If you have difficulty achieving or maintaining an erection, you may want to take a look inside your medicine cabinet. There are a number of prescription and over-the-counter drugs that may lead to erectile dysfunction (ED). While these medications may treat a disease or condition, in doing so they can affect a man’s hormones, nerves, or blood circulation, resulting in or increasing the risk of ED. Medications account for 25 percent of ED.
Impotence, or ED, is the inability to achieve or maintain an erection more than 20 percent of the time. Erectile dysfunction affects 18 to 30 million men and can affect all age groups. This number has increased significantly as awareness of the disorder has heightened and more prescriptions are written.
ED is one of the most common sexual problems and affects nearly 50 percent of all men over the age of 40 at some stage. In the past it was commonly believed that ED was caused by psychological problems; it is now known that 80 to 90 percent of impotence is caused by physical problems.
There are risk factors for the development of ED. As men age, the level of circulating testosterone decreases. This may interfere with normal erection. Low levels of sexual desire, lack of energy, mood disturbances, and depression can all be symptoms of low testosterone. By far, the most important cause of the development of ED is the presence of illnesses like high blood pressure, diabetes, high cholesterol levels, and cardiovascular disease. Diabetes can be the cause of ED in more than 50 percent of men (three times as high as in non-diabetic men). These conditions, over time, can lead to a degeneration of the penile blood vessels.
Common causes of erectile dysfunction include the following:
- Prescription drugs
- Heart disease
- Vascular disease
- High blood pressure
- Metabolic syndrome
- Hormonal imbalance (low testosterone)
- Advancing age
- Chronic illness
- Surgery or trauma
- Anxiety and depression
- Poor communication or conflict with your partner
A vicious cycle often plays out in our society. Over 200 commonly prescribed drugs are known to cause or contribute to impotence. Poor lifestyle choices which lead to illness can also cause ED. Further, the drugs used to treat these illnesses can cause ED. But too often the drugs used to treat the resulting ED should not be used to treat the original illnesses, nor should they be combined with the drugs that caused the ED in the first place. Drugs affecting impotence include the following:
- Anti-anxiety drugs
- Antihistamines used to treat heartburn, acid indigestion, and GERD
- Non-steroidal anti-inflammatory drugs
- Prostate cancer medications
- Medications to treat benign enlargement of the prostate
- Parkinson’s disease medications
- Anti-arrhythmia drugs
- Muscle relaxants
- Anti-epileptic drugs
- Chemotherapy drugs
The best rule of thumb is to consult your doctor before modifying or discontinuing any prescription drugs.
There are only three oral drugs approved by the FDA to treat erectile dysfunction: Cialis, Levitra, and Viagra. All work by increasing the flow of blood into the penis so that when a man is sexually stimulated, he can get an erection.
There are certain situations in which these drugs may not be safe to take. If you have suffered from a heart attack, stroke, or life-threatening arrhythmia (irregular heart rate) within the last six months, you should discuss other options with your doctor. It is also advised to avoid these drugs if you have uncontrolled high or low blood pressure or if you experience chest pain during sexual activity.
Side effects of these drugs can include:
- Upset stomach or “heartburn”
- Flushing (feeling warm)
- Nasal congestion
- Changes in vision (color, glare)
- Back pain (with Cialis)
Stop taking these medications and call your doctor or seek emergency medical treatment immediately if you experience any of the following:
- Painful erection
- Prolonged erection (longer than four hours)
- Chest pain
- Itching or burning during urination
- Sudden or decreased vision loss in one or both eyes (NAION, non-arteritic anterior ischemic optic neuropathy)
NAION causes a sudden loss of eyesight because blood flow is blocked to the optic nerve. On May 27, 2005 the FDA confirmed it was investigating a possible relationship between the use of Viagra and NAION. This was originally noted by Dr. Howard Pomeranz, an eye expert at the University of Minnesota in 2000. Since then, there have been several other similar reports. In a study in the Journal of Neuro-Opthalmology, Dr. Pomeranz noted seven new cases of NAION in men taking Viagra. Pfizer has issued a press release saying it has found no link between NAION and Viagra. People who have a higher chance for NAION include those who:
- Are over 50 years old
- Have heart disease
- Have diabetes
- Have high blood pressure
- Have high cholesterol
The recurring cycle of disease, prescriptions, and adverse reactions can be prevented in almost all cases by finding the underlying cause of the illness and addressing it with a therapeutic lifestyle program. Is the high cholesterol due to food choices or a lack of exercise? Is it a genetic variant which can be tested? Will specific effective heart-healthy supplements such as CoQ10, garlic, omega-3 fatty acids, niacin, or red rice yeast lower the cholesterol? Is the high blood pressure due to low levels of Vitamin D or high levels of nor-epinephrine? What are the stress factors? Are carbohydrate cravings that elevate the blood sugar a result of low levels of serotonin and/or poor food choices? Is the individual supported in a program that is scientifically based and provides education on nutrition, exercise, stress management and appropriate supplements to help maintain normal blood sugar and healthy weight loss? Is a neurotransmitter imbalance contributing to your ED?
The American College of Cardiology 2004 national guidelines recommended therapeutic lifestyle changes (TLC) as the standard of care in the management of cardiovascular disease (CVD) risk factors: “Many patients with classic CVD risk factors can achieve risk-reduction goals without medication within three months of initiating TLC.” The following highly respected organizations and others recommend TLC as a first line therapy before prescribing pharmaceutical drugs for conditions most doctors see every day.
- National Institutes of Health
- Center for Disease Control
- American Heart Association
- American Diabetes Association
- North American Menopause Society
- National Institute on Aging
Lifestyle choices can lead to degeneration of the erectile tissue and the development of ED. One way to improve ED is to make some simple lifestyle changes. For some men, adopting a healthier lifestyle such as exercising regularly, eating a healthy diet, and reducing stress may be all that is needed to find relief.
Poor dietary choices may lead to vascular disease (the most common cause of ED), which interferes with the erection process by restricting blood flow to the penis. Vascular disease (atherosclerosis) accounts for 50 to 60 percent of ED in men over age 60.
Smoking, drug, or alcohol abuse will compromise the blood vessels of the penis. Lack of exercise and a sedentary lifestyle will contribute to the development of ED. Lean, physically active men are less likely to have problems with ED.
Seek a professional to guide you through the myriad effective natural therapies, including acupuncture, herbs, and homeopathic remedies. Also keep in mind that good nutrition can support erectile function by improving overall health.
For those who require more intensive treatment, adopting these lifestyle changes in addition to other treatments can help.
Successful management of ED includes the following:
- Identify the underlying causes of health issues
- Get hormonal testing
- Seek natural approaches to attain optimal health
- Make therapeutic lifestyle changes
- Quit smoking, avoid excessive alcohol and drug abuse
- Reduce stress and anxiety
The good news is there are many effective therapies for ED. Explore your options and put zest back into your life!