[The erection pill]

The introduction of sildenafil (Viagra) for the treatment of erection disorders has received much international attention. In the USA the prevalence of severe erection disorder amounts to 10% for men aged 40-70 years, which is much higher than was expected, in the Netherlands as well. This is probably due to embarassment with the condition and the absence of simple treatment. With the advent of sildenafil the problem of erection disorder is now openly discussed. An interview investigation in Leiden, the Netherlands, showed that two-thirds of men with erection problems (n = 200) who volunteered to participate in a relevant study, had consulted to a physician before; one-third of the volunteers were interested in using an erection pill, one-third also in other treatments, and one-third wanted to be treated by any method. These figures indicate that most men already take their problem seriously. As age is the main contributing factor to erection disorder, the safety of sildenafil in the elderly is a point of concern. Nitrate use is an absolute contraindication, poor cardiovascular condition is a relative contraindication. Sildenafil will probably become the drug of choice for the treatment of erection disorder. It constitutes a major step forward.