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Prostate cancer is a complex heterogeneous disease that acts differently in different men. Therefore, treatment varies amongst individuals. A wide array of treatments exists for prostate cancer, which includes surgery, radiation, hormone deprivation therapy, chemotherapy, dietary changes and the use of various herbal supplements.
A patient may undergo hormonal therapy to reduce the level of testosterone in the body. Drugs that reduce testosterone production by the testicles like Luteinizing Hormone-Releasing Hormone (LH-RH) agonists are administered. The effect is not immediate and occurs 2-4 weeks after initiation of the therapy. Orchiectomy or castration is a surgical procedure that completely removes the testicles. It produces an immediate and permanent reduction in testosterone. Another alternative hormonal treatment is the use of hormone-blocking drugs, called antiandrogens. Antiandrogens like flutamide and nilutamide block the body’s ability to use androgens, such as testosterone.
Surgeons may use different techniques to remove the prostate. Surgical removal of the entire prostate gland is called radical prostatectomy. Radical prostatectomy is usually performed to remove early-stage prostate cancer that has not yet spread to other parts of the body. Side effects after radical prostatectomy for prostate cancer include incontinence and impotence. Cryosurgery, in which liquid nitrogen is used to freeze and kill prostate cancer cells is a common procedure. During cryosurgery, a warming catheter is inserted through the penis and this protects the urethra.
Radiation therapy involves the use of high-energy x-rays or subatomic particles to kill cancer cells. The rays may either be beamed from a machine or emitted by radioactive seeds implanted in the prostate.
Chemotherapy is also used to destroy cancer cells. Drugs are introduced into the body via the blood stream. The drugs work by destroying those cells that divide or grow rapidly. The most common side effects of chemotherapy are tiredness, nausea and hair loss.
Watchful waiting also known as “observation” is an option that physicians may use. The patients receive no active treatment unless symptoms appear. They may be asked to schedule regular medical checkups and report any new symptoms to the doctor immediately.
According to the American Cancer Society, the five-year relative survival rate for patients where cancer is detected while still in the local and regional stage is almost 100%.
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What is Sore Throat?
Almost everyone gets a sore throat at one time or another. Children tend to have them more often than adolescents or adults. Sore throats are most common during the winter months when upper respiratory infections (colds) are more frequent.
Sore throat (pharyngitis) is a painful inflammation of the pharynx, which is the part of the throat that lies between the mouth and the larynx (voice box). Sore throat is often a symptom of various illnesses such as colds and flu, glandular fever, respiratory tract infections, tonsillitis, and chickenpox. While most sore throats heal without complications, in some cases, they develop into a serious illness.
Causes of Sore Throat
The major cause of sore throat is infection. Sore throat may be caused by either viral or bacterial infections. But it can also be caused by allergies and environmental conditions.
Viral Sore Throat
Approximately 90% of sore throats are caused by viral infections. There is no simple way to distinguish a viral sore throat from a bacterial sore throat. Viral sore throats are quite contagious. They can be spread by personal contact and by coughing or sneezing. Cold and flu viruses are the main culprits. When a stuffy-runny nose, sneezing, and generalized aches and pains accompany the sore throat, it is probably caused by virus. For a viral infection, no antibiotic is usually needed and the infection can be expected to run a four to six day course.
Another group of viruses that cause sore throat are the adenoviruses. The adenoviruses usually cause infections of the lungs and ears. Adenoviruses may cause white bumps on the tonsils and throat, diarrhea, vomiting, and a rash. Sore throat caused by adenoviruse lasts about a week.
One particular virus responsible for causing sore throat is the coxsackie virus. This virus causes a disease known as herpangina, which occurs most commonly among children under the age of ten and is most common during the summer. It is sometimes called summer sore throat. Summer sore throat can be quite severe. Symptoms include a high fever and the presence of tiny grayish-white blisters on the throat and mouth. The blisters erupt in a few days and are followed by a scab which may be very painful.
Mononucleosis (mono) is a viral infection caused by the Epstein-Barr virus, a member of the herpesvirus group. This virus lodges in the lymph system, causing massive enlargement of the tonsils and swollen glands in the neck, armpits and groin. Mono can affect the liver, leading to jaundice (yellow skin and eyes). One of the main signs of mono is a sore throat that may last for 1 to 4 weeks. Mono is a severe illness in a teenager or young adult, but it is less severe in a child. Symptoms caused by mononucleosis can last for 4 weeks or more.
Bacterial Sore Throat
About 10% of all sore throats are caused by bacteria.
