Sex-Enhancing Drugs | Big Think

Sex-Enhancing Drugs

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Michael Perelman says there are a host of options out there, including alternative therapies, but it all depends on your sexual tipping point.

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Michael Perelman:

Internationally renowned, Dr. Michael Perelman is Co-Director, of the Human Sexuality Program, New York Presbyterian Hospital. He is a Clinical Professor of Psychiatry, Reproductive Medicine, and Urology at Weill Medical College, Cornell University. A National Institute of Health Fellow, he received his MS, M.Phil. and Ph.D. degrees in clinical psychology from Columbia University--where he wrote the first sex therapy doctoral dissertaion in Columbia's history in 1976.

Dr. Perelman's clients, experience common sense advice filtered through the wisdom of over 30 years of clinical practice. Dr. Perelman has been invited to present his Sexual Tipping Point model at professional meetings around the world and has published widely in the professional literature. He is frequently quoted and often featured by the media.

Besides private practice, Dr. Perelman serves on multiple professional society,editorial, and industry Advisory/Directors Boards. He is the Past-President of the Society for Sex Therapy and Research. His research interests are integrating the use of sexual pharmaceuticals with sex counseling to provide better risk/benefit for men and women suffering from sexual problems.

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TRANSCRIPT:

Question: What are the differences between Viagra, Cialis, and Levitra?

Michael Perelman: I am privileged, actually, to be an advisor to all three of these companies and there are remarkable similarities between these drugs because they are all in the same class of medication and they all work in the same way. Essentially they help blood accumulate in the penis by diminishing the outflow; it does not go back to the rest of the body quite as fast as it might otherwise. We walk around normally flaccid as men, without an erection, because there is an enzyme, phosphoridesterades [ph?] that degrades the potential for erection normally, so these drugs all block that enzyme. So it is as if you have pulled the plug in the bathtub and then you stuff it up with Kleenex and it kind of goes out more slowly. So if you have water coming in and the water is going out more slowly, the bathtub gets filled up quite nicely, and, in fact, would even overflow. So how do these drugs work? The drugs all work very similarly in that they affect that enzyme. Cyalis has a longer duration of action. What that means is it lasts from 24 to 48 hours verses the other drugs last a less long period of time. Because each of these molecules is unique, even though they are part of the same class of drugs, they have slightly different side effects. So while Levitra and Viagra would remain within the system, within the body, a shorter amount of time than Cyalis, in many cases that would be desirable and in some cases that would not be desirable, so this is important that the patient have a conversation with his physician as to really what’s best for them, and there are reasons to consider one drug over another as what to try first. In fact, Cyalis, for instance, has just been approved for daily dosing, so smaller amounts of the drug are used on a daily basis, almost like a male vitamin, to keep a certain level of arousal, capacity for arousal I should say in place with less side effect, and yet the other two drugs that are used on what is called a PRN basis and as needed basis, or do not last in the body as long a period of time. So the side effect profile, which is something that you do not see advertised on television and discussed in a serious way, is more, again, the stuff of late night jokes, long-lasting erections. The other aspects or side effects are something that you need to discuss with your physician, and that will help determine which drug is best for you, and that can be a trial and error experiment with some guidance from your doctor as to this notion of duration of action. Do you want a drug that has more availability for more spontaneity or do you want a drug that you know is going to work for you that you are comfortable using? And in that sense, Viagra, having been first to market, is many people’s choice only because, like Kleenex, we do not think of a facial tissue, we frequently will use the name Kleenex,

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