“Dear Pharmacist
I have erectile dysfunction and routinely take Viagra. Is it safe and do you have a natural recommendation?” –L.B., Sacramento, California
Answer: About 30 million men deal with impotence or weak erections. With the advent of Viagra in 1998, couples could finally turn off reruns of “Happy Days” and make their own. Last year, the FDA gave Levitra the heads up, and more recently, Cialis.
Safety is a relative term and we won’t have long-term data for years to come. These drugs are generally well tolerated, although there exists the potential for dangerous interaction with certain heart medications. Side effects like headache, blurred vision, dizziness, flushing and dyspepsia are possible. Girls, picture your guy stumbling into the bedroom with that — not so sexy.
Still, these drugs sell, and they work well. They spark excitement by relaxing blood vessels in the penis. This is accomplished by raising a substance called “nitric oxide.” Yes, macho men, that IS related to the same explosive element that’s in bombs! The power of nitric oxide can be indirectly harnessed, purified and sold as a pricey pharmaceutical. Repeated doses are required because the effect is temporary.
A naturally occurring amino acid called L-Arginine also boosts nitric oxide, just like pricey pharmaceuticals. We already know that arginine is needed for male fertility. Many over-the-counter sex pills enhance mojo because they contain arginine, but their effect on nitric oxide is also short-lived. The substance is rapidly degraded. Among the many brands, one stands out for its unique time-release formula: Perfusia-SR. Available without prescription, it delivers arginine to the body very slowly over 12 hours. This ensures steady levels in the body, long-lasting benefits and few, if any, side effects. For now, Perfusia-SR is only sold the Internet, or by calling 800-452-5621.
Other formulas containing arginine are widely available in U.S. pharmacies and health food stores. Arginine is not a cure-all. Treatment success depends largely on the cause of a man’s problem. Good sex can be destroyed by drug side effects, hormonal imbalances, prostate problems, underlying disease, testosterone imbalances and free-radical damage from smoking and drinking. There’s also “sexual alienation syndrome,” the term I’ve coined for the condition of not wanting to sleep with the partner you’re stuck with.
Another factor affecting men is their vascular health. Simply put, if plaquing is extensive, the only thing that may be hardened is the arteries. Thinking two steps ahead, you realize that arginine increases blood perfusion, so it fills a niche for men who suffer with both erectile dysfunction and coronary heart disease. One small study shows significantly increased blood flow to the heart, especially when combined with statin cholesterol-lowering drugs.
For those who are infected with herpes-type viruses, balance arginine with lysine to prevent an outbreak. Also, precautions are advised for those who take estrogen/progesterone (female hormones) and potassium-sparing water pills. Don’t take arginine if you have ulcers or severe liver or kidney problems.

Suzy Cohen, RPh, has been a licensed pharmacist for over 30 years, blending conventional medicine with natural approaches to help people feel better and live healthier. She is the founder of Script Essentials, a supplement company known for targeted, custom-formulated products, some with patented innovations.
With a special focus on thyroid health, functional medicine, and drug-induced nutrient depletion (what she calls “drug muggers”), Suzy is the author of several books including Thyroid Healthy, Drug Muggers, and Diabetes Without Drugs. She also writes a nationally syndicated health column and shares practical, easy-to-understand guidance with readers around the world.
