its approval in 1998, according to maker Pfizer Inc.
Also complicating the question: NAION is considered one of the most common causes of sudden vision loss in older Americans, and estimates suggest there are anywhere from 1,000 to 6,000 cases a year. Risk factors include diabetes and heart disease, two of the leading causes of impotence.
Still, “we take this seriously,” Cruzan said.
Side effects include vision problems The questions come at a time when federal regulators and the drug industry are facing criticism about what they do to ensure the safety of drugs already on the market. Pressure on the FDA to investigate reports of side effects has increased since Merck & Co. yanked its pain reliever Vioxx from the market last year because of potentially deadly heart trouble.
Big money is at stake. Pfizer Inc. said in its most recent quarterly filing with the Securities and Exchange Commission that sales of Viagra rose 5 percent — to $438 million — in the first quarter of the year.
 
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Pfizer shares declined Friday on the New York Stock Exchange after news of the blindness cases.
Viagra and its competitors are blockbuster drugs that revolutionized treatment of erectile dysfunction, and they already come with serious warnings: They’re not to be used by men who take nitrate-containing drugs, because the interaction could cause deadly drops in blood pressure, or by men with heart conditions whose doctors have warned that sex itself could be too much exertion.
We also warn about temporary vision changes — seeing bluish tinges or having difficulty distinguishing between green and blue. The drugs apparently have a temporary effect on the retina, a different issue from NAION.
Viagra also is at the center of controversy over Medicaid’s payment for prescriptions of the drug for convicted sex offenders in New York and other states.
Some evidence of connection 
The possibility of a link with blindness was raised publicly earlier this year, when Dr. Howard Pomeranz of the University of Minnesota reported in an ophthalmology journal seven patients who reported NAION vision loss occurring within 36 hours of a Viagra dose.
“A definite causal relationship cannot be established at this time,” Pomeranz wrote.
Viagra and its competitors work by slightly dilating arteries so that blood flow in the penis increases. Whether it affects blood flow to the eye isn’t known, but Pomeranz argued that some effect on the optic nerve is plausible.
So he urged that ophthalmologists ask NAION patients whether they use impotence drugs, and report any additional cases. Also, Viagra users who suffer NAION in one eye should be cautioned that continued use might raise the risk of vision loss in the other eye, Pomeranz wrote.
The loss of vision is permanent.
Pomeranz told MSNBC Friday that "the drug is doing something to alter the circulation of blood to the optic nerve and in turn causing an injury to the nerve resulting in a loss of vision."
The patients in the study had a history of high blood pressure and an anatomical risk factor involving the optic nerve.
"If a patient takes the medication and 45 minutes later suddenly notices the onset of vision loss, to me that’s certainly some evidence there is a connection between the two," Pomeranz told MSNBC.
Because the drugs affect blow flow a connection "makes sense," NBC's chief science correspondent Robert Bazell told MSNBC Friday. He added that the condition is rare and there isn't yet cause for widespread concern.
But publicity over the FDA investigation could result in more cases coming forward, said Bazell, noting that a bigger study examining the link is needed.
'Confident about safety' 
Levitra is sold in the United States by GlaxoSmithKline PLC and Schering-Plough Corp. and overseas by Bayer AG.
Viagra was approved by the government in 1998. It may aid in the treatment of enlarged hearts that can

Wednesday, May 6, 2015

How Does an Erection Occur? Complete guide with full of useful instructions.

In order to get an erection, several parts of the body must work together. The brain sends a message of sexual arousal through the nervous system to the penis. This message causes the muscles along the penis to relax. At the same time, the artery to the penis dilates to twice its diameter, increasing the blood flow sixteen-fold, and the veins which carry blood away from the penis are blocked. As a result, the two spongy-tissue chambers in the shaft of the penis fill with blood and the penis becomes firm. A breakdown in any of these systems makes getting or keeping an erection difficult.

How is Impotence Diagnosed?

