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Viagra vs. Cialis - Any Differences?

Sources:

The online pharmacy viagra Myth: The Surprising Impact On Love And Relationships by Abraham Morgentaler
The Viagra Alternative: The Complete Guide to Overcoming Erectile Dysfunction Naturally by Marc Bonnard, Marc, M.D. Bonnard
Viagra: A Guide to the Phenomenal Potency-Promoting Drug by Susan C. Vaughan
The Harvard Medical School Guide to Men's Health : Lessons from the Harvard Men's Health Studies by Harvey B. Simon, Harriet Greenfield

Viagra and Cialis are both drugs used to provide a man with an erection. They serve similar purposes, and also work in similar ways. They differ mostly in popularity.

Some men have erection difficulties, such as erectile dysfunction. Impotence is another word this dysfunction is known as. Impotence happens to a lot of men. Some men sometimes have trouble getting or keeping an erection. Most men, in fact, will have a problem getting an erection at some time in their lives. About half of all men in the United States between the ages of 40 and 70 have erectile dysfunction to some degree as studies show. For others it happens more often.

That male erectile dysfunction can often be treated is the good news. To improve their sex lives Viagra has been used by about 16 million men around the world. First they have to get help with talking to their doctor and getting treatment. There is treatment for male erectile dysfunction.

Viagra and Cialis are both prescription drugs. They have to be prescribed by a doctor. They both work by increasing bloodflow to the penis.

These prescription drugs have helped about millions men around the world improve their sex lives. Viagra first became available in 1998. Viagra is a prescription drug used to treat erection difficulties, such as erectile dysfunction . Amazingly, 9 tablets are dispensed every second worldwide and no other therapy or prescription drug for erectile dysfunction has been studied as much or has the same amount of real-world experience as viagra since its launch. For their patients with erectile dysfunction it’s no wonder more than 600,000 doctors have chosen the prescription drug viagra. Cialis is not as popular, but it is known to be atleast just as effective.

Viagra works for up to 4 out of 5 men versus 1 out of 4 on sugar pill as studies have shown. Viagra improves erections in most men no matter how long they have had erectile dysfunction, what caused it, how often they have it, or how old they are. Viagra has been proven to work in clinical studies of thousands of men. When taken correctly, viagra works for most men and that is a fact. The effects of Cialis can last longer than that of Viagra, at times lasting many hours! In this case, a doctor has to be consulted.

Cialis and viagra work by increasing blood flow to the penis. It is not a hormone or an aphrodisiac. Viagra can work in as quickly as 30 minutes once you take it. Viagra works for 4 hours so you can set your own pace. Viagra can be taken as often as once a day in most patients. Cialis and Viagra and competitors in the market, with Viagra being the more popular of the two.

Viagra has helped about 16 million men around the world improve their sex lives. The number one prescribed medicine for erectile dysfuntion in the United States of America is viagra. Some people may have some questions about the safety of viagra. Especially when it has to do with something as important as your sexual health this is normal for any person taking any drug. One thing you can feel good about is that viagra has been tested in more than 130 controlled studies (completed and ongoing) including over 13,000 men. Viagra has been shown to have a strong safety profile T\through these studies and its real-world experience. Cialis follows Viagra in amount of use in America.

Patients using Viagra or Cialis also commonly take medicine for high blood pressure. You may be taking medicine for high blood pressure. If so, you should also be glad to know that, of the nearly 10 million men in the US who have taken viagra, more than 1 million of them have also taken medicines for high blood pressure. Often a physical problem is erectile dysfunction. Viagra is a medicine that treats this problem by increasing blood flow where you need it. You must be sexually excited to get an erection with viagra. Nothing will happen if you take viagra and are not sexually stimulated. You won't get an erection just by taking the pill. It’s a medicine that treats the physical problem of erectile dysfunction. Viagra is not an aphrodisiac or a hormone. For both Viagra and Cialis to work, sexual stimulation is necessary.