The most common bacterial sore throat is caused by a bacterium called group A Streptococcus. This type of sore throat is called strep throat. The pain of strep throat often feels much like sore throats caused by other bacteria or by viruses. The tonsils often swell and become coated and the throat is sore. The patient may have a high temperature, sour breath and may feel quite ill. If strep throat isn't treated it can sometimes result in rheumatic fever, which can damage the valves of the heart.
The most dangerous throat infection is epiglottitis, caused by bacteria that infect a portion of the larynx (voice box) and cause swelling that closes the airway. This infection is an emergency condition that requires prompt medical attention. Suspect it when swallowing is extremely painful (causing drooling), when speech is muffled and when breathing becomes difficult.
Noninfectious Sore Throat
Not all sore throats result from viral or bacterial infections. Sore throats can also be caused by allergies and environmental irritation. These forms of sore throat are not contagious.
Allergy: The same pet dander, molds and pollens that trigger allergic reactions such as red, swollen eyes and a runny nose can also cause a sore throat. Cat and dog danders and house dust are common causes of sore throats for people with allergies to them.
Irritation: Many materials in the environment can also irritate the pharynx. Such irritants include cigarette smoke, polluted air, chemical fumes, and dry air. During the cold winter months, dry heat may create a recurring, mild sore throat with a parched feeling, especially in the mornings.
Symptoms of Sore Throat
The symptoms for a sore throat caused by both bacterial and viral causes are the same:
pain in the throat
pain and difficulty in swallowing
red throat
swollen tonsils
coated tonsils
swollen neck glands
pus covering the throat or white spots
coughing
fever
If the sore throat is due to a viral infection the symptoms are usually milder.
Sore Throat Treatment
The treatment of sore throat will vary according to the cause. Sore throats are usually mild and can be treated at home with over-the-counter remedies available from your local pharmacy. They usually get better on their own, in 3-7 days. It is extra rare for antibiotics to be needed. This is only the case when the sore throat is the result of a serious bacterial infection.
Sore throat treatment and comfort measures:
Strep throat requires antibiotics. Sometimes it is difficult to determine whether the cause is viral or bacterial, so antibiotics may be prescribed as a precaution.
Pain relievers - nonsteroidal anti-inflammatory drugs, (such as aspirin, ibuprofen, and naproxen) are often more effective pain relievers than acetaminophen (Tylenol). These medications reduce pain and fever that accompany a sore throat. Children should not be given aspirin because of the risk of Reye's syndrome.
Salt water gargle can be a good way to relieve a sore throat. It help soothe the irritated throat and reduces swelling in the tissues. This is the safest, least expensive and probably the most effective treatment of a sore throat.
Use over-the-counter throat lozenges every couple of hours or hard candy. It can help relieve sore throat and cough. It does stimulate saliva production, which bathes and cleanses your throat.
Drinking enough fluids is very important, warm drinks may be especially soothing. Avoid caffeine because it can cause water loss.
Get plenty of rest. Getting extra sleep can promote more rapid recovery, especially if a virus is the cause.
Avoid smoking or being around smoke and other throat irritants.
Humidify the air. Adding moisture to the air prevents your mucous membranes from drying out. This can reduce irritation and make it easier to sleep. Hot, dry air will aggravate sore throat.
Take a high-potency multivitamin and the herb echinacea to build up your immune system.
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The Stone-Builders [By their Weapons]
[Big-chest was a reluctant hero, for the most part, that is, in killing the Stone-Builders; yet when he could, he did so of course, --but I say reluctant I suppose with reluctance; for it was not unlike everyone at this time to be disinclined to kill them, they seemed to be in the vein of the gods, un-killable: yet he killed them and fought them, more so than anyone else—less out of conviction than out of desire to avoid dishonor and social embarrassment for himself.]
Said I [I, being: Short-legs], I had seen one time Big-chest walk into a campsite of theirs, the Stone-Builders that is, —I tried to tell this story to my brother, Stern-toes, once, but I never could explain it right, but I think he got the jest of it, if not the seriousness, we did both laugh at the Stone-Builders for hours on end, afterwards. As I was about to say, myself and Little-eyes witnessed this whole happening from a distance of course. The Stone-Builders were full of what they called: ‘wone, or wine,’ something along that order, some sounds take me back a bit, they had new sounds all the time, yes O yes, inventing new sounds like the growing of leafs on a tree, coming into our brains like new winds, dragging it into a mode of thinking more everyday, instead of being fond of the birds, and just living: eating, sleeping and dying—these words we never heard of before were floating everywhere in the air, ever since that is, the arrival of the Stone-Builders on the scene: before this, before Eve walked out of that Garden, things were dangerous, but much more quiet.