Virtually all men occasionally fail to get an erection. That's normal. But if a man has trouble getting or maintaining an erection about 25 percent of the time, he should see an urologist. These physicians specialize in disorders of the kidneys, bladder, prostate, penis and urethra.
Usually, after asking questions about when and how the impotence developed, the urologist will give the patient a complete physical exam to determine if his hormone levels are normal and if the blood vessels, nerves and tissues of his penis are working properly. If this initial work-up doesn't pinpoint the cause of the problem, a nocturnal penile tumescence test can be done.
Men with no physical abnormalities almost invariably have nightly erections during sleep. The patient may spend a few nights in a sleep laboratory where a gauge that measures the frequency and duration of nocturnal erections is attached to the base of the penis. A home version of this, the snap-gauge test, can also be used. Before going to sleep, the patient attaches the gauge to the base of his penis. During the night, the gauge will break at different degrees of penile rigidity and show whether a partial or full erection has taken place during sleep. If nocturnal erections do not occur, the impotence is most likely physical. Additional testing is then required to identify the precise cause of the problem.
To Help Prevent Impotence
  • Exercise regularly
  • Limit the amount of fat and cholesterol in your diet
  • Drink only in moderation
  • Don't smoke
What Are the Physical Causes of Impotence? 
Physical impotence occurs when there is a problem with any of the systems needed to get or maintain an erection. The good news is that potency can usually be restored when a man is treated for underlying medical conditions, when medications are adjusted or when lifestyle habits are changed.
Here are some of the top causes of impotence:
  • Vascular Disease. Hardening of the arteries can affect the artery leading to the penis so that it cannot dilate enough to deliver all the blood necessary for an erection. Impotence can also occur if the nerves that control blood flow to the penis are damaged.
  • Diabetes. One out of every four impotent men has diabetes, which can cause nerve deterioration (diabetic neuropathy). Impotence may result if nerves or blood vessels that control the flow of blood to the penis are affected. In some cases, keeping the diet and blood sugar under control can decrease impotence. But permanent nerve damage can result in a chronic problem.
  • Disease of the Nervous System. Some conditions, such as multiple sclerosis, Parkinson's disease and spinal cord injuries, can affect or cause impotence.
  • Cancer Surgery. Surgery to remove cancer from the prostate, bladder, colon or rectal area can cause impotence if the nerves and blood vessels that control erections are damaged in the process of removing cancerous tissue.
  • Medications. Some prescription medications for high blood pressure, depression, spinal cord injury, diabetes and other conditions can cause temporary impotence by interfering with the nerve impulses or blood flow to the penis. Doctors may be able to adjust the dosage of a drug or change the medication to reverse or minimize the problem.
  • Smoking. A recent study at the New England Research Institute in Watertown, Massachusetts, found that impotence was equally common among smokers and non-smokers in general. However, among men with certain health problems, those who smoked were much more likely to have potency problems. For example, 56 percent of smokers with heart disease were completely impotent compared with only 21 percent of non-smokers with the disease.
  • Alcoholism. Excessive alcohol consumption disrupts hormone levels and can lead to nerve damage. This type of impotence may be reversible or permanent depending on the severity of the nerve damage. Some clinical studies suggest about 25 percent of all alcoholics become impotent -- even after they stop drinking.
  • Hormone Imbalance. Abnormal testosterone levels are rare, but they can cause impotence. In addition, other illnesses, such as kidney failure and liver disease, can disrupt the balance of hormones.
What Are the Psychological Causes of Impotence?
A man who is depressed, under stress, or worried about his "performance" during sex may not be able to have an erection. Qualified therapists or counselors who specialize in the treatment of sexual problems can often help diagnose and sort through these problems. Some impotence problems can be solved when a man understands the normal changes of aging and how to adapt to them. For example, as men get older they generally need more direct stimulation to achieve an erection. They may also have less firm erections, take longer to ejaculate and need more time between erections.

