Long term viagra usage

Hello Doctor,

I'm 36 and in good health.  About 6 years ago, I had a bout of Peyronie's that resolved for the most part, but left a lack of distal rigidity (soft head).  This makes maintaining an erection more "high maintenance" than it used to be, as I need constant stimulation to stay hard.  Viagra really does the trick and gives me better, firmer erections that don't require constant "attention".  In short, it's a real boost toward "fixing" what Peyronie's did to me.

One side issue: I have not had nocturnal erections for the last few years (since Peyronie's), and when I do get them, they're fairly weak and short lived.  Neither do I get any spontaneous erections during the day.  I asked my Uro to do a testosterone test, and he said the only thing that was irregular was a low "inactive testosterone" level.  

My question is this, I'm very concerned about being only 36 and using Viagra (I vary between 25mg and 50mg).  I also take L-Arginine (3 grams per day).  My concern is that my body will adapt to the viagra and I will see diminishing returns, or ultimately it will love efficacy alltogether and I will be left in my 40s, God forbid, with no other course of action.  

I am very concerned about this ... can you advise me on what you know insofar as guys in my age range being on viagra for the long-term. (I realize the drug's only been out around 10 years.)

Thanks,
sonvolt

[Kevin Pho, MD]

Viagra has been out for less than 10 years, so long-term data is not available.  I am not aware of studies that show a diminishing effect for Viagra.  

Metabolic disease like diabetes and thyroid disease can also lead to the ineffectiveness of Viagra.  These should be tested for with appropriate blood tests.  

Checking for vascular conditions can be done as well with an ultrasound of the peripheral vasculature.  

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com