Well, Big-chest, noticed one evening—not being too far in the thick of the foliage by their campsite [the Stone-Builders site]—they had killed a man-eater [lion]; there were four of them, called ‘soldiers,’ at the campfire-site, a resting place to them: just laughing, and drinking, and being playful like a group of little cubs: lion cubs—wild and whimpering [whiny] lion-cubs, that is exactly what they were like. I could see Big-chest laughing to himself—inside that big muscular oversized chest: as he watched them wrestle around with one another, actually they did get a little over physical with one another, like the wild boars whom would chase after one of us, wanting to eat us for a feast, and then they’d settle down again. It was a cold winter’s night that day, so there was a real chill in the air, and not all that much leafy undergrowth for us to hide or for that matter to slap the chill away: nor for that matter Big-chest: although he had a coat of hair all over him to keep him warm anyways—showed a bit of chill in his face also. Although—I was grateful for the few large trees with the plant-life tucked around me, it absorbed some of the wind—the brisk, cold winds seeping by us, around us, and almost through us: the shrubbery covered us, as we remained in the distant woods, with a pile of leaves up to our knees: leaves for warmth and camouflage, --camouflage being a plan incase we figured we’d have to duck, hide ourselves-quickly should they get the best of Big-chest, but we doubted that: Big-chest was just the opposite of us----mean,--plus
as always, Big-chest was confident of his abilities, he stood in the woods, no shadow—not sure what he did with it, but he was cleaver; just a big blob of muscle, hair and sharp eyes, small squinty eyes pinned on the four Stone-Builders, at the camp site, and their man-eater, that was going to be his dinner. He was actually blocking our vision a bit, but I think he did that because he wanted to show his audience—which was us—who was the braver. I actually had some kind of a feeling for those men who were about the meet Big-chest, a gloomy feeling at best, and a thankful feeling: thankful, it was not us in their place; yet both I and Little-eyes, both surely held feelings of revenge for the Stone-Builders, and this was kind of a good time for the revenge to seep out, but I don’t care for revenge for the most part, not really, it takes too much energy, saps you—in review, all was quite mysterious to me.
Then unsuspected, he walked into the camp, tall as a mountain, hairy as a leafy think forest, long, a very long mouth from ear to ear, his teeth showed—he walked reminiscent of the king of the Stone-Builders [I think he was mimicking him—he like to do such things], he must have seen him walk, for he was arched just like their king, head back, eyes slanting down as if they were subordinates; --among the four he crept up, not a word, not a sound, the dark-dragging behind him, the sky had very little light given by the stars, but it followed him overhead none the less, a cloud covered the moon—as if he and Big-chest were pals; now he had seen their weapons by the fire, where the dead lion lay, if anything, Big-chest was shifty: sly, observant: he was swaying his body akin to the huge trees in a storm, not sure exactly why, but I think it got his blood moving and his limbs more flexible for swinging when he used them for clubs—and it made for a good showing: his hands were as big as large branches of a tree: and as hard. Closer and closer he came to the fire, no one noticed him yet, can’t figure it out, no one, no one at all, --could they not hear him a little, just a tiny bit, I asked myself, for both myself and Little-eyes could hear his foot steps even in the woods, at twice their distance, I was about to learn we had better hearing than these new creatures. But then this new breed of course, can not have all the advantages, thank goodness, thus, our senses were better, we were tuned higher one might say, and they were tuned with more and a higher intelligence than we.
His fingers now, almost touching the ground—I could see—he, he had long thick arms, and fingers, and perturbing muscles, he was impressive to look at, huge to digest with your eyes, and frightening if you did not see him on a daily bases, and dangerous to be around, at any time. Then all of a sudden two of the four turned their necks to see what was in back of them; not sure if they heard him, sensed him, or just did out of an automatic military checking ritual,--whereupon, they almost went into shock: two stood up, all four were some fifteen feet from their weapons. The two who were squatting, the closest to the fire, were in a panic, the other two were a little farther away, standing now, unsure, thinking. I think one was releasing himself; he made a puddle and was trying to cover it up by kicking dirt, how modest. I figured why waste your time, this was precious time, run, run, run: that is what I’d do, but I really was hoping they’d not run, I must have an evil side in me also, just like them; you know, they got this pride thing, and I was hoping they would stay with this pride and arrogance, and then as I stopped thinking for a moment, Big-chest knock it out of them, if that is, they had any pride left. I think I was starting to get like them, that being: aggressive thoughts.
