side effects during the decade from 1998 (the year
Viagra was approved) through 2007, Viagra has been
implicated in at least 1,824 deaths mostly from heart
attacks. Cialis (approved in 2003) has been linked to
236 deaths, and Levitra (2003) to 121. In addition,
the three medications appear to have caused or
significantly contributed to at least 2,500 nonfatal
heart attacks and other potentially serious heart
problems, and more than 25,000 other potentially
serious side effects, among them: mini-strokes, vision
loss, and hearing loss.
So how can the FDA call them safe? And what can
men do to protect themselves?
How Safe is “Safe”?

'Prudent Use'

I’m not saying that erection drugs should be avoided.
As prescription medications go, they’re fairly benign—
but with one big caveat, the unsettling number of
cardiovascular problems and deaths. If you’re a man
interested in erection medication, here are some
suggestions for safe use. Discuss them with your
doctor:
• If you take nitroglycerin for angina or any nitrate
medication, you absolutely cannot take erection
medication.
• If you don’t smoke, aren’t overweight, get regular
exercise, don’t drink more than two alcoholic
beverages a day, and don’t take drugs to control high
cholesterol, high blood pressure, or diabetes, you’re at
low risk for cardiovascular disease, and can probably
take an erection drug safely.
• But the more risk factors you have for heart disease
—smoking, obesity, diabetes, sedentary lifestyle,
alcohol abuse, high cholesterol, and/or high blood
pressure—the more problematic erection drugs are
likely to be.
I repeat: There’s no proof that Viagra et al. increase
risk of heart attack and stroke. But if I were at
significantly elevated risk for heart disease, I’d use
these drugs cautiously if at all. I’d take the lowest
dose that did the job. And I’d monitor my reactions
carefully. The FDA may call erection drugs “safe,” but
with more than 200 monthly reports of side effects
(and probably many more unreported), use these
drugs cautiously.

'Great Sex Without Erections'

Erections are fun, but the fact is, they’re not
necessary for either great sex or male orgasm. There
are plenty of marvelously satisfying ways for men to
make love without an erection, and in an erotic
context with sufficient stimulation by hand, mouth, or
intimacy gadget, men with semi-erect or even flaccid joysticks
can have marvelous orgasms

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