It is important to understand sexual arousal in order to understand how these drugs work. Now I will describe what usually happens when a man is sexually excited. First the arteries in the penis relax and widen (this allows more blood to flow into the penis). Secondly, the increased blood flow causes the penis to become hard and erect. Thirdly the veins that normally carry blood away from the penis get compressed (this restricts the blood flow out of the penis). Fourthly, more blood begins flowing in and less flows out, making the penis larger; this causes an erection. It is not such a step-by-step process as described above, and in reality it is less organised.

Bloodflow is a vital factor for the working of Viagra and Cialis. The nerves or blood vessels that play a part in this process work properly for most men. This may not be true for other men. The man may not be able to get an erection in these cases. Viagra works by increasing blood flow to the penis. When a man is sexually excited, he can get and keep an erection this way.

Viagra works for most men who take it. More than 4 out of every 5 men taking viagra had better erections versus 1 out of 4 on sugar pill in studies. Viagra has been shown to work time and again in studies of thousands of patients. Patients had erectile dysfunction that ranged from mild to severe in those studies.Viagra works in most men no matter how long they have had erectile dysfunction, what caused it, or how old they are.

Viagra works just as fast as Cialis. Viagra, in fact, works in as quickly as 30 minutes. Then, you have at least 4 hours to have a romantic experience at your own pace. Viagra can be taken once a day as needed for most patients.

To know for sure if viagra is right for you there is only one sure way. You have to visit your doctor. Only your doctor can tell you for sure. It’s important you see your doctor for a physical exam and a face-to-face conversation about erectile dysfunction. Only your doctor can decide if viagra is right for you. One can learn about buying viagra online. Do not use an Internet service that offers an online diagnosis. Viagra works fast.

It is important to know where Viagra and Cialis are available. Only a doctor knows which one is better for you.

Nitrate drugs act very badly with Viagra and Cialis. Don’t take viagra if you use nitrate drugs, often used to control chest pain (also known as angina). This combination could cause your blood pressure to drop to an unsafe or life-threatening level. Be sure to ask your doctor if your heart is healthy enough for sexual activity.Viagra isn't for everyone and that is important to know. People taking nitrates should neither take Viagra or Cialis.

Cialis and Viagra are both strictly prescription drugs. Both prescription and nonprescription it's important to tell your doctor about any medicines that you take. A medicine you are taking for another health problem might be causing your erectile dysfunction. Never stop taking any medicine before talking to your doctor. Talk with your doctor about the medicines you are taking. Continuous consultation with the doctor is necessary.

Being developed by Lilly, Cialis, is currently undergoing approval and is competing with Levitra to be the next major treatment for ED on the market. Cialis is an emerging tablet-based oral treatment for impotency & erectile dysfunction (ED)Which will soon be licensed for prescription. Cialis is proving highly successful in clinical trials and is generating major interest as a real alternative to Viagra and Uprima like Levitra.

Resulting in an erection, the response is to increase blood flow to his penis. Cialis helps increase blood flow to the penis and may help men with ED get and keep an erection satisfactory for sexual activity. Blood flow to his penis decreases, and his erection goes away once a man has completed sexual activity. Cialis helps vary this bloodflow.

In clinical trials, Cialis improved confidence in ability to achieve and maintain an erection, satisfaction with the hardness of erections, ability to maintain erections for successful sexual intercourse, and satisfaction with sexual intercourse. Cialis has been shown to improve erectile function in most men, including those with mild, moderate or severe ED.

Within 30 minutes in some patients, Cialis goes to work fast and can work up to 36 hours, allowing you to respond to your partner when the moment is right. You respond to your partner only when the moment is right because sexual stimulation is required for Cialis to work. Remember, Cialis is not for everyone. You have to talk to your doctor and consult first.

To take Cialis you have to do exactly as your doctor prescribes. Your doctor will prescribe the dose that is right for you.

The absorption of Cialis is not affected by food with Cialis. You don't need to plan around meals or avoid high-fat foods. You can eat and drink like you normally do, but do not drink alcohol in excess when taking Cialis (for example, 5 glasses of wine or 5 shots of whiskey). This combination may lower your blood pressure or increase your chances of getting dizzy. Viagra and Cialis should not be taken after consumption of alcohol, also for moral reasons.