In any case, Big-chest took his right hand swung it backwards to build up momentum, and with the force of a giant tree, hit the head of one of the squatters as he was about to stand up, it sounded faintly similar to thunder, and I could hear it snap, and rip, similar to a timber falling after lightening strikes it, strikes a tree out of its roots, its stretching roots out of the ground. He fell on his chest, then pushing himself, flopped over and onto his shoulder as if it had nothing holding his head in place, like a dead fish flopping, jumping in a creek—he lost his inner breath. The other one tried to get to his weapon, but Big-chest, akin to lightening, jumped with one leap over to him, picked him up by one leg, his penis showing, as Big-chest looked strangely at it, as if to laugh at a small ugly worm, for they all liked covering them up for some odd reason, and Big-chest now must have figured out, he knew why. And we both in the bushes started to giggle, snicker, laughing at the sight—I wanted to say laugh again—but we had to hold our laughing inside our stomachs for a while, so as not to spoil his feat. Then after our expressions of amusement, a stern grin appeared on Big-chest’s face—I think he heard us—in any case, he tossed him into the fire when he got bored looking at him, after twisting him about for a few seconds, breaking his leg in several places I imagine, for I kept hearing crunches, as if bones were cracking, and then there was his screams.
Then one of the two standing routed himself through the woods yelling something on the order of: “Hhhhh eel pppp...!” Not sure what that meant. The last one, I call him the brave one, or definitely I could call him the stupid one, or should I say foolish one, none-the-less, he pulled out a sharp object, about the length of his hand, and stood in front of Big-chest as if he was going to fight him. At this point I said, and Little-eyes thought: this was the end for him; he [the soldier] looked like a banana compared to Big-chest. I asked myself, ‘Is he crazy? Run, and run while you can,’ and I was on Big-chest’s side now, more than ever, but it didn’t sound like it for that split-moment, but I felt it was a little unfair, size and all. But the man, whom I am calling a brave-soldier, stood his ground, and actually looked at Big-chest in the eyes. My-gosh, the man must have been half his size, about 175 pounds, quick on his feet though, for he was dancing around Big-chest, trying to stab him, and poke him. He looked more like a bee trying to sting someone, but that just irritated him more. Big-chest had taken arrows out of himself one-hundred times before, I bet; arrows deeper than that knife would have ever penetrate, if the person had gotten a chance to lunge it into Big-chest, and he didn’t get that chance: and it never hurt him much: those pokes. These little wounds were nothing, --but should he leap and get a good stab possible in the upper chest of Big-chest, or eye, then I’d worry.
To make a long story short: Big-chest just looked dumfounded at the figure in front of him dancing in a circle, and didn’t move very much, except around; I’ve seen Little-eyes close his eye-lids now, he knew, he knew what was about to happen, and with his waving quick long arms, Big-chest picked up the seven foot lionesses, and put it over his shoulder, the crazy Stone-Builder charged at him, and Big-chest with a quick sweep, with a turn, knocked the man flat on his back, onto the ground, he had hit him with the man-eater, as he balanced it over his shoulder. Then, somewhat, disparate, or so it seemed, reminiscent of a dying fish jumping about trying to get back into the water—he: Big-chest—kicked him in the mid-section of his belly, sweeping him into the fire like trash, now almost a dead fish. The Soldier could not move, he surely had a broken spine I thought, had he not, he would had gotten up and run fast out of the fire, and he didn’t: or couldn’t, for Big-chest couldn’t run with the man-eater on his shoulder so it was a good time to escape, if he could. But he didn’t, or couldn’t, nor do I think he intended to. But again, the man tried to move out of the fire with no suitable means other than his arms which were now on fire, for surely his ribs and legs were broken. Big-chest simply turned away from him as if he was insignificant, as I did myself. The defeat was predictable, and most unnecessary. I got thinking: what kind of creature fights when they cannot compete. It has always been the law of the land—to run, unless cornered: hence, when you can’t battle, don’t. It wasn’t necessary to die like that. I was learning about pride and arrogance quickly from these new creatures though; all in time and observation I told myself, and I’d be well informed on their unusual habits.
