Buy Cialis

Title: Cross-Gender Sex Pill ,  By: Mann, Arnold, Time South Pacific, 08180628, 04/13/98, Issue 15

Section: Medicine

IRWIN GOLDSTEIN COULD HARDLY WAIT for the FDA to approve Viagra. The renowned Boston University urologist is so excited about last month’s approval of the first-ever impotence pill for men that he is opening a new sexual-dysfunction clinic, and will soon begin prescribing the drug-for women.

As doctors learn more about the causes of impotence, they’re becoming increasingly convinced that the underlying mechanisms of male and female sexual dysfunction may not be so far apart. And if that’s the case, it’s entirely possible that the same pharmacological science that restores sexual function to men can work similar magic in women.

Viagra trials in women are already under way in Europe. This month the FDA is holding an invitation-only meeting of scientists and pharmaceutical executives to discuss possible testing and use of the drug in women in the U. S . And in June leading sex researchers will devote their annual meeting in Cape Cod to discussing how a range of impotence drugs might be tested in female p atients. If the medications prove effective, they could offer women a safer alternative to the current best weapon against female sexual dysfunction, hormone-replacement therapy, which carries a slightly increased risk of cancer. Meanwhile, with the approval of Viagra (release date: mid April) as an impotence treatment, doctors will be able to prescribe it “off-label” for women too. “We intend to use it in women once it’s released for men,” Goldstein says. “Not even a question.”

Viagra’s effects on the hydraulics of male sexuality are pretty straightforward. Originally developed as a heart medication, the drug works directly on the blood vessels, blocking an enzyme called phosphodiesterase. This enzyme prevents the release of certain neurotransmitters-most notably one called cyclic GMP-that cause the smooth muscles surrounding the arteries to relax, a llowing the arteries to expand. When this occurs in penile arteries, it leads to engorgement, which leads to erection.

While Viagra doesn’t work for every impotent man, it does work for up to 80% of them. “There appears to be no group that has been tested that has a zero response,” says urologist Dr. Harin Padma-Nathan of the University of Southern California. Even men with the most severe forms of impotence-spinal-injury victims, diabetics, those who have undergone prostate-cancer surgery–have responded.

Such results ought to mean good things for women too. Female genitals fill with blood during sexual stimulation just as male genitals do, resulting in engorgement of the clitoris and lubrication of the vagina. As women age, they experience some of the same genital problems men do, as a number of ailments-particularly atherosclerosis and diabetes-impair blood flow; this leads to vaginal dryness, pain during intercourse and problems in achieving orgasm. Indeed, according to one study, more than a th ird of women in the 18-to-59 age group experience sexual dysfunction, compared with just 10% of men. “Male sexuality has always been viewed as more important, says Julia Heiman, a psychologist at the University of Washington and one of America’s leading experts on female sexual dysfunction. “A man needs an erection to have intercourse, so it’s easy to regard a man’s sexuality as important and interesting pastime.”

How effective Viagra is come of the tests. The FDA and Pfizer, the manufacturer, do not encourage women to use it. “We strongly recommend against women taking their husband’s pills or physicians using it off-label,” says Raymond Rosen, professor of psychiatry at the Robert Wood Johnson, who will chair the Cape Cod.

Still, some physicians see potential benefits in careful, off-label use of the new drug. Goldstein plans to test female patients-mostly postmenopausal women- for impaired blood flow and give Viagra to those he thinks it can help. He has already received E-mail from women eager to try it. Other doctors are bracing for the same. “The Viagra avalanche is about to begin,” says Rosen. “Where the oral contraceptive was liberating for younger people, Viagra may be the sexual-liberation pill of older adults.” This time both men and women will be getting in line.

~~~~~~~~

By ARNOLD MANN

Viagra (chemical name: sildenafil): Relaxes muscle cells to enhance blood flow. Early female trials under way in Europe: U.S. female trials will be discussed at an FDA meeting later this month

Vasomax (phentolamine): Oral version of an approved injectable drug. Dilates blood vessels to increase flow. Male trials are near completion in the U.S.; female trials are planned

Spontane (apomorphine): Works through the central nervous system. Male trials are nearing completion; female trials are planned

Prostaglandin creams: Applied to the surface of the genitals to stimulate blood flow. Male trials are under way; female trials are planned

ILLUSTRATION

Title: Love Potions ,  By: Song, Sora, Time, 0040781X, 1/19/2004, Vol. 163, Issue 3

Section: Love, Sex & Health

MEN

PRESCRIPTION THERAPIES

• Viagra, Levitra and Cialis: All these drugs work the same way, by relaxing smooth-muscle cells and widening blood vessels, primarily in the penis. Cialis stands out as particularly long-acting–up to 36 hours, compared with four or five hours for the others

• Testosterone: For men who don’t produce enough, patches (Androderm, Testoderm) and gels (Androgel) deliver extra hormone through the skin

• Alprostadil: This vasodilating drug can be self-administered as an injection (Caverject) in the penis, or inserted into the urethra as a suppository (MUSE)

WOMEN

PRESCRIPTION THERAPIES

• Testosterone: Doctors prescribe the hormone in lower doses than typically used for men, though it’s not approved for this use by the FDA. Women can also take under-the-tongue drops specially formulated by pharmacies or use patches and gels

• Estrogen: Tablets (Vagifem), creams (Estrace, Premarin) and a silicone ring (FemRing) inserted into the vagina release estrogen to alleviate such symptoms of menopause as vaginal dryness

• Viagra and Levitra: Initial trials are disappointing, but the drugs appear to work for some women

MEN

NONPRESCRIPTION THERAPIES

• Ginkgo biloba: Better known as a memory enhancer, this herb is believed by some to improve blood flow to the body, including the penis. Conclusive scientific proof is lacking

• Ginseng: In the lab, ginseng has been shown to release nitric oxide, but there’s no evidence to suggest that it improves erectile function

• L-arginine: This naturally occurring amino acid is a precursor to nitric oxide and is believed to improve the flow of blood to the genitals

WOMEN

NONPRESCRIPTION THERAPIES

• Avlimil: The pill contains various plant leaves and roots and is touted as the female Viagra, but experts question its effectiveness

• Zestra: A botanical-oil lotion applied to the genitals can create a tingling sensation and enhance orgasm (breath mints or a few drops of Binaca on your partner’s tongue during oral sex do the same)

• XZITE: A daily capsule, manufactured in Marina del Rey, Calif., containing Chinese plant bark, flowers and roots, which doctors at UCLA’s Female Sexual Medicine Center say works for many of their patients

MEN

DEVICES

• Penile prostheses: These surgically implanted devices are still used by men who, for medical or physical reasons, don’t respond to drugs

WOMEN

DEVICES

• Slightest Touch: UCLA doctors express high hopes for this device, which uses a set of electrodes to stimulate nerve pathways