Headache and upset stomach were the most common side effects with Cialis. Backache and muscle ache were also reported, sometimes with delayed onset. Most men weren't bothered by the side effects enough to stop taking Cialis. Although a rare occurrence, men who experience an erection for more than 4 hours (priapism) should seek immediate medical attention. that you are healthy enough for sexual activity Discuss your medical conditions and medications with your doctor to ensure Cialis is right for you.

Don't drink alcohol in excess (to a level of intoxication) with Cialis. This combination may increase your chances of getting dizzy or lowering your blood pressure. Cialis does not protect a man or his partner from sexually transmitted diseases, including HIV.

You have to be careful if it is taken with certain other medicines. You could get dizzy, faint, or have a heart attack or stroke. Cialis may uncommonly cause an erection that won't go away (priapism). If you get an erection that lasts more than 4 hours, get medical help right away. Priapism must be treated as soon as possible or lasting damage can happen to your penis including the inability to have erections. Cialis may also cause vision changes, such as seeing a blue tinge to objects or having difficulty telling the difference between the colors blue and green. There can be other side-effects. These are not all the side effects of Cialis. Ask your doctor or pharmacist for more information.

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Cialis and other medicines may affect each other. Always check with your doctor before starting or stopping any medicines. Other medications can affect Cialis. Especially tell your doctor if you take medicines called nitrates, medicines called alpha blockers (these include Hytrin® (terazosin HCl), Flomax® (tamsulosin HCl), Cardura® (doxazosin mesylate), Minipress® (prazosin HCl) or Uroxatral® (alfuzosin HCl)), ritonavir (Norvir®) or indinavir (Crixivan®), ketoconazole or itraconazole (such as Nizoral® or Sporanox®), erythromycin, or other medicines or treatments for ED.

It is difficult to write a paper on Viagra versus Cialis because both drugs are so similar. They have similar purpose, similar effect, similar side-effects, similar prescription requirements, and similar duration of effect. The main difference is that Viagra has more of a name and is more popular in use. However, medically they are more similar than different.

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In the 2005 study entitled “Pathological Gambling Caused by Drugs Used to Treat Parkinson’s Disease,” the authors mine records of Parkinson’s patients seen at the Mayo Clinic in Rochester, MN (MCR), between 2002 and 2004, and find 11 people who had developed pathological gambling (PG) - they conclude that the PG was caused by Parkinson's drugs. The authors so completely fail to provide evidence compelling enough to support this conclusion that the fact that it was published in a peer-reviewed journal boggles the mind. It is available online for free at the Archives of Neurology, if you are interested. It may actually be necessary to read the study for what I am about to say to make sense – I don’t know.



According to the authors of this study, the 11 people who gambled fit the DSM-IV-TR criteria for PG.* They also say that the PG was temporally associated with the commencement, increase, and/or cessation of dopamine agonist (DA) therapy, a type of drug used to treat Parkinson’s disease (PD), and, for a disproportionate percentage of these people, the culprit was a DA called pramipexole.



Finally, the authors provide the results of their survey of the field of literature, and present in a table six studies in support of their conclusion that Parkinson’s drugs cause – not just “are associated with,” but cause PG.



In Part One, I will address the central assertion, that DAs cause PG, in the context of identifying a causal relationship. In Part Two, I will address the significance of prevalence in that endeavor. And in Part Three, I will address several other questions that come up when one actually reads the study rather than the press coverage it received.



I am probably not telling you anything new when I say that researchers, or responsible ones, at least, can’t just declare that X causes Y, they have to – or are supposed to - prove it, or at least put forth compelling supporting evidence.



Nor can they themselves willy-nilly decide what is compelling and what isn’t – while there is some leeway, there are certain gauges that are accepted as valid, and the degree to which their evidence measures up on those gauges determines its persuasiveness.



One such gauge is Naranjo’s algorithm, which consists of a series of questions to which each possible answer (yes/no/unknown) is assigned a different number of points, thereby weighting the each answer according to its significance. In the end, the total number of points indicates how compelling the evidence is. Below is how this particular study fares using Naranjo’s algorithm:







As you can see, the evidence provided in this study is not compelling enough to indicate even a probable association, never mind definite, or causal, association.



