I am 65 and was diagnosed with PD 18 months ago. I have a 50-degree upward curvature and some associated erectile dysfunction, but with Viagra I am still able to be sexually active. I plan to purchase the Fastsize Extender and use it in conjunction with L-arginine in hopes of reducing the degree of curvature. Is there a problem using L-argenine and Viagra together?

Dr. Levine answers: As you know, erectile dysfunction (ED) frequently accompanies Peyronie’s disease and in fact up to 90% of patients have been reported some reduction of rigidity. The use of all three of the PDE-5 inhibitors (i.e. Viagra, Levitra, and Cialis) have been used successfully to improve rigidity in Peyronie’s disease patients. It should be recognized though that a much stronger erection with curvature may have a greater risk of being reinjured during sex and make the deformity worse. But this has not been reported. The use of the L-arginine is as an anti-fibrotic (i.e. anti-scarring) agent. It should be taken daily and the recommended dose is 1000 mg twice per day. Viagra, Levitra, and Cialis are taken on an as-needed basis, but can be taken up to once per day. There is experimental evidence to suggest that Viagra as well as the other two PDE-5 inhibitors can have some anti-scarring effects as well, but these have not been demonstrated in proper trials.