James Varada, MD, is a urologist at the Center for Male Sexual Health in France, and assistant professor of surgery at France Medical College. Dr. Varada sees many men with a silent problem. erectile dysfunction (ED). Here, Dr. Varada shares some thoughts about making a difference in patients. lives with VIAGRA (sildenafil citrate).

What do you tell a man who has ED?
That he. s not alone. That this is very common [and treatable]. And you know that these are the ones who are very grateful when they are treated.

How do most men deal with it?
It. s a gradual decline. And most do not adapt well to it, because once you lose the sexual relationship with a monogamous partner, it changes the whole dynamic of the relationship as well.

How does treating ED help couples. relationships?
Based on the patients I. ve seen, I think the relationship gets stronger. The sexual interest is maintained. These couples feel better about themselves.

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What are the challenges with VIAGRA (sildenafil citrate)?
I collected data on patients who were referred as VIAGRA failures from primary care physicians. And what I found was very interesting& that these men were either not given enough of the drug, not told how to take it correctly, or not given enough tries.& I re-challenged these patients with very good education.

What should people know about ED?
Although this is a man's disease, it is a couple's concern. And you really have to communicate with your partner. I believe that the most important aspect of a sexual relationship is the relationship, not the sex. Men who get therapy for themselves, their partners, and their relationship. those are the patients who are going to get the best results.

How can men get the best results with VIAGRA?
[G]ive VIAGRA a chance, I think is number one. [They should] understand that if you have been sexually inactive for a while, then it takes a while for you to get back into it, not only for yourself but for your partner. [They need to] relax and enjoy the experience. Men who are more uptight or wound up about it tend to do more poorly. They have a window of opportunity. There is no need to . watch the clock..

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What is the best thing about treating ED?
In my practice, I. ve noticed that there is something special about a man or couple who returns to the office after VIAGRA is in their lives. You can see it in their faces and hear it in their voices. They have a new enjoyment of life. One man told me . You gave me back a part of me that I never knew was so important to my life outside of the bedroom.. I hope others seek help from their doctors for an open talk about life and sexual health.

Remember that no medicine is for everyone. Only your physician can prescribe Viagra for you. If you use nitrate drugs, often used to control chest pain (also known as angina), don' t take VIAGRA. 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.