~~~~~~~~

By Sora Song

Title: OVERCOME YOUR GREATEST SEXUAL FEAR ,  By: Chillot, Rick, Prevention, 00328006, Apr2002, Vol. 54, Issue 4

Section: Men’s Health Special Report

Life without erections is like rock and roll without guitar solos: It’s doable, but a lot less entertaining. Think it can’t happen to you? Think again.

“The best study we have shows erectile problems in 52% of men ages 40 to 70,” says Ira Sharlip, MD, spokesperson for the American Urological Association in Baltimore and president of the Sexual Medicine Society of North America in Schaumberg, IL. That translates to an estimated 20 to 30 million men who can’t get the erections they want. It’s an alarming statistic, but don’t panic. The truth is, there are more options than ever for reviving a penis that’s lying down on the job.

On any given day (or night), there may be obvious reasons why a man has trouble summoning an erection: stress, fatigue, anxiety, the baby crying in the next room. But if the problem persists, it crosses the line from occasional disappointment to a medical condition called erectile dysfunction (ED). “We usually say that if the problem lasts 3 months or more, you have ED,” says Dr. Sharlip.

The defining symptom of ED is the inability to achieve and maintain an erection sufficient for satisfactory sexual function. While erectile dysfunction is not an uncommon problem among men as they get older, says Dr. Sharlip, neither is it an automatic consequence of aging.

To know why erections stop reporting for duty, you have to understand how they get there in the first place. Many a man has been accused of thinking with his penis, but in fact the opposite is true: Men have erections with their brains. Whatever the triggerevery erection is a sequence of events that begins in your head, says Tom Lue, MD, professor of urology at the University of California, San Francisco and spokesperson for the American Foundation for Urologic Disease in Baltimore.

“Basically, when a man is sexually stimulated, a signal is transmitted from the brain down the spinal cord and reaches the penis,” he explains. Then the stimulated nerves in the penis release a chemical called a neurotransmitter. This chemical signal causes blood vessels in the penis to open up. Blood is pumped into spongy tissues in the penis, causing it to swell and stiffen like a water balloon. And there’s your erection. A problem at any step in this process can cause the erection to be weakened or prevent it altogether, and all the Victoria’s Secret catalogs in the world won’t help then.

Here are the known erection killers.

Low hormone levels. No matter how romantic the setting, unless you have enough sex hormones (primarily testosterone), the brain-to-penis transmission just won’t happen, because you simply won’t be aroused. (It’s normal for a man’s testosterone levels to decrease with age, but such changes usually happen gradually and don’t completely erase the libido.)

Psychological problems. A brain overwhelmed by stress, anxiety, fatigue, or other mental concerns is less likely to send out the “Let’s party!” signal.

Nerve damage. Injury to the brain, spinal cord, or nerves in the pelvic area can prevent the erection signal from reaching its destination. Nerve damage can be caused by uncontrolled diabetes, surgery, or cancer therapy.

Blocked vessels. If the arteries that bring blood into the erection chamber are blocked, the erection will be weak or even nonexistent.

Damage to the penis. Scar tissue or other structural damage can prevent the erection from occurring.

Medication. Certain medicines have side effects that inhibit erections. Your doctor will know if any of your medications fall into this category.

It may seem like there’s a lot of things that can go wrong. But low hormone levels, long-term psychological problems, nerve damage, and penis injury are relatively rare causes of ED. The problem that most men should be concerned about is blocked arteries. “High blood pressure, high cholesterol, coronary artery disease: People with these conditions will also have trouble pumping blood into the penis,” says Dr. Lue. It’s the same process that leads to heart disease: Arteries become gunked up, and the narrowed channels can’t bring in enough blood to do the job.

In a study of 50 men experiencing impotence , 40% had significant blockages in their coronary arteries, though they had no other symptoms of vascular disease. That makes ED an early warning signal of heart disease and stroke.

When you take your erection problems to your family doctor, odds are you’ll come away with a prescription for sildenafil citrate, known to comedians everywhere as Viagra. Why? All the hype and late-night talk show jokes aside, because it’s actually a very effective medication. “It works for two-thirds of the men who try it,” Dr. Sharlip says. “It’s the first-line treatment for ED.”

Viagra does its job by causing the chemical messenger that stimulates erections to persist in your body longer than it normally would. This keeps narrowed blood vessels allowing an erection to occur. This medicine doesn’t produce erections; rather, it sets to occur naturally. “You still need some sort of sexual stimulation for an erection to happen,” says Dr. Lue. Your doctor will typically instruct you to take Viagra 1 hour before sex.

Because Viagra works so well, there’s a danger of forgetting that it’s medication, not a magic trick. And like all medications, it comes with cautions. For some men, particularly those with serious heart conditions or those taking certain other medicines, Viagra can be deadly.

“People can die if they take Viagra with the wrong combination of drugs,” warns Dr. Lue. Any drug containing nitrate, notably nitroglycerin (used to treat angina symptoms), can be a lethal mix with Viagra. Tell your doctor what drugs you’re taking.

Borrowing Viagra from a friend, ordering it on the Internet, or taking it without your doctor’s supervision is a stupid and possibly suicidal move. Not only are you risking dangerous side effects, you’re cheating yourself of a doctor’s visit that could turn up serious health problems, such as heart disease or diabetes, that are contributing to ED.

What happens when Viagra doesn’t work? Then it’s time to see a specialist, says Dr. Lue. “Your doctor will refer you to a urologist who will do a more specialized examination,” he explains. Depending on the cause of your erectile dysfunction, there are a number of other options for treatment. (See “Your Options for Treating Erectile Dysfunction” at left.)

