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Viagra is produced in 25mg, 50mg, and 100mg versions. This makes sense, since most people only need a 25mg or 50mg dose. 100mg is too large of a dose for most people, and too high of a dose is more likely to cause side effects like headaches and flushing.

If I have been diagnosed with erectile dysfunction in the past, could this possibly count against me when applying for health insurance?

If current proposed health care reform stays in place, in 2014, this won't matter. But until then, the answer is, it depends.

Mostly it depends on what the insurance company considers a preexisting condition and what they will or will not cover. Also, most insurance companies use a certain formula or logarithm to determine eligibility. They may look at your medical history to see what conditions you have been diagnosed with, what you've been treated for, what medications you've taken, etc.

Compounding this is the fact that erectile dysfunction is usually not a standalone issue, but a symptom of another underlying condition, physical or psychological, like diabetes or clinical depression, and that is more likely to be what the insurance company will be looking at as far as preexisting conditions go.

Some insurance companies won't cover the cost of Viagra or other drugs to treat erectile dysfunction, and if that's the case, then my personal opinion is they shouldn't hold ED against you, since they won't cover its treatment anyway.

Usually when I take Viagra, at some point I feel kind of like like I'm getting a hot flash, and sometimes I wake up during the night and the sheets are soaked with my sweat. What's going on?

This isn't necessarily a sign that you're going through male menopause.

The Viagra definitely could be responsible for those types of symptoms. Viagra causes blood vessels to dilate, and although it is primarily targeted to affect blood vessels in the penis, it can affect blood vessels in other parts of the body - hence the facial flushing, stuffy noses, and headaches that can sometimes accompany use of the drug.

Viagra probably doesn't actually increase your core body temperature, but it does make your body feel hotter, and makes you radiate more body heat, because more of your blood is flowing to the surface of your skin. Alcohol does the same thing, which is why taking a shot of alcohol can make you feel warmer when you're in the cold, but if you're out in the elements and really at risk for hypothermia, it's a bad idea, because it will make you lose body heat.

It's unlikely that you'd take Viagra while at risk for hypothermia, but jf you're ever thinking about it - don't.

The night sweats - those can be a side effect of Viagra as well. Some men who have taken Viagra in studies have reported excessive perspiration or night sweats.These symptoms are most likely harmless, but if they are troubling to you, talk to your doctor and let him or her know what is going on.

Does Viagra have any effect on a man's ability to father a child  - either long term or short term use?

This might seem an odd question, because your first instinct would be to say that Viagra would most certainly increase a man's likelihood of fathering a child - for obvious reasons. However, you have to look beyond the hydraulics here. Even though a man may be able to successfully complete an act of intercourse and ejaculation, it may not matter if his output is compromised.

Taking Viagra certainly doesn't mean a guy will start shooting blanks. However, there is some evidence that Viagra can damage sperm in a way that will make them less likely to be able to fertilize an egg.

Each sperm has a little cap, called the acrosome, that is composed of enzymes that help it break through the egg's outer wall and penetrate it to achieve fertilization. But exposure to Viagra can cause the acrosome to break down too early, leaving sperm stranded on the outside.

The damage to the sperm was evident after a single exposure to the equivalent of one 100mg tablet. Researchers also voiced concerns there could be long term cumulative effects, especially for younger men.


What's ironic is that some sperm banks have been giving donors Viagra to help them make their contributions. A prescription for higher production may in fact produce an inferior product.

On the other hand, there's evidence that women experiencing infertility may be helped by Viagra in some cases. Some women are unable  to conceive is because they can't build up a robust enough uterine lining to support the zygote. By increasing blood flow "down there" Viagra can help thicken the lining, giving the developing embryo a better chance of being carried to term.

So, if you and your female partner are trying to conceive a child, consider giving her the Viagra instead.

I've heard people online talking about "stacking" Viagra with other ED drugs. How is this better than just taking Viagra by itself?

In pharmacology and medicine, "stacking" is an informal term that refers to taking two or more drugs at the same time, or in rapid succession, or alternating doses. In clinical settings, it's sometimes done with painkillers. The rationale is that two drugs that do the same thing but a little differently will have a synergistic effect, or prevent the patient from developing a tolerance to one drug.

The kind of stacking you've heard about probably refers to taking different erectile dysfunction drugs simultaneously, which is unsafe and is something I'm sure no doctor would ever approve of. It's just not a good idea, for several reasons. First of all, you shouldn't need to. There are a few different ED drugs available now, and one of them should work for you by itself.

Stacking is just unsafe. If you're combining ED drugs, you're overmedicating yourself. If you take the recommended dosage of more than one drug, you're way overmedicating. People who "stack" drugs may lower the dosages to try to compensate, but who knows how effective this is, especially if the drugs interact.

That's another thing - these drugs are not intended to be taken together, so you don't know how they will interact. There could be unanticipated side effects. Because Cialis has a longer period of effectiveness, some people think that combining it with Viagra or Levitra will extend those drugs' effects, but who knows? You could be more likely to experience priapism, which would be uncomfortable and embarrassing if you have to seek medical treatment.

Also, while you might be able to score a couple of different samples of ED drugs from your physician, no responsible doctor would prescribe more than one at a time. So chances are the guys who are stacking are getting their drugs from multiple and possibly sketchy sources. If you're not getting medication prescribed through a doctor or certified online pharmacy, who knows what you're getting. That stuff can be dangerous.

