When the little blue pills called Viagra were introduced to the market in 1998, it was really breaking news. At last, there was a medicine that could help men with an erection that was too weak for a satisfying intercourse. Not all men, but many.
When I give talks and lectures about sex, I almost always get the question: ”How does Viagra make erection stronger? Does it work for women too?”
I’ll answer the second question first: No, Viagra has no effect on women. It does not make them more sexually aroused or give them more fantastic orgasms. (Well, maybe if their male partners use it).
With men, it’s something else. To understand how Viagra works, you have to know a little about how erection is produced and sustained. The mechanics is quite simple. Imagine that you want to fill a balloon with water: You hold the balloon to the faucet and let the water run. The balloon will fill and get bigger and firmer. If the water runs fast the balloon fills quickly, but if there is a lot of limescale in the pipes, the water flow will be slow and it takes ages to fill the balloon. If there is a small hole somewhere in the balloon, it will never get filled.
The erection mechanics is about the same. The penis has two elongated, spongious structures resembling balloons. They are small and soft when they are empty, but become elongated and firm when filled. When something excites the man and makes him want sex, the blood vessels leading to the penis open and the structures fill with blood. If the erection mechanism works the way it should, his penis gets elongated and stiff – that’s the erection.
But it is also important that the blood stays in the spongious structures long enough to enable the man to have an orgasm. So the blood vessels leading blood from the penis must stay closed. Otherwise, the man will lose his erection too early.
Viagra only works if the man wants to have sex
Even if the mechanics seems simple, a lot of things have to function. First, the man must want to have sex. Desire is crucial to get the process started. Desire makes the brain send signals down to the blood vessels in the pelvis to produce something called NO ( although in this situation, YES would have been more appropriate). NO makes the vessels open, provided they are elastic and can change their diameter. And as the vessels must not close again too early, NO is produced until the man has had his orgasm. The stiffness itself helps to keep the blood in the penis by pressing the vessels together. So will a good strong bulk of pelvic floor muscles.
So what exactly does Viagra do? It keeps the production of NO in the vessels going, so they can stay filled and the erection holds until the man has orgasmed.
But even if Viagra helps a lot of men, it is no miracle cure. It doesn’t work if the man has lost his desire for sex. If the blood vessels have lost their elasticity and are stiff and narrowed by arteriosclerosis, they fill too slowly and there won’t be much erection. It the pelvic floor muscles are too weak, they can’t keep the blood in the penis and the erection will wane off too quickly.
So, to keep your ability to get an erection, or regain what you have had: do pelvic floor exercises and avoid arteriosclerosis. The remedy is lifestyle, again and again…