The bottom line: “A man who’s willing to do whatever is necessary has a 90 to 95% chance of having satisfactory sexual functioning for the rest of his life,” says Dr. Sharlip.

For some men, keeping their erection options open into their 70s isn’t a top priority. If you want your ability to have erections to outlast your ability to grow hair on your head, take steps now to ensure an active retirement-home sex life later. You want to keep those geriatric care nurses on their toes, don’t you? Here’s the plan.

Stop smoking. Amazingly, there are still men for whom the threat of an early death isn’t motivation enough to quit. So how about the threat of an early death after years without sex? Smoking is as bad for the arteries that support an erection as it is for the arteries that nourish your heart.

Stop eating like a pig. Or, since pigs generally prefer to eat grains and vegetables, start eating like one. A healthy diet will help you lose weight and lower your cholesterol, keeping you alive longer and, very possibly, keeping you erect longer.

Get your butt off the couch. Exercise to shed pounds, lower your blood pressure, and keep your blood vessels healthy, including those critical ones in the groin area.

Have sex regularly. Besides making you feel good and strengthening your relationship, having and using erections may help keep your penis in working order. Which, of course, allows you to keep having and using erections.

THERAPYDESCRIPTION 
	
ViagraThis pill allows erections to occur with
sexual stimulation. It's the first choice
for most ED cases. 
	
Injection TherapyMedication is self-injected directly into the
penis before sex to increase bloodflow and
produce an erection. 
	
SuppositoryAn alternative to injection therapy; the
medicine is delivered by a capsule that you
you insert into the tip of your penis. 
	
Vacuum DeviceThe penis is inserted into a cylinder, and air
Is pumped out, producing an erection. 
	
SurgeryIn certain situations, this can be done to bypass
 A blockage of bloodflow to the penis. 
	
ImplantA prosthetic device is implanted into the penis
To provide stiffness.

PHOTO (COLOR): Obsessing about your “problem” is the last thing you need to do in bed. Most erectile dysfunction is curable.

PHOTO (COLOR): What you don’t use, you lose.