Impotency and Viagra

Background and information on alternatives to Viagra
The penis is a vascular organ which requires exercise. A healthy male will normally experience 3 to 4 erections during their sleep which may last a hour or more each. They are a normal body function whose purpose is to oxygenate the penile erectile tissue. Its inability to achieve and maintain an erection suitable for vaginal intercourse is called "male erectile dysfunction" (ED) or impotency, for short. Impotency affects over 30 million men and their partners. To some men impotency is a symbol of the loss of their manhood, and can be critical to a man’s ego and self-image. And often, because of this, some men are afraid to seek help. And, often when he does, the physician feels uncomfortable or is unable to help because many aren’t aware of the options. If the truth were known, however, virtually 100% of impotency problems can be successfully diagnosed and treated, whether physical or emotional, unless there is permanent injury or severance of the nerves and or vascular supply necessary in the erectile process.
The appropriate treatment for impotence depends upon whether the cause is physical or psychological. A man whose impotence is psychologically based generally still has erections during sleep, whereas an individual whose impotence is physical in origin usually does to. One easy, inexpensive way to test for nocturnal erections is with postage stamps. Glue a strip of stamps around the shaft of the penis before going to bed. If the ring of stamps is broken in the morning, the cause of the impotence is likely psychological. If the strip is unbroken, the impotence is likely physiological. You can also purchase a kit called Snap Gauge from UroHealth Corporation. This test is designed to detect the measure the rigidity of erections experienced during sleep. Call 800.328.1103 for more information.

Tuesday, May 5, 2015

5 Ways to Protect Yourself From Payday Loan Scams

Need cash fast? You aren't alone. Many people find themselves in a bind with payday looming far ahead. Payday loan services offer the cash you need right away. However, it is important not to let the allure of fast money get in the way of your common sense. Many predatory people and phony companies out there operate to separate unsuspecting victims from their money. Payday loan scams are common throughout the country, and it is important with the advent of online applications to be careful of scams if you are considering a payday loan. Not only could you lose money, but you could put yourself at risk for identity theft.
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Why would a person need a payday loan?
Payday loans function as short-term loans that you can obtain quickly, without the hassle of paperwork and credit checks. Banks are often not an option if you need an amount under $500, especially for people with poor credit. Payday loans are often advertised as great for emergencies, but most Americans take them to cover ordinary living expenses. According to the results of Pew Charitable Trust's "Payday Lending in America" study, 69 percent of those interviewed used their first payday loan to cover utilities, credit card payments, rent or food.
The problem with payday loans is the fees, which are usually very high. States that allow payday lending generally have regulations and laws in place to help protect consumers; however, getting stuck in a cycle of debt is easy to do. The risks are high, even if you are using a legitimate, law-abiding payday loan service. The biggest risk of all is falling victim to one of the many payday loan scams out there. So how do you protect yourself?
Steps to avoiding payday loan scams
1. Check for a license. States that allow payday loans offer a license that businesses can apply for which certify them as a direct payday lender. It's important to check for this license when you're looking into a payday loan service because a licensed business must comply with state laws in order to keep from having it revoked. This means if you have a problem, you have far more protection on your side. Shady loan services will often either be unlicensed or operate from outside the U.S. so they don't have to abide by any rules and regulations. These are the services to avoid because borrowing money from them means you are essentially unprotected.
2. Watch for hidden fees. Read the terms presented to you carefully before signing anything. Hidden fees are one way predatory lending companies pull the wool over unsuspecting customers' eyes. Most states have a maximum for how high the fee-per-$100 borrowed can be. Check what that fee is so you'll be able to tell if you're getting charged more than you should.
3. Don't send any money in advance. Ever read a news story about someone who sent money off to Nigeria because they were told they'd inherited a large sum of money? Payday loan scams are rife with this kind of trickery. Often, a disreputable service will ask you to send money to cover the cost of taxes or application processing. This is bogus, and a sure sign you are not dealing with a legitimate payday loan service. Authentic payday loan services will collect all associated fees when your payment comes due.
4. Make sure you can contact them. It is much easier to deal with a lending service if you can speak with representatives on the phone. Even better, many payday loan services have physical locations where you can talk to someone in person. What you want to watch for are services that only provide an email address for contact. It's also good to locate a physical address to be sure you are dealing with a company that is based in the U.S. (and thus subject to federal rules and regulations).
5. See how they rate on the BBB. While it isn't a perfect method of ensuring reliability, the Better Business Bureau is a good resource for consumers. Through the BBB, you can find information on the company, including whether it has had any past violations, how many customer complaints have been received, how the company has handled these complaints and a rating of its overall performance. Can't find the service in the BBB database? It might be that no complaints have ever been filed, or it might be that the company is not registered in the U.S.
Aren't all payday loan services scams?
No, not all of them. Companies like LendUp take a different approach compared to many of their peers. Repeat borrowers earn points they can use to borrow more money for longer periods of time and receive lower APRs. Points are earned through making timely payments and taking online financial education courses. The best part? LendUp reports your payment progress to the three major credit bureaus -- Equifax, TransUnion and Experian -- to help build your credit, which most payday loan services don't do.
Certainly, the payday loan industry is rife with fraud and abuse, but if you are in a bind, there are services that can help you out. Again, it is not recommended to take out more than one payday loan. If you need extra money before your next paycheck arrives, you should try other options available to you -- such as borrowing from friends or an advance from your employer -- before turning to a payday loan service. But if you must, here is a list of reviews of the most popular payday loan services.

