In April 1998, the drug sildenafil citrate, widely known under the trade name Viagra, was approved for clinical use. This moment did not just become the starting point of the existence of another drug on the pharmacological market. It turned out to be the beginning of a new era in the field of sexual medicine, marked by a real breakthrough in the fundamental and clinical fields, as well as in the public perception of sexual pathology.

Viagra has become the first effective and safe oral drug for the treatment of erectile dysfunction (ED)

The attitude towards this disease in medicine has undergone drastic changes over the past hundred years. Currently, there is no doubt that erectile dysfunction, previously considered as a consequence of psychological problems, in most cases is a manifestation of organic damage, often of a systemic nature. The main stages of the development of sexual medicine in the XX century.

The story of the discovery of Viagra is an example of how random observation can have a huge impact on the course of scientific progress. In the course of clinical trials of a new antianginal drug, Pfizer Inc. researchers noted that, although taking the drug is not accompanied by a significant clinical improvement in the course of angina pectoris, in many patients it leads to the development of a kind of side effect, which consisted in improving erectile function. This observation led to the study of the possibility of using this substance in the treatment of ED.

The appearance of Viagra also had a great impact on clinical research in the field of sexual medicine. In recent years, terminology has been clarified and new definitions of various forms of sexual disorders have been developed. Clinical trials of Viagra have become an incentive for the creation of new diaries and questionnaires to assess the state of men’s sexual function. The analysis of demographic indicators of participants in large-scale clinical trials revealed risk factors for ED, which, in turn, contributed to the understanding of its pathogenesis.

The appearance of Viagra had a huge public response

A large number of ED patients who had not previously consulted doctors have received hope for a cure, and by now millions of men around the world have returned to normal sexual life thanks to taking this drug.

Currently, discussions are continuing about the long-term effectiveness of Viagra and the possibility of developing tachyphylaxis. An important characteristic of any pharmacological drug is its side effects. The most common side effects when taking Viagra include headache (7% of cases), redness of the face (7%), dizziness (2%), dyspeptic disorders (1.8%), nasal congestion (1.4%) and visual disturbances, usually in the form of blue staining of objects (1.2%).

In most studies, the frequency of side effects and treatment refusals as a result of their development were comparable in the groups of patients receiving Viagra and placebo. It should also be noted that the frequency of side effects decreases as the drug is taken. So, in the Carson study, the frequency of all side effects, except for visual disturbances and dyspeptic disorders, decreased during the course of taking the drug.

Thus, Viagra became the first effective oral drug for the treatment of ED, with the advent of which a new era in the development of sexual medicine began, thanks to which in recent years it has become an independent section of modern urology.

The research considering Viagra effectiveness

The clinical efficacy of Viagra has been evaluated in a large number of studies conducted in many countries of the world. Taking the drug leads to an improvement in erectile function in patients of different ages, regardless of the etiology, severity and duration of ED.

The effectiveness of the drug is long-term, and the vast majority of patients continue taking Viagra years after the start of treatment. Side effects of Viagra in most cases have moderate severity and their frequency decreases during the administration of the drug.

Taking Viagra does not adversely affect the state of the cardiovascular system, moreover, it is accompanied by an improvement in the functional state of the vascular endothelium, violations of which play an important role in the pathogenesis of various cardiovascular diseases. The possibility of correcting endothelial dysfunction with the use of Viagra in the future may lead to an expansion of indications for the use of this drug.