PHOTO (COLOR): Exercise keeps all your blood vessels healthy.

~~~~~~~~

By Rick Chillot, Rick Chillot writes about health and other topics from his home in rural Pennsylvania.

Experts believe that most cases (some 70%) of erectile dysfunction (ED) have a physical, rather than mental, origin. But it’s also true that ED can produce emotional wounds that a pill won’t heal, says Gerald Weeks, PhD, chairman of the department of counseling at the University of Nevada-Las Vegas and author of several textbooks for doctors and sex therapists, including Erectile Dysfunction: Integrating Couple Therapy, Sex Therapy, and Medical Treatment (W.W. Norton & Company, Inc., 2000).

“After the problem’s happened a few times, a man may try to have sex more often, thinking he can correct it by extra stimulation or force of will,” says Weeks. In such cases, sex becomes hyperfocused on the man getting an erection, with his partner’s needs given short shrift. When that strategy fails, the man will typically start avoiding sex, and his partner may feel that she’s no longer attractive to him.

In another common scenario, an older man whose penis has been revived by modern science may find that his wife isn’t celebrating the resurrection. “About one-third of all women lose interest in sex at some point in their life,” explains Dr. Weeks. “When they stop having sex because of the man’s erectile problems, it takes the pressure off her to summon sexual desire that she doesn’t have.”

If you’re facing these kinds of difficulties, a sex therapist can help. This sounds like a racy solution, but don’t get the wrong idea: The sexy stuff is actually done at home with your spouse, not during the office visits. “In a typical session, the therapist will ask the couple a series of detailed questions about what’s happening or not happening. Then he’ll give them behavior-oriented homework assignments,” Dr. Weeks explains.

Sex therapists, especially those who also do marital therapy, can make medical treatments more effective by helping couples deal with psychological issues that may be contributing to ED. They can also help couples get their sex lives back on track after a long dry spell and advise them on how to bring various medical therapies into the bedroom.

Sex therapy doesn’t mean signing up for years of analysis; most problems can be overcome in a matter of 10 to 15 1-hour sessions, says Dr. Weeks. To find a board-certified sex therapist, go to www.prevention.com/links for links to the American Board of Sexology and the American Association of Sex Educators, Counselors, and Therapists.

Title: ‘Cajun king of spam’ stirs pot of controversy ,  USA Today, JUN 25, 2003

Section: Money, Pg. 01b

SLIDELL, La. — Ronnie Scelson has a gun by his computer, a mean crawfish stew recipe and a bone to pick with those lawmakers and e-mail cops clamoring to can spam.

“I hate spam as much as the next guy. What I do is not illegal,” the bulk e-mailer says. “It’s the people who spam sex, viagra and get-rich-quick schemes that give commercial e-mailers a bad name.”

In his secretive business world, such bluster qualifies as a manifesto. But Scelson, 30, dubbed the “Cajun king of spam,” is no ordinary bulk e-mailer. While others would rather be heard only through a cascade of e-mails, the cherubic Scelson speaks out — offering a rare peek into the life of one of the nation’s biggest spammers, say anti-spam activists and Internet service providers (ISPs).

What it reveals is a fidgety chain smoker in a cat-and-mouse game with anti-spam forces. Scelson says he spits out 60 million to 70 million ads a day, or about 2 billion a month. “I can reach more people in one month than those who watch the Super Bowl,” he says.

The avid Scooby-Doo fan, a high school dropout who has achieved riches, has also emerged in recent months as a central figure, and target, in the national war against spam, the unwanted e-mail that clogs the Internet, infuriates consumers and last year cost businesses an estimated $10 billion in lost productivity.

Last month, Scelson testified before the U.S. Senate about spam. He has been threatened by anti-spam activists, who often post his home addresses and phone number on the Internet. His industry faces a raft of new anti-spam legislation, stepped-up crackdown efforts by law-enforcement officials and more aggressive legal action by ISPs. Authorities also are plotting to better protect the vulnerable e-mail servers that marketers exploit to route messages anonymously.

Yet Scelson continues to openly defend the profession. “I’m like Eminem,” he says. “We built ourselves from nothing and became famous.”

An estimated 2 trillion spam messages are expected this year — more than 300 for every person on the planet. About 90% of it comes from the 150 biggest spammers, which includes Scelson, says Spamhaus Project, an anti-spam Web site. There are an estimated 2,000 spammers in the USA.

Four out of five children receive spam, says a study released this month by security-software maker Symantec. A third of the 1,000 kids polled, ages 7 to 18, said the e-mail made them “uncomfortable.”

“What they (spammers) do is tantamount to dynamite fishing,” says John Reid, who volunteers at Spamhaus Project. “They destroyed e-mail as an advertising medium and are about to destroy it as a communications medium.”

But Scelson says he is a responsible bulk e-mailer.

He says he gives consumers the option to be removed from mailing lists, does not hide behind forged e-mail addresses, does not bounce e-mail through foreign relays and leaves contact information on his bulk mail. He defends his business in online discussions and fears federal legislation won’t be applied fairly. If a federal anti-spam bill is passed, Scelson says, he will move all his operations offshore.

Scelson also argues select consumers want spam, and some research backs him. Commercial e-mail ads produce more than $7.1 billion in sales annually, the Direct Marketing Association says.

Most of all, Scelson fixates on the “hypocrisy” of AOL, MSN and other large ISPs, who he says inundate subscribers with junk e-mail. America Online spokesman Nicholas Graham fires back: “Consider the source. We take what he says with a grain of salt.”

Living well

From his home office, where a dozen rack-mounted computer servers hum 24 hours a day, Scelson sends millions of e-mails to 50 or so computer servers in the USA, China, South America and Europe. It costs $20,000 a month to pump out e-mail hawking everything from insurance to toys to lingerie. Software plows through 165,000 e-mail addresses an hour, searching for the roughly 16% that are active. Automated e-mail is then sent to the accounts, asking subscribers if they want spam. On average, only 3,000 of 5 million respond “yes,” Scelson says. He says he continues to send e-mail pitches to those accounts and leaves others alone.

Still, that’s enough for Scelson to charge several dozen clients $10,000 to $50,000 a month to funnel their ads to consumers. He estimates he makes $30,000 to $40,000 in profit in a good month. A staff of 16 part-time technicians helps Scelson fend off hack attacks from anti-spammers and maintain his far-flung operations.

He, his wife and their three children live in a five-bedroom home with a swimming pool in a leafy, upper-class neighborhood 40 miles east of New Orleans near the Mississippi border. A pool table fills one room; in another is a big-screen TV and state-of-the-art stereo system.

That once seemed inconceivable to Scelson, who has an eighth-grade education. At 18, he worked at a Baton Rouge computer shop and began selling computers. Competition with low-cost PC makers Dell and Hewlett-Packard forced him to try something else. A bulk e-mailer gave Scelson his first taste of the industry as a technician in 1995. Scelson, whose thirst for fame may be exceeded only by his chatty nature, was hooked.

‘Deceptive’ behavior

Critics, though, say Scelson represents the dark underside of commercial e-mail. Because of his profession, he says, he regularly receives obscene late-night phone calls and other threats. A recent e-mail from “Gorbachev” warns: “Scum like Scelson will never stop spamming until they are physically unable to do so.” Another, from “sik puppy,” asks, “Why does this vermin have a pulse?”

“You wonder why spammers use aliases, change addresses and don’t talk?” says Scelson, taking a drag from a cigarette. “I didn’t own a gun until recently. But now I have several, including a 9mm next to my computer.”

His wife, Amy, 28, chimes in. “People are nuts to get so mad that they threaten someone’s life over a piece of virtual mail.”

As of now, no major ISP is suing Scelson. But they have declared open season on other spammers. Last week, in its most aggressive action yet, Microsoft sued 15 alleged spammers in the USA and United Kingdom. It, like AOL, spends millions annually on anti-spam efforts. EarthLink has pending legal action against what it says are more than 80 spammers.

Tuesday, Microsoft said it has created a specialized group of about 20 researchers and programmers to develop technology to fight spam. “Like almost everyone, I receive a lot of spam every day, much of it offering to help me get out of debt or get rich quick,” Gates, the world’s richest man, wrote in an e-mail to customers and partners. “It’s ridiculous.”

Federal and state lawmakers, meanwhile, are drawing up harsh anti-spam bills. Under a proposed RID Spam Act, ISPs could sue offending spammers for up to $500,000 — and a federal court could triple that to $1.5 million. Violators also face imprisonment.