11
Early winter
We had no way of knowing which winter would be good to us or bad for us, and winter this particular winter had come early, and therefore our food supply was exhausted, depleted that is, rather quickly. When Little-eyes and I returned back to the cave the following evening, we had told in our symbolic way: expressed at the Banana Cave that is, to the entire Horde how Big-chest had killed the Eve People. And you could hear the laughter for miles around. I tried to explain how Big-chest had seen or sensed their movements, their evil objective, and their killing intent: as he always seemed to be able to sense survival quite well; he had a special quality of seeing through a person to his evil side, as he could see through us, thus, he could see through the Stone-People as well. I explained how one of the men stayed to fight him, trying to outstare Big-chest, and got kicked into the fire, and died. They all shook their heads in wonderment, we were not the smartest of the inhabitants of earth, but that was sure dumb we all thought, no vocal language was needed for that understanding or response. I think Big-chest had taken his trophy to his cave in our area, and was having a formal meal at this time. We liked anyone who could out smart the Stone-People I suppose, they were smug and we were helpless to them most of the time; they had well groomed weapons, and we had simply rocks and some clubs, along with a few sharpened stones, as they now were being called, knifes, up to the appearance of the Stone-People, they were just tools. And so it felt good if anything, good to see the odds turn for once, and to be frank, they didn’t turn much, if ever in our favor after that episode. But our surprise would come in the morning: --yes, we would not be forgotten for once.
Morning
In the morning when several of us looked out of our cave entrances, in the center of the canyon below our cliff dwellings, as we often did to be sure we were safe from man or beast, in the open area in the valley below us, we saw half a lion torn open, lying in the center of our domain, for us, it was a treasure, a gift, a donation if anything, and all of us quickly ran to eat what meat Big-chest had left for us. Big-chest was not always so generous, or kind, but for some odd reason, he knew we were starving for some protean, and our bodies were starting to show our ribs. Aimless to say, this never happened again—not in such a quantity, but we all gave Big-chest a super big smile as we walked proudly out of our canyon-caves and ate the raw meat [for he appeared standing erect by a cave entrance observing the feast he provide]; yes, some of us even were tarring at the red meat, animal protein, liken to wolfs.
12
The Hermit by the Sea
It was a short period of time from when Big-chest appropriated the lion [took it from the Stone-Builders] and we all ate the meat, when I joined the Horde in the valley on a crisp morning—a morning that told me, the seasons were about to change, thus, leading into spring; I could see my breath: it was so brittle, so I knew winters end was near. There was great commotion in the valley below, as there often was when someone or something new came about to celebrate, I had noticed from my cliff dwelling a gathering of the Horde, looking down, I quickly dashed along the sides of the cliff until I reached the floor of the valley to see what it was, as did Little-eyes, as I had woke him, trying to explain a happening was taking place.
Thin-hips of the Horde [Sister to Moss]
When I reached the bottom and many of the folk were going to and fro, some with sad and hungry faces, very sad posture, I made my way through several folks now gathered around this one section of the cliff; old-Moss, the Hermit by the Sea, was laying dead, his sister, Thin-hips, was there pacing, walking back and forth, kind of chanting, humming something, sounds on top of sounds—death had waxed his face I noticed. Old Moss was the oldest folk I had ever known, ever heard of. He must have been 60 or 65 years old—I doubt Big-chest was that old. No one ever lived that long, no one that is but Moss, I suppose. You could tell by looking at him, half his death was caused by starvation, the other by his long walk back to the Valley of the Caves, the strenuous walk; a walk many took to come back when they felt their time was short on this ground, like some fish, we all seem to know our dying ground; he came from the far off place, called the Great Cliffs by the Sea. I had only seen him when I was a kid and then once or twice coming and going, within a twenty-year period. He lived in the sand hills far from the Horde as I was saying, to the extreme East, and not far from there to the south was the Great Sea and the cliffs he always told his sister about, much larger than ours, higher than ours he’d say. He add, this place was somewhere between the Sea, and the cliffs, and the strait, and this valley was a flat area, plateau, this is where he wondered off too often, or so he’d claim, upon his return. He knew my father quite well, Long-arms, and did visit him, it was always when I was gone it seemed. They appeared to get along quite well, as one might expect, two strange folks to say the least; not sure what they had in common, matter of fact, if anything, one was lazy—my father, the other, Moss, was quite active I heard.