Monday, May 4, 2015

Everything you need for an all-night party ... his and hers Viagra

It's the newest recreational drug of choice for young men - bought illicitly in bars and nightclubs. Naomi Harper, 28, and her boyfriend wondered what all the fuss was about. And then they tried it ...

At 28 you should be too old to be experimenting with drugs. But I'm at least 30 years too young to be messing about with the blue tablets in the palm of my hand. I'm not normally coy about drugs, but there's something about the idea of Viagra that makes me pause. These are not the sort of things you get given in a club. These are huge, thick-looking, old people's pills.
 
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I take a deep breath and pass one over to my boyfriend. 'Cheers,' he says, with a nervous smile. I put the blue diamond on my tongue and swallow it down with a heavy gulp.

I first heard about taking Viagra for fun when my boyfriend's housemate Dominic bounded into the kitchen one morning, grinning and flushed with a new-found cockiness.

'What's the greatest number of times you guys have had sex in one night?' he demanded. 'Take that number and double it, because that's a night on Viagra. You've got to try it. You both should.'

 
I laughed, but wasn't too surprised - there are few things my friends wouldn't try. We have good jobs but few responsibilities. Even though some of us are doctors, journalists, management consultants and lawyers, we spend our free time indulging ourselves like wealthy, overgrown teenagers.

It turns out that many of my friends have enjoyed taking Viagra, either on its own or in combination with other recreational drugs. If you are used to taking illegal substances at the weekend, the prospect of popping something medically approved shouldn't be very daunting.

My friends have a few cautionary tales, though. One says Viagra stops him from sleeping properly. Another complains of a blue haze affecting his vision whenever he takes it. And my friend Rahul once found it an embarrassing inconvenience. 'I popped it one time and failed to get laid,' he tells me. 'I walked back from the girl's house the next day, and the mere chaffing of my boxer shots against my penis as I walked turned me on.'

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If I am being offered Viagra, then there must be a large market for it on the recreational scene. I decide to investigate.

Viagra was initially designed as a heart drug, but clinical trials showed it was no more effective than cheaper medicines already on the market. When Pfizer tried to abandon the trial, the male patients refused to stop taking it. It was only then that the side effect that has made Viagra famous was discovered.

Dr Graham Jackson, a consultant cardiologist at Guy's hospital, was part of the original research team when Pfizer developed Viagra. He explains that there are actually three different drugs on the market: Viagra, Cialis and Levitra. Levitra and Viagra work in about an hour and last around six hours, but Cialis takes two hours to work and lasts up to 48 hours.