“The difference between legitimate marketers and spammers is crystal clear,” says Trevor Hughes, executive director of Network Advertising Initiative. It helps companies deliver marketing e-mail. “Spammers like Scelson forge headers, spoof e-mail addresses and crack anti-spam filter software. They do everything they can to be deceptive and avoid accountability.”

Scelson denies the charges.

But even while Scelson defends his industry, his peers would prefer he keep a lower profile.

“Given all the crap that’s going on with spam, it’s probably not wise to have a high profile,” says Alan Ralsky, 58, who calls himself “the Godfather of spam.” The gruff West Bloomfield, Mich., resident says he sends 30 million e-mails abroad each day peddling jewelry and vacation giveaways.

Sometimes, Scelson, who can be as earnest as he is blunt, wonders whether the fight is worth it. He says he’s been booted off AOL, AT&T, Broadwing and other networks, and has sued to stay on others. Rising costs and legal fees forced him to file Chapter 13 bankruptcy court protection in March, claiming $500,000 in debt. And he’s created at least 30 companies over the years.

“The ISPs have tons of money and time. How do I fight them?” says Scelson, pacing his office. While later shoveling spices and vegetables into crawfish stew in his backyard, he fantasizes about life after spam.

What he really wants is to create online video commercials or a free e-mail service with banner ads. He chuckles at the irony of producing ads that companies and consumers would willingly pay for.

“I’ve become famous because of spam, but eventually people will forget about spam,” he says. “That’s a fact of life.”

TEXT OF BIO BOX BEGINS HERE

About Ronnie Scelson

Age: 30.

Education: High school dropout.

Residence: Slidell, La.

Family: Wife, three children.

Average daily spam e-mails sent: 60 million to 70 million messages.

Types of ads: Home mortgage, insurance, teddy bears.

Interests: Everything Scooby-Doo, computers, cars.

TEXT OF INFO BOX BEGINS HERE

Top bulk e-mailers

Ronnie Scelson, who sends 60 million to 70 million spam e-mails a day, is among the USA’s best known.

Among the others:

Avg. daily spam

Type of spam

Eddy Marin, 41

250 million

viagra , mail-order brides, loans, computer software.

Brendan Battles, 31

50 million

CDs of e-mail addresses.

Alan Ralsky, 58

30 million

Vacation giveaways, mortgages, work-at-home opportunities.

Sources: Spamhaus Project, USA TODAY research

(c) USA TODAY, 2003

Title: Let’s Talk About Sex ,  By: Fass, Allison, Forbes, 00156914, 4/14/2003, Vol. 171, Issue 8

Section: Marketing

Giddy middle-aged lovers flirt suggestively over a pool table, ride piggyback and play footsie to the strains of “You Can’t Hurry Love.” They don’t have to: The amorous couples in this TV commercial, airing in New Zealand to push a newly approved drug for erectile dysfunction, have “36 hours of freedom to choose the moment,” an announcer says. Nudge-nudge, wink-wink.

The TV ad promotes a pill called Cialis, one of two new anti-impotence drugs that have been approved overseas and could win U.S. clearance within months. Cialis is made by Eli Lilly & Co. and biotech boutique Icos. The second drug, Levitra, is backed by Bayer AG and GlaxoSmithKline. Both duos are bent on cutting into the blockbuster franchise of Pfizer’s viagra by offering limp lotharios a better chance at romance with drugs that the makers claim kick in faster and last longer. Hence the nickname for Cialis: It’s the “weekend pill,” while viagra could fade in as few as four hours.

Where there’s love, there’s war. Pfizer has sued the backers of both drugs, alleging patent infringement. Meanwhile, the new drugs’ makers already are plotting a U.S. marketing blitz that will be one of the biggestin pharmaceutical history. Their marketing budgets, including consumer ads, thousands of salesmen and an abundance of free samples, could each total the $300 million that Pfizer spends on viagra , whose sales rose 13% to $1.7 billion last year.

With three drugs on the market the ensuing ads will be unabashedly sexual, a dramatic change from Pfizer’s shy approach when viagra was unveiled five years ago. Consumers will hear lots of frank talk about middle-age sexpeppered with tacit jabs at one another’s pills.

The companies also will try to make erectile dysfunction seem like an inevitability of middle age, “almost like when your eyesight starts to fail,” says Nancy Bryan, a vice president at Bayer. That pitch could extend the market beyond the 30 million men in the U.S. who have the disorder and into the ranks of healthy men looking for a pick-me-up.

One of the best-known brands in the world, viagra is a formidable opponent, but its shortcomings offer opportunities for the newcomers. Popular as it is, viagra doesn’t work in up to 40% of the men who have tried it. Plus, consuming food and alcohol can diminish the drug’s potency; so much for that romantic dinner before bedtime. No wonder half the guys who try viagra drop it.

viagra also has a lingering image problem caused by reports of fatal heart attacks in several men soon after it was introduced. Study results have ruled out cardiac risk in men with healthy tickers, but that fact didn’t garner as much attention as the deaths.

Cialis, an almond-shaped yellow pill versus viagra ’s blue diamond, may have an edge. If it is approved for use in the U.S., the makers will play up the extra time a 20mg tablet gives a guy to woo his way into the sack, as their ads now do in Europe, Australia and New Zealand. The audience: wealthy, active men age 40 and older. “We’re not targeting retirees on the beach in Florida,” says Robert Brown, a global marketing director for Eli Lilly, in a verbal swipe at viagra .

Through sponsorships and spokesmen, the Lilly-Icos team hopes to link its drug to longer duration, speed of action and athletic prowess. It shelled out $1 million to sponsor this year’s America’s Cup. And in New Zealand it tapped Graham Lowe, 56, a popular rugby coach, as a spokesman for Cialis. In the U.S. consumer ads will be created by ad giant GreyWorldwide, which also creates ads for Botox, Allergan’s wrinkle-buster.

Given the Cialis sell, playboys “are going to say ‘I want the viagra -like pill that lasts the whole weekend,’” says Lehman Brothers Managing Director C. Anthony Butler, who believes the two new drugs will lift sales of the entire category to $6 billion worldwide by 2009. He predicts Cialis will grab one-third of that–and that viagra will become even bigger, rising to the $3 billion mark by then.

Levitra, with a burning-flame logo, is being pitched as a turbocharged viagra . A20mg dose can supposedly take effect in 15 minutes and last for at least five hours. Bayer and GlaxoSmithKline want to woo 40-plus middle-income guys in committed relationships, fellows who supposedly don’t need a lot of time to maneuver their mates into bed. The Levitra man isn’t a swaggering “superhero” like those who will want Cialis, sniffs GlaxoSmithKline Senior Vice President David Pernock. He insists Levitra could become the leader within 24 months of U.S. approval. “We’re in this thing to win,” he says.

Ah, the joy of being second. Because of public squeamishness about impotence, Pfizer soft-pedaled viagra for years after its 1998 debut. Its first commercial featured craggy-faced Senator Bob Dole, then age 75, and didn’t mention viagra by name. Early ads showed a silver-haired couple dancing. The tag linewas more polite suggestion than pitch. Still, sales of the drug hit $788 million by year-end 1998.

Marketing will be the primary differentiation for these pills, since each works the same way. All are PDE-5 inhibitors and act by blocking the predominant enzyme in erectile tissue, phosphodiesterase-5, which in turn prolongs muscle relaxation and increases blood flow to the penis.

The drugs also share some potential side effects, namely headache, flushing and gastrointestinal distress, mild discomforts that could nonetheless take the fun out of a lusty romp. Also, all of the drugs can be fatal if ingested by patients who also take nitrates or nitroglycerin for heart ailments. An additional question mark for Cialis: It inhibits another phosphodiesterase enzyme, PDE-11, which is found in the testicles and the heart, although the Lilly-Icos team insists studies show no problems.

Pfizer is on the defense. The New York-based drug giant filed a lawsuit last year in the U.S. District Court in Delaware, alleging both Cialis and Levitra infringe a recent viagra “method-of-use” patent. The suit is pending. A similar one in Europe was dismissed. Still, Pfizer, which gets 5% of its sales from viagra , is preparing for the worst. It recently completed a study of 228 viagra users, showing half were able to have an erection and “successful” intercourse within 20 minutes.

Pfizer also plays up the fear of the unfamiliar. Print ads aimed at physicians tout viagra as “the one you know.” Consumer ads appeal to men who have never tried viagra , a group Pfizer hopes to convert before Cialis and Levitra reach them. In one TV spot a guy’s newfound ebullience is explained this way: “He finally asked his doctor about viagra for the first time.”

Just wait until he hears about the “weekend pill.” “The penis doesn’t know loyalty,” says Irwin Goldstein, director of the Institute for Sexual Medicine at Boston University. “If there’s a pill out there that’s going to make his erection more rigid, he’s going to switch.”

PHOTO (COLOR): Hope springs eternal: Levitra’s David Pernock.

PHOTO (COLOR): viagra and Cialis, in an overseas ad, target middle-agers with erectile dysfunction.

