At 10:25 PM 2/22/01 EST, Axwell@a... wrote:
> How does Viagra affect the voice ?
Oh, dear...it was about time this came up on the list, I suppose.
Viagra [sildenafil citrate] is a selective inhibitor of the enzyme cyclicGMP
phosphodiesterase, which is present in penile tissues [corpus cavernosum to
be specific]. Contrary to pedestrian and somewhat vulgar humor, the penis
is not a muscle, but rather a highly vascular structure which becomes erect
by engorgement with blood. In response to tactile stimulation, the cells of
the corpus cavernosum release a compound called nitric oxide. The nitric
oxide, in turn, activates the enzyme guanine cyclase to cause an increase in
local levels of cyclic GMP. Viagra potentiates the accumulation of cyclic
GMP by inhibiting its degradation. Cyclic GMP, a local vasodilator which
dilates the arterioles to the corpus cavernosum to allow the ingress of
blood, engorgement of this spongy vascular tissue and the consequent
erection [or "boinger" in the trade :-)] .
As such, there should be no direct affect on voice. Sildenafil does not
make men "manlier"; has no effect on testosterone levels; won't lower the
voice, etc. However, there may be some indirect effects on singing, I
suppose. There is a 4% incidence of nasal congestion [due to engorgement of
nasal blood vascular tissues]. Other side effects are headache, facial
flushing, dry cough; all of which can affect singing. And I suppose it's
possible that if Viagra were still in one's system when the mezzo gets
sultry [as mezzos are wont to do from time to time :-> ], one could end up
with a "boinger" right there on stage. The terminal half-life of the drug
is about 4 hours, which means that, pharmacodynamically speaking, it is
essentially clear from the system in about 6-8 hours] Another potentially
more serious side effect of Viagra includes priapism [rare painful
unremitting erection] which would not be good for either kind of performance.
Finally, sildenafil may depress platelet function, although there is no
additive effect over aspirin. There is no reported incidence of bleeding
problems, so the potential of vocal fold hemorrhage would only be theoretical.
I suppose the safest use, from the standpoint of vocal performance and vocal
health, would be to wait at least 8 hours for the Viagra to clear from one's
system before singing.
Dr John, please feel free to chime in if I've missed anything cogent.
Regards to all,
GWendel [MD, PhD, etc]
tenor
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