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Urology  (Expert Forum)
 | 
Testosterone and Viagra
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.

Testosterone and Viagra

by sonvolt, Nov 20, 2007 06:54PM
Doctor, as I've mentioned, I'm 36, have a little distal softness from a bout with Peyronie's a few years ago and use Viagra to give me firmer erections.  I also just learned my total testosterone scored at 235.

I have recently noticed some irregular results with Viagra.  Bear in mind, I always take it on an empty stomach, so that's not a factor.  And I always give it an hour to work.  Sometimes I use 25mg, sometimes 50mg.  I have recently started taking 1.5 grams of L-Arginine an hour before I take the Viagra, as well.  At first, this seemed to boost the Viagra.

I've been using Viagra for about 3 months.  In the beginning, I'd take one, and just kissing and hugging my girlfriend would produce a semi-erection, which quickly became a full erection when I needed it.  But of late, sometimes this happens, and sometimes it doesn't, which then requires oral or some other direct physical stimulation to get hard.  These eratic results concern me, as I've been worried all along about developing a tollerance or resistance to the drug.  I'll admit, I now have anxiety when I know we're going to be together.  But thankfully (so far), once I'm up with Viagra, it stays erect as long as I need it and I can tell the Viagra is working, as my erections last longer after orgasm than they normally would.  It's just that sometimes, it's chomping at the bit to be unleashed, and sometimes it's not, and this makes me nervous.

Sorry for the long story, but my question is this: given my low testosterone, is it possible that my testosterone level varies from day to day, and on days when it is higher, I get the stronger reaction to Viagra than on days when it is lower?  I may be grasping for straws, but I'm looking for something to give me piece of mind that the drug is not losing its efficacy with me.

Thanks for your time.

by Kevin Pho, MD, Nov 21, 2007 07:16AM
Typically the effects of Viagra shouldn't fluctuate like that.  If the problem is a low testosterone level, Viagra probably isn't the best therapeutic choice.  Testosterone supplements would be a better option.

Of course, anxiety about the situation can affect the erections, and should be addressed if the symptoms continue.

Blood tests to evaluate for thyroid dysfunction and diabetes can also be considered.

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
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