~~~~~~~~

By Allison Fass

Title: IT CETERA ,  By: Fast, Ingo, Entertainment Weekly, 10490434, 06/26-07/03/98, Issue 438/439

• IT SOUND Scratching Once a staple of early rap, it’s made it’s comeback on albums from Janet Jackson and Mariah Carey. Joan Osborne even took a turntable on tour with her.
• IT VILLAIN Girl Reporters Notice how Deep Impact and Godzilla revolve around the Eve-ishness of Tea Leoni and Maria Pitillo, who see natural disaster as their big break?
• IT CARTOONIST Chris Ware Meet the king of the indie-comic-book world. This illustrator’s funny and often disturbing drawings will fill a book that will ship later this year.
• IT INFOMERCIAL Slam Man Hosted by Sugar Ray Leonard, this home-boxing workout tape comes with a blue foam whupping boy whose body parts light up when they’re hit. Yowza!
• IT VACATION DESTINATION Morocco Not just Rick’s place anymore, Tom and Nic, Sly and Whoopi have taken R&R here.

IT VIDEO DIRECTOR Jonathan Glazer A brilliantly inventive MTV auteur (and when’s the last time you heard that phrase?), he directed Jamiroquai’s “Virtual Insanity” and made Jay Kay, the cat in the hat, look like Fred Astaire. Also lensed Radiohead’s creepy revenge clip “Karma Police.”

• IT COMBO viagra and Prozac One gives what the other takes away.

PHOTO (COLOR): Prozac capsule and viagra tablet

• IT CHANNEL The Game Show Network Feel like a million bucks yelling “No whammies! No whammies!”
• IT PROFESSION Math After Matt Damon proved mathematicians can be wispy-haired sensitive souls in Good Will Hunting, upcoming films [Pi] and Rushmore make number crunching a prime gig.
• IT EXERCISE Pilates Pronouncing the name of this stretching regimen is half the battle.
• IT DRINK: Red Bull A supercharged, highly caffeinated energy drink from Austria. Could easily fuel Ah-nuld’s Hummer.

PHOTO (COLOR): Can of Red Bull energy drink

• IT RERUN Law & Order Hell, it’s only on about 73 times a day!

PHOTO (COLOR): George Dzundza, Michael Moriarty, Richard Brooks and Chris Noth of TV show Law & Order

• IT GAME Nintendo’s Game Boy Pocket Camera For budding Spielbergs, the toy that enables the user to project his or her image into a videogame.
• IT PARLOR GAME Ping-Pong Fans include Veronica Webb, Woody Harrelson, and hipster director Tony Kaye (American History X). Can we now stop pretending we like to play pool?
• IT READ Hello The English tab that covers British TV stars, soccer players, and heirs to the thrones of countries you never knew existed. And yes, Hello’s subjects are as scintillatingly scandalous as those on Jerry Springer–but their estates are nicer.
• IT L.A. DIS The smoking excuse (now that you can only puff outside) “I’m going for a cigarette.” Read: “You’re boring me, I’m leaving.”
• IT MATCHMAKER The Lovegety The Japanese gizmo that beeps whenever you are within 100 yards of a similarly programmed and like-minded Lovegety.
• IT METAL Titanium From credit cards to the walls of the Guggenheim museum in Bilbao, Spain, this is the king of the metals.
• IT COMEDY LAUNCHING PAD The Upright Citizens Brigade This NYC-based improv quartet, who often pop up on Late Night With Conan O’Brien sketches, have finally landed their own yuk-fest airing this summer on Comedy Central.
• IT GRIPE “My area code is changing!”
• IT INDULGENCE Gap to Go In selected cities, you can now order tees, jeans, and boxers via phone or fax. “Jeeves, bring us the phone!”
• IT MAKEUP Stila Created by makeup artist to the stars (and wife of Anthony Edwards) Jeanine Lobell, it emphasizes glitter over garish.
• IT COUNTRY France Paris makes up for Edith Piaf and Charles Aznavour by being ground zero for such new-wave techno bands as Air, Dmitri From Paris, and Daft Punk.
• IT CARTOON CHARACTER Velma The underappreciated heroine of Scooby Doo was stylistically ahead of her time with pleated skirts and kneesocks. She gets the nod of approval from an inebriated high school student in Can’t Hardly Wait.