Another set of guidelines can be found on the World Health Organization’s web site – following each bullet point below are my comments on how compellingly the evidence presented in this study fulfills these criteria:

Building on the seminal work on determining causality of the Surgeon General’s Advisory Committee on Smoking and Health (1964),3 the generally established criteria underpinning vaccine [or, in this case, drug] adverse event causality assessment that the GACVS uses may be summarized as follows:

• Consistency. The association of a purported adverse event with the administration of a [drug] should be consistent, i.e. the findings should be replicable in different localities, by different investigators not unduly influencing one another, and by different methods of investigation, all leading to the same conclusion(s).
  
  
  
  This study was preceded by a single other study which claimed to have found the same association. Even if that single study had adequately supported its conclusion (which it did not), it would obviously fail to provide what could be called consistency of any sort.
  
  
  
  
• Strength of the association. The association should be strong in the magnitude of the association (in an epidemiological sense), and in the dose-response relationship of the [drug] with the adverse effect.
  
  
  
  The authors do not provide the information necessary to evaluate the magnitude of the association, i.e. prevalence – see Part Two.
  
  
  
  
• Specificity. The association should be distinctive ñ the adverse event should be linked uniquely or specifically with the [drug] concerned, rather than its occurring frequently, spontaneously or commonly in association with other external stimuli or conditions.
  
  
  
  PG occurs frequently, spontaneously, and commonly in association with other external stimuli or conditions, like depression and disability.
  
  
  
  
• Temporal relation. There should be a clear temporal relationship between the [drug] and the adverse event, in that receipt of the [drug] should precede the earliest manifestation of the event or a clear exacerbation of an ongoing condition. For example, an anaphylactic reaction seconds or minutes following immunization would be strongly suggestive of causality; such a reaction several weeks after vaccination would be less plausible evidence of a causal relation.
  
  
  
  The authors neglect to define any parameters for identifying a temporal association, and indeed inclusion of three of the eleven on that basis stretches the bounds of plausibility past the breaking point.
  
  
  
  
• Biological plausibility. The association should be coherent; that is, plausible and explicable biologically according to known facts in the natural history and biology of the disease.
  
  
  
  There are those who point to the role of dopamine in addiction, but there are serious questions that remain not only unanswered, but unasked. For example, if one’s cheap cialis is maintaining an appropriate level of dopamine in the brain, why would one be any more vulnerable to addiction than anyone else?

Clearly, the evidence presented In this study, as evaluated by two widely respected and utilized measures, is not nearly compelling enough to support the conclusion that there is a causal relationship between DAs and PG. But if that doesn’t convince you, read on to Part Two.

******

* Pathological gambling is defined in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DMS-IV-TR) as follows, and the study does not describe in which five each patient has engaged: A. Persistent and recurrent maladaptive gambling behavior as indicated by five (or more) of the following:

1. is preoccupied with gambling (e.g., preoccupied with reliving past gambling experiences, handicapping or planning the next venture, or thinking of ways to get money with which to gamble)
   
   
2. needs to gamble with increasing amounts of money in order to achieve the desired excitement
   
   
3. has repeated unsuccessful efforts to control, cut back, or stop gambling
   
   
4. is restless or irritable when attempting to cut down or stop gambling
   
   
5. gambles as a way of escaping from problems or of relieving a dysphoric mood (e.g., feelings of helplessness, guilt, anxiety, depression)
   
   
6. after losing money gambling, often returns another day to get even ("chasing" one's losses)
   
   
7. lies to family members, therapist, or others to conceal the extent of involvement with gambling
   
   
8. has committed illegal acts such as forgery, fraud, theft, or embezzlement to finance gambling
   
   
9. has jeopardized or lost a significant relationship, job, or educational or career opportunity because of gambling
   
   
10. relies on others to provide money to relieve a desperate financial situation caused by gambling
    
    

B. The gambling behavior is not better accounted for by a manic episode