'There's a recreational circus going on with these drugs,' he says. 'You can get Viagra from any cab driver now. Nothing much would happen if someone without erectile dysfunction took Viagra, although they might think they feel better, psychologically. But it would make a difference if you took it along with other drugs. Cocaine, marijuana, ecstasy, alcohol, nicotine, crystal meth - they all can cause erection problems. Viagra dilates the blood vessels and allows blood to flow into the penis when these drugs are stopping it.'

Little is known about the effects of Viagra on women, and Dr Jackson thinks results will never be proven clinically. Pfizer set up a female sexual dysfunction unit a few years ago, comparing Viagra in women to a placebo, but the study had to be stopped because 85 per cent of the women responded to the placebo. It seems that even the very idea of Viagra is enough to make some women aroused.

'There's no documented evidence of any major catastrophe with people taking these drugs recreationally, but it's not the sort of thing that's reported,' he says. I'm surprised when he tells me Viagra could even make certain illegal drugs safer: 'Cocaine is a very dangerous drug because it causes coronary arteries to shut down and can give you a massive heart attack. It's dreadful. And in a funny way, Viagra can actually help a cocaine user, because it does the opposite thing to the blood vessels.'

The danger with Viagra comes when users buy it online or from dealers instead of going through a doctor. 'Men with erection problems and no cardiac symptoms are cardiac patients until proved otherwise. They should get their drugs from a doctor and be evaluated. But for most young people, taking Viagra won't do any harm. Nothing much would happen.'

With this in mind, I think there can be no harm in trying it once. I've heard that you can now get Viagra over the counter at Boots, but only if you are a man aged between 30 and 65, and the idea of explaining myself to a pharmacist is distinctly unappealing. Instead, I browse through my junk mailbox to see what's on offer. All the junk mail directs me to the same single website: a Canadian online pharmacy promising Viagra, Levitra and Cialis for upwards of $7 a tablet. Dr Jackson had warned of buying Viagra this way: you can never know if the right ingredients are in the pills, and in what quantities.

My best option is to buy some from my friend Andy, a regular user who gets his supply from a dealer he trusts. He is pleased to oblige, and produces a bulging wrap of clingfilm containing at least 15 tablets. For a man who claims to have taken Viagra 'only eight or nine' times, he has a very healthy supply. He charges me a tenner for two chunky pills and sends me on my way with a wink.

When the big night arrives, I'm not really in the mood, and my boyfriend is reluctant. He has never had any problem performing before, no matter what substances he has taken, and he's worrying about what the extra encouragement might do to him. I'm a little concerned about that, too - what if it does nothing to me but turns him into a priapic pest all night?

We sit awkwardly on my sofa, waiting for the pills to take effect. After about 45 minutes, I'm feeling a little flushed. Boyfriend has gone a bit red in the face, too. Dr Jackson mentioned this was a possible side effect, but I've cranked the heating up in my flat, so maybe I'm just imagining things. Boyfriend says he still feels nothing.

But 15 minutes later, I'm as red-faced as a clown, and certainly relaxed. There's a comforting buzz going through me, even though my heart is racing. Boyfriend looks up at me. 'I think it works,' he says. 'See what you think.'

And the evidence before me seems to suggest that it does - for him, at least. I begin to notice a slight difference in myself, too - perhaps a heightened sensitivity? I can't be sure.

After three hours of not being sure, we pass out, exhausted.

In the cold light of day, I wonder if I'll do Viagra again. It's not an aphrodisiac. It doesn't make you more aroused; it just distributes blood around your body in a certain way, and in my boyfriend's case, a particularly welcome way. Dr Jackson isn't quite right when he says Viagra won't have any effect on a healthy young man - my boyfriend certainly had some added exuberance - but the difference is mechanical, rather than emotional.

It's the idea of Viagra that is powerful. The idea is enough for women to become aroused even if they are taking a placebo pill. It's enough for my friends to believe they can be porn stars for a night. But the truth of Viagra is that it is a failed heart drug with an unusual side effect. It's a drug manufactured for people that have syndromes and conditions. And that idea just isn't sexy enough for me to want to take it again.

My boyfriend says never say never, though.