PHOTO (COLOR): Comic book Library of Novelty

PHOTO (COLOR): Slam Man mechanical boxing opponent figure

PHOTO (COLOR): Tube of Stila lip gloss

ILLUSTRATIONS

~~~~~~~~

Illustration by Ingo Fast

Title: Grassroots effort for Lilly’s Cialis ,  By: Young, Lesley, Marketing Magazine, 00253642, 1/19/2004, Vol. 109, Issue 2

Section: NATIONAL news

The erectile dysfunction drug market is starting to swell with the arrival of a pugnacious first competitor to Viagra in Canada: Lilly ICOS’s Cialis, dubbed “le weekender” in Europe.

Lilly ICOS received approval for Cialis, a prescription drug that treats ED, in Canada and the United States late last year. Cialis is now offered in more than 50 countries worldwide and boasts a duration of 36 hours, compared to Viagra’s five.

ICOS is using a grassroots personalized direct-to-consumer (DTC) campaign, an effective strategy to differentiate itself from Pfizer, according to Lea Katsanis, associate professor of marketing at the John Molson School of Business at Concordia University in Montreal.

“There is a large untapped market for ED drugs,” she notes, adding ICOS is likely going after brand new prescriptions. “Viagra did not experience the exponential growth it forecast.”

Called “Music for 2,” the unbranded Lilly ICOS promotion is designed to help men improve their sexual health and revitalize relationships with their partners. It features an annual live concert series in romantic settings — promoted through contests — a music and ED health-themed informational Web site (the Canadian site is music36.ca) and CD giveaways. The inaugural concert is slated for February in Monte Carlo and features tenor José Carreras and Blondie singer Debbie Harry.

David Ricks, marketing director of Eli Lilly Canada in Toronto, says that unlike other makers of ED drugs, Lilly ICOS chose music over sports as a platform to engage men in conversation with their partners and doctors about a condition that impacts them at the deepest emotional and physical levels.

“We did a lot of consumer research on middle-aged men and their musical tastes,” says Ricks. “And we found that one-third of men in their 50s enjoy music.”

In Canada, a buzz campaign is launching that will place free CDs in strategic locations across the country, starting with airports. The discs feature romantic music and encourage men to register for the contest that will eventually send 36 Canadian winners and their partners to Monte Carlo. Unbranded radio ads will also promote “Music for 2″ and ED on eight radio stations in Canada. (”Music for 2″ will first be open to men in Canada, Mexico, the United Kingdom, Germany, Portugal and Sweden before expanding to other countries.) Katsanis says the approach also reaches out to men’s partners, an important target because women tend to be more open about sexual health issues and will encourage men to seek ED help.

The “Music for 2″ campaign was developed by Manning Selvage and Lee in the United Kingdom and executional support in Canada was provided by National Public Relations in Toronto. Eli Lilly Canada’s consumer ad agency is Grey Worldwide in Toronto.

A third competitor to Viagra, Levitra (marketed by Bayer and GlaxoSmithKline) is waiting for approval in the Canadian market.

Katsanis says the increase of DTC advertising for lifestyle drugs in North America will make it increasingly difficult for Health Canada to sustain its strict regulations on drug ads. “There’s no question the market is going to get a lot more competitive and the ads will become a lot more aggressive,” she adds.

PHOTO (COLOR): Research showed men 50-plus appreciate music

~~~~~~~~

By Lesley Young

Title: THE HIGH HARD ONE ,  By: Bie, Tom, Skiing, 00376264, Dec2001, Vol. 54, Issue 4

