Viagra (sildenafil) was approved by the Food and Drug Administration to treat erectile dysfunction (ED) in March of 1998. That means it has been on the market more than 25 years. Scientists are still learning about this fascinating drug. Could Viagra enhance health in several ways? Might this medication also improve longevity?
Will Sildenafil Prolong Life?
This reader wants to know if can Viagra enhance health:
Q. I read that men who developed erectile dysfunction had, on average, a shorter life expectancy. Recently, I began experiencing some erectile dysfunction symptoms. My physician prescribed daily sildenafil.
To take the medication safely, I began to explore the internet regarding interactions with other medications, food and beverages. Much to my surprise, I also found several sites describing the health benefits of erectile dysfunction medications.
Specifically, a study of 23,000 men with diagnosed erectile dysfunction who were prescribed a phosphodiesterase 5 inhibitor (PDE-5i) found they had a 13 percent lower rate of major adverse cardiovascular events such as heart attack, stroke or heart failure. This is in comparison to 48,000 men with diagnosed erectile dysfunction who were not prescribed a PDE-5i drug. In addition, those taking an ED drug had a 39 percent lower rate of death due to cardiovascular disease and a 25 percent lower rate of death due to any cause.
Is the information reporting the health benefits of sildenafil sound? If sildenafil does have such profound health benefits, why are physicians not prescribing it to improve health outcomes and longevity?
Scientists Also Want to Know: Can Viagra Enhance Health?
A. Thank you for alerting us to an interesting study (Journal of Sexual Medicine, Jan. 2023). This research, based on insurance claims information from a large population, did indeed produce the results you have outlined for both sildenafil (Viagra) and tadalafil (Cialis).
Drugs such as sildenafil and tadalafil are referred to as phosphodiesterase type 5 inhibitors. That’s a mouthful and is abbreviated PDE-5is.
The authors of this research conclude:
“In a large population of US men with ED, PDE-5i exposure was associated with lower incidence of MACE [major adverse cardiovascular (CV) events], CV death, and overall mortality risk compared to non-exposure. Risk reduction correlated with PDE-5i exposure level.”
Put succinctly, men taking drugs like Viagra and Cialis had fewer cardiovascular complications and lived longer.
Why Would Viagra Enhance Health?
Scientists know that these ED drugs work by relaxing blood vessels and increasing blood flow. Consequently, it shouldn’t be a big surprise that they could have health benefits throughout the body.
People with diabetes are a bit like canaries in the coal mines. That is to say, they are a highly vulnerable population for cardiovascular disease. An article in the Journal of the American College of Cardiology (May 27, 2008) revealed that men with type 2 diabetes and erectile dysfunction were at greater risk of “cardiovascular events and deaths.” The men in this study who were also taking drugs like sildenafil were at lower risk for major adverse cardiovascular events (MACE).
What Else are PDE-5is Good For?
An article in the Annual Review of Pharmacology and Toxicology (Jan. 20, 2023) analyzed the available data on PDE-5is. Here is what the authors reported:
Pulmonary Hypertension:
This is a very serious health condition. The NIH describes it as:
“…a condition that affects the blood vessels in the lungs. It develops when the blood pressure in your lungs is higher than normal. About 1% of people globally have pulmonary hypertension.
“Pulmonary hypertension makes the heart work harder than normal to pump blood into the lungs. This can damage the heart and cause symptoms such as shortness of breath, chest pain, and lightheadedness.”
Sildenafil has been approved by the FDA to treat pulmonary hypertension. The brand name for this form of sildenafil is Revatio. It contains the same ingredient (sildenafil citrate) as Viagra.
The authors of the review article on the use of these drugs conclude that:
“Sildenafil and tadalafil are FDA approved for the treatment of PAH [pulmonary arterial hypertension] and are used to reduce mortality either as monotherapy or in combination with prostacyclin analogs or endothelin-1 receptor blockers.”
Alzheimer’s Disease and Neurodegenerative Disorders:
The authors summarize the available studies using PDE 5 inhibitors. They conclude:
“These studies provide encouraging results for the development of new compounds with potential efficacy as PDE5 inhibitors to mitigate pathogenic processes of AD. However, carefully conducted multicenter clinical trials are needed to determine the benefits and safety of PDE5 inhibitors in patients with AD. Moreover, further mechanistic studies are required in order to understand the role of PDE5 in the pathophysiology of AD for future development of novel inhibitors.”
That is pretty technical. Here is an article I wrote about this research that is hopefully more understandable. You will find the link here.
Will Viagra Enhance Health? Yes…But…
There are downsides to sildenafil and other ED drugs, primarily flushing, headaches, heartburn and visual problems (European Review for Medical and Pharmacological Sciences, March 2017). In rare instances, a person taking this medication experiences trouble with the liver. You can read about some of the better-known potential complications at this link.
There are more details about the potential visual problems at this link.
Final Words:
Because they are so strongly identified with sexual medicine, it may take some time for researchers to confirm the broader health benefits of sildenafil or tadalafil. For example, can these drugs fight osteoporosis?
Like all medications, there are pros and cons to PDE 5is drugs. Please share your experience with ED drugs like Viagra or Cialis in the comment section below.