But what about stacking with supplements, you say - meaning herbal supplements, like horny goat weed, or "herbal Viagra" blends. Well, you should be careful with those too. You often don't know what's really in them, and it's impossible to gauge what their effect will be when combined with prescription drugs. Really, don't mess around with drug cocktails without checking with your doctor.

By the way, you didn't happen to come across this suggestion on a body building forum, did you? Because among body builders who use steroids, "stacking" steroids, and ED drugs, is not uncommon. You know why? Somewhat perversely, anabolic steroids can stimulate sex drive, but increase the likelihood of erectile dysfunction. They also make your junk shrink, but I don't know any remedy for that.

Sometimes I get really bad heartburn after using Viagra. Is the Viagra to blame?

There's a likelihood that it's related. Dyspepsia, indigestion, heartburn - these can all be side effects of Viagra. And if you already get heartburn, using Viagra can aggravate it.

What's happening? While the drug causes the smooth muscles in the penis to relax, allowing increased blood flow that causes erection, it also causes other smooth muscles in the body to relax, including the sphincter that closes off your stomach from your esophagus. That permits the flow of stomach acid going the wrong way - up. The situation isn't helped any by the fact that you're probably in a horizontal position for some, if not all of the time the Viagra is in effect, making it easier for the acid to move into the esophagus.

What can you do? You can take an antacid before or with the Viagra as a preventative. Some people say drinking a large glass of water with the Viagra reduces or eliminates the heartburn for them. Also, limit your alcohol intake when using Viagra. Alcohol relaxes the esophageal sphincter as well, exacerbating the problem (and alcohol can worsen post-Viagra headaches if you're prone to hangovers). Having sex standing up is optional.

I saw a news article about pharmaceuticals, including Viagra, getting into the water supply. How does this happen? Does it cause environmental problems?

Viagra in the drinking water sounds like a fantasy or a joke (or a recipe for a very happy village), but it's not far from reality. Significant traces of prescription drugs have been found in groundwater, rivers, lakes, bays, and coastal waters, including erectile dysfunction drugs, antidepressants and other psychiatric medications, hormones, and other substances like caffeine and nicotine.

How does it get there? Well, what goes in has to come out. When you take a drug and your body can't metabolize all of it, some gets excreted. So, those drugs are getting into the water through wastewater, i.e. sewage. Even treated sewage can still have those chemicals in it. Yeah, it's not nice to think about. Drugs can also leach into groundwater if they are thrown away and disposed of in a landfill.

The good news is that (hopefully) not a lot of that is getting into the drinking water supply, but that depends on where you live and what your water source is. And they're still out in the environment, where you can be exposed to them, and they can impact wildlife. The full and longterm effects aren't known, because environmental agencies have just recently started monitoring pharmaceutical pollution.

For the average Viagra user, there's not a lot you can do to prevent this from happening. Maybe don't take a higher dose of Viagra than required, to avoid excreting the excess amount. In the (unlikely) event that you have some unneeded or expired Viagra that you need to dispose of, don't throw it in the trash or flush it down the toilet. Take it to a pharmacy, medical facility, or police station where they accept prescription drugs for disposal. This goes for any type of drug, prescription or over the counter, that you might need to get rid of.

Anyway, Viagra probably isn't one of the drugs that would have the greatest impact. The ones that are really causing problems are hormones - estrogen and phytoestrogens. They can disrupt the normal development and reproduction of wildlife, and exposure to excess estrogens can have serious health consequences for humans, including...impotence in men.

Does Viagra cause an increase in testosterone levels? Will it deplete my testosterone?

Since there is a correlation between testosterone and libido or sexual potency, it's not surprising that there could be some confusion about the connection between testosterone and Viagra.

However,  Viagra has no effect whatsoever on testosterone levels. The hormone testosterone is produced by the body's endocrine system, in the testes and pituitary gland. Viagra produces erections by affecting muscles and blood vessels, causing them to relax and dilate. The increased blood flow, not increased testosterone, is what causes an erection.

Using Viagra also doesn't utilize or "use up" your testosterone, and actually, some studies show that sexual activity causes an increase in testosterone levels in males.

That said, if you have erectile dysfunction and Viagra doesn't work for you, the cause may be low testosterone levels. If your testosterone levels drop too far, Viagra won't be enough to help.

While Viagra doesn't affect your testosterone levels, there are a lot of medications that do, none of which are related to sex. These include statins, Propecia/Proscar (finasteride), opiate painkillers, and some chemotherapy drugs, all of which may lower testosterone. Low testosterone levels can have negative health consequences for men, or may indicate other health problems, so if you have concerns about your testosterone levels, ask your doctor to have them checked.

Is it possible to be allergic to Viagra? What are the symptoms?

It's possible to be allergic to any drug, or a component in a drug, such as a filler or coloring. Viagra allergies are rare, but yes, it's possible.

There are certain side effects of Viagra that are normal, though. If you're having nasal congestion, that might seem like an allergy symptom, but it is a fairly common Viagra side effect. Facial flushing is also a common side effect, and could be mistaken for a rash.

However, if you develop a skin rash, itching, or hives after taking Viagra, this could be a sign of an allergy. Likewise, any kind of swelling of the face, lips, or tongue could indicate a serious allergic reaction. If you have wheezing or difficulty breathing after taking Viagra, you should get medical attention. These are all signs of an anaphylactic  reaction, which can be life-threatening.

If you think you've had an allergic reaction to Viagra, don't take it again. Allergic reactions can worsen dramatically from one exposure to the next, so while one reaction may be mild, the next one could be fatal. It's not worth taking a chance.