Section: SKIING SCENE

When planning your next ski trip, you might want to pack some Viagra along with your Volkls. A recent study conducted by London’s Hammersmith Hospital shows that the popular impotency drug may also help prevent high altitude pulmonary edema (HAPE). The scientists discovered that the enzyme phosphodiesterasealso can restrict blood flow to the lungs, which can induce HAPE. According to Peter Hackett, high-altitude expert and author of Mountain Sickness: Prevention, Recognition and Treatment, taking Viagra helps break down the offending enzyme and allows more oxygen into the lungs.

~~~~~~~~

By Tom Bie

Title: ASK MEN’S HEALTH ,  Men’s Health, 10544836, Jun98, Vol. 13, Issue 5

Q I’VE HEARD that the new impotence pill viagra can give much harder erections to men who aren’t impotent. Can it? If so, send me a case.

A The rumors that viagra can somehow improve a healthy erection are unfounded. “ viagra is unquestionably the most exciting therapy for impotence that has been developed,” says Harin Padma-Nathan, M.D., director of the Male Clinic in Santa Monica, California, and a leading viagra researcher. “But if you have normal erections, there is no room for improvement with this drug.”

viagra blocks an enzyme that causes erections to wilt, which helps impotent men become hard “naturally.” If you still attain erections normally, your body chemistry doesn’t need the extra help. Taking viagra may only make your head throb; headaches were reported in about 15 percent of men who tested the drug.

“ viagra is only for men who have the consistent inability to attain and maintain an erection adequate for sexual performance,” Dr. Padma-Nathan emphasizes. If this description hits home, see your doctor. He can prescribe viagra only if you have a genuine erectile problem.

Q Halfway through a weight-training session, I become nauseated. I warm up, I drink plenty of water, and I don’t eat too soon beforehand. So what gives?

A Nausea during lifting may mean you’re pushing too hard, says Carl Maresh, Ph.D., professor of exercise physiology at the University of Connecticut. It’s a fairly common response to lifting too much weight and not giving your body enough time to recover between sets. Also, pay attention to your breathing pattern during workouts. Holding your breath or hyperventilating can cause you to become nauseated and dizzy.

It’s also important to make sure your diet is well balanced. “Nausea can be a sign of low blood-glucose levels,” says Maresh. Your body needs an adequate intake of carbohydrates throughout the day, not just before your workout. But eating a complex carbohydrate snack such as a bagel roughly an hour before your workout might alleviate the problem. If none of this helps, see a doctor. “If you’re doing everything right and you still find yourself becoming nauseated, it could signal something more serious,” says Maresh.

Q Have you heard of a new kind of margarine made with olive oil? Is it any better for me than butter or regular margarine?

A Sold under the brand name Olivio, this spread stacks up well against full-fat butter and margarine, says Sonja Connor, R.D., research dietitian at Oregon Health Sciences University It contains only 1 gram of artery-clogging saturated fat per tablespoon, compared with 7 grams for butter and 2 grams for margarine. It’s also low in bans fatty acids, a type of fat that has been linked to heart disease. Olivio gets 6 percent of its fat from bans fatty acids, compared with margarine’s 7 to 30 percent–a pretty respectable figure, according to Connor.

What’s more, most of Olivio’s fat is monounsaturated, a type that some researchers think can lower harmful LDL cholesterol levels while raising the good HDL levels. If you like its slightly stronger flavor, Olivio’s a healthy choice, says Connor. If you don’t, there are plenty of other reduced-fat spreads out there. (For our favorites, check out “The Slimmest of Margarines,” Men’s Health, March ‘98.)

Q I work in retail and I’m always reaching for things, so my shirt comes untucked about a hundred times a day. What can I do about this? And should shirts be tucked straight down, or should they be untucked enough to cover your belt?

A “Most men who can’t keep their shirts tucked in just need longer shirttails,” says Frank Childers, corporate tailored-clothing coordinator for Nordstrom. Two brands with longer-than-average shirttails are Nordstrom’s own collection of dress shirts and Faconnable, he says. As for your second question, shirts should be tucked straight down. When you move around, the shirt will pull out just slightly–enough to feel comfortable while still looking good.

Q I’m trying to lose weight and I’ve recently switched to fruit as my regular snack. A co-worker told me that grapes are among the highest-calorie fruits due to their high sugar content, and I’ve heard bananas should be avoided because they’re too starchy. So what should I eat?

A “Grapes and bananas may have more calories than other fruits, but they’re still far better than most other snacks,” says Elaine Turner, Ph.D., R.D., assistant professor of nutrition at the University of Florida. For example, a can of soda and a bag of chips contain roughly 300 calories, 10 to 12 grams of fat, and hardly any nutrients. A handful of grapes and bottled water, on the other hand, ring up only about 100 calories, and quite a few vitamins and minerals. Just this one change, made daily over the course of a year, could be worth almost 20 pounds of weight loss, says Dr. Turner. As far as fruits go, citrus fruits and melons contain the fewest calories because of their high water content. But we recommend eating a variety. “The bottom line,” says Turner, “is that all fruits are nutritious and virtually fat-free.”

Q I have very pale skin, even in the summer. I read somewhere that you can get melanin injections that both darken the skin and prevent sunburns and skin cancer. True?

A Melanindoes darken skin and protect against sunburn and skin cancer, says Norman Levine, M.D., chief of dermatology at the University of Arizona Health Sciences Center. But it can’t be injected directly.

What you may have read about is an experimental drug called Melanotan, which stimulates your body to produce more melanin. In early trials, Melanotan appears to darken skin color, says Dr. Levine, who’s involved in the drug’s development. However, Melanotan won’t be available for at least a few years; so for now the only safe way to darken your skin is to use a self-tanning product. You’ll also need a sunscreen with an SPF of at least 15 anytime you’re outdoors. And make sure it’s waterproof, or you’ll sweat most of the protection away, says Dr. Levine.

Q When you write about let pulldowns, you always say to pull the bar to your chest. But what about pulling it down behind your head? Does this do the same thing?

A The exercise that you’re describing works the back muscles much the same way that pulling the bar to your chest does, according to Len Kravitz, Ph.D., of the University of Mississippi. “Many trainers choose not to do behind-the-neck pulldowns because they think there’s a higher risk of injury, but I disagree,” says Kravitz. “Done properly, let pulldowns behind the neck are perfectly safe–and the variation keeps your workout interesting,” he says.

The key to avoiding injury with any exercise, of course, is proper form. Sit at the pulldown machine and grip the bar overhead with palms facing away from you, your hands slightly more than shoulder-width apart [A]. Keeping your upper body perpendicular to the floor, slowly pull the bar down behind your head, your elbows pointing to the ground and slightly outward [B]. (Forcing your head forward or not maintaining an erect posture can lead to injury, says Kravitz.) Slowly return to the starting position.

PHOTO (BLACK & WHITE): viagra can somehow improve a healthy erection are unfounded.

PHOTO (BLACK & WHITE): Vigra is unquestionably the most exciting therapy for impotence that has been developed.

PHOTO (BLACK & WHITE): IF YOU BUILD IT: A new medication called viagra will improve your erections only if you’re impotent.

PHOTO (COLOR): PROPER FULLDOWN PROCEDURE

Title: Levitra makes gains on Viagra ,  By: Thomaselli, Rich, Advertising Age, 00018899, 12/15/2003, Vol. 74, Issue 50

Section: News

Less than four months after its U.S. launch, erectile-dysfunction drug Levitra is leaving a tangible impression on consumers and making gains on market leader Viagra.

According to IMS Health, Levitra has taken a 14.4% share of the $1.74 billion market since being approved by the Food and Drug Administration on Aug. 19.

Last month, Levitra’s first branding spot from WPP Group’s Quantum Group, Parsippany, N.J., hit No. 1 on Intermedia Advertising Group’s ad tracking poll. According to IAG VP Steven Walsh, it represented the first time that a pharmaceutical company’s direct-to-consumer spot ranked in the top three. IAG’s data measure general recall, brand recall, message understanding and likability.

The spot features a man finding a football in his garage and repeatedly trying to throw it through a tire hanging from a tree. He fails, until it is implied he takes Levitra. He then has no problem accomplishing the feat.

While awareness of the Bayer/GlaxoSmithKline co-marketed product seems to have translated into prescriptions, Pfizer’s Viagra still has a whopping sales lead on Levitra and Eli Lilly’s Cialis, which hit the market two weeks ago. Viagra, handled by Omnicom Group’s Cline Davis and Mann, New York, spends $87 million annually on advertising. Cialis and Grey Global Group’s Healthy Grey Village, New York, are set to spend $100 million (AA, Nov. 3) on a campaign that began last week.

But officials from Bayer and GlaxoSmithKline, who will spend $75 million on Levitra, remain undaunted by Viagra’s five-year head start.

“Competition is a good thing. It breeds innovation,” said Sharon Wible, senior product manager for GSK. “We just felt that we did our research on this and we found that of the 32.5 million men who suffer from erectile dysfunction, 81% were undiagnosed. …We felt there was certainly a piece of the market for us.”

Ms. Wible said GSK and Bayer set internal records by having a campaign up and running six days after FDA approval. The two-pronged attacked including the branding work and a separate sponsorship with the National Football League that produced a promo called “Tackling Men’s Health,” with former NFL coach and player Mike Ditka as the spokesman.

PHOTO (COLOR): TOTAL RECALL: Ad hit No. 1 on Intermedia’s tracking poll

~~~~~~~~

By Rich Thomaselli