The Great Sea
But he did bring back information to his sister, who shared it with us, and of course he’d tell other people also of his journeys, or try to describe them best he could, and we were all quite interested in his tales—it was entertainment: yes he was a man of tales, I guess in one way I admired him for that, it was almost like some of the occupations the Stone-Builders had, or called occupations, which were really doing things by order of their king and getting fed by someone else because of the king—strange. Thus, Moss was our entertainer, and Moss did get fed by most of the Horde’s residents for doing so, I think they’d call him in to their cave to hear him talk, or draw pictures, or act out his strange adventures. Half the time we never knew what he was saying, but then, so what and it was amusement. Everyone liked him, and so did I.
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For most men, the size of the penis is a measure of masculinity and one's ability to satisfy another person sexually. Due to this, penis size can have a significant impact on your self-esteem and self-confidence. Having a smaller than average size penis can lead to feelings of anxiety and fear of intimacy.
Hundreds of studies and researches have been made to determine the average penis size. Here are some results:
Study #1
The Alfred C. Kinsey Institute for Sex Research
Year: 1948
Sample: 3500 white college males
Average penis length = 6.2 inches
Average penis girth = 4.9 inches
Comments: It is important to note that the information used in the survey was based on men who measured themselves. Only white males were included in the survey and they were all college students, so it did not represent a wide diversity of races or ages.
Study # 2
Durex Condoms
Year: 1980
Sample: 2,936 men from different countries
Average penis length = 6.4 inches
Average penis girth = 5.2 inches
Comments: Men were asked to measure themselves and then report their results online. The bulk of respondents were from the United States and the majority of participants were white.
Study # 3
LifeStyles Condomns
Year: 2001
Sample: 301 volunteers over 18 years old
Average penis length = 5.9 inches
Average penis girth = 5.0 inches
Comments: Each volunteer was measured by a researcher.
Study # 4
Brazilian Urologist
Sample: 150 Brazilian men
Average penis length = 5.7 inches
Average penis girth = 4.7 inches
Comments: Each volunteer was measured by a researcher.
One important conclusion is that volunteers may in fact exaggerate their own size when permitted to measure themselves.
So considering the results above, it would seem that the average erect penis measures between 5.7 and 6.4 inches in length and between 4.7 and 5.2 inches in circumference.
(note: 1 inch = 2.54 cm, 0.25 inch = 0.635 cm)
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With an ex-Presidential candidate as its pitchman, more mentions on late-night talk shows than Joan Embry and the dubious honor of being the world’s top pharmaceutical treatment for impotence, few drugs in history have been more in the public eye more than Viagra – or gotten more attention for affecting the public's eyes. Along with its impact below the belt, Viagra (Sildenafil Citrate) is well-documented to cause retinal dysfunction lasting several hours after it is taken. Most commonly, it causes increased light sensitivity, blurring, and a bluish tint or haze to vision in many men who take the medication.
Since receiving FDA approval in March 1998, Viagra has been prescribed more than 22 million times in the U.S. alone and is available in 90 other countries, according to manufacturer Pfizer. Here’s what you need know about Viagra and your vision:
Who is most likely to get ocular side effects?
Viagra is available in three prescribed doses – 25, 50 and 100 mg pills. Side effects are usually dose-related, meaning the greater the dosage, the greater the risk. According to reports by Pfizer and subsequent studies, ocular side effects occur in:
About 3 percent of men taking doses of 25-50 mg
About 11 percent taking 100 mg doses
About 50 percent of men taking 200 mg
Nearly all men taking 600 to 800 mg.
Why does Viagra cause vision changes? Viagra is effective on erectile dysfunction because it inhibits phosphodiesterase 5 (PDE-5), an enzyme that enhances the effects of nitric oxide, which is released during sexual stimulation to relax the smooth muscle of the penis and facilitate blood inflow. However, the drug also has a milder inhibiting effect on PDE-6, an enzyme actively present in retinal photoreceptors. This causes an increase in the concentration of cyclicGMP, resulting in a depolarization of the rod cell – and increased light sensitivity and the infamous "blue vision."
When do side effects occur? The side effects are short-lived and generally peak within 1-2 hours after the drug is taken. What is the long-term vision damage? Hard to say, since the drug has been on the market for only a few years. So far, no long-term retinal damage has been reported, but then again, long-term electroretinograms (ERG) have not been done, says Michael F. Marmor, MD, a Stanford retinal specialist who has published studies on the ophthalmic effects of Viagra. He believes the drug could conceivably result in lasting damage to photoreceptors, so he recommends that you avoid it if you have macular degeneration, diabetic retinopathy, retinitis pigmentosa or other retinal disease. (Meanwhile, Viagra's own label issues warnings to patients with existing AMD or retinitis pigmentosa because they were not studied in past clinical trials.)
