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Erectile Dysfunction FAQs (cont.)

Do ED drugs have side effects?

The most common side effect of Viagra and similar drug use is headache, affecting about 16% of users. A drop in blood pressure, transient dizziness, and facial flushing (red face) are reported in 10%. Indigestion occurs in 7% and nasal congestion in 4%. Between 3% and 11% of users report some visual problems while on Viagra. This visual disturbance is described as either blurred vision, increased light sensitivity, persistence of a bluish tinge, or temporary loss of the ability to distinguish between blue and green.

Cautions: Viagra, Levitra, and Cialis are absolutely not to be taken by men with heart conditions who are taking nitrates such as nitroglycerine or isosorbide (Isordil, Ismo, Imdur). Certain street drugs such as "poppers" also can cause serious problems if taken with Viagra, Levitra, or Cialis. Ecstasy is a street drug that may increase sexual desire but interferes with performance. This has prompted some men to combine ecstasy with Viagra, Levitra, or Cialis. This mixture (a combination sometimes called "sextasy") can improve erection ability but also causes severe headache and priapism. (Priapism is an abnormally prolonged erection that becomes extremely painful and may result in permanent damage to the erection mechanism.) There are also potentially dangerous effects to your heart from mixing Viagra and similar medications with various other street drugs.

What are penile implants?

Two types of devices are available, a semirigid and a multi-component inflatable system.

With the semirigid device, two matching cylinders are implanted into the penis. These devices provide enough rigidity for penetration and rarely break. The major drawbacks are the cosmetic appearance of the penis, the need for a surgery, and the destruction of the natural erectile mechanism when the device is implanted.

The inflatable devices consist of two cylinders inserted into the penis, a pump placed in the scrotum to inflate the cylinders, and a reservoir that is contained either within the cylinders or in a separate reservoir placed beneath the tissue of the lower abdomen. The inflatable prosthesis generally remains functional for 7 to 10 years before a replacement may be necessary.

Isn't surgery a rather drastic measure?

In the past, the placement of prosthetic devices within the penis was the only effective therapy for men with certain types of erectile dysfunction. Now, this is the last option considered when all other treatments are unacceptable or unsuccessful. Nevertheless, surgery remains a reliable form of therapy (see Impotence/Erectile Dysfunction for surgical options). Once a surgical implant has been done, the normal structure of the penis is permanently altered, which means that the surgery is not reversible.

What if I feel embarrassed to talk about this?

This is a delicate topic, and your doctor should be sensitive and caring to make you comfortable about sharing these intimate details of your private life. Schedule enough time with your doctor to conduct a full interview and physical examination. The first step in the medical management of erectile dysfunction is taking a thorough sexual, medical, and psychosocial history.

  • Your doctor will ask if you have difficulty obtaining an erection, if the erection is suitable for penetration, if the erection can be maintained until the partner has achieved orgasm, if ejaculation occurs, and if both partners have sexual satisfaction.
  • The doctor will want to know all medications you have taken during the past year, including all vitamins and other dietary supplements.
  • Tell the doctor about your tobacco use, alcohol intake, and caffeine intake, as well as any illicit drug use.
  • Your doctor will be looking for indications of depression. You will be asked about libido (sexual desire), problems and tension in your sexual relationship, insomnia, lethargy, moodiness, nervousness, anxiety, and unusual stress from work or at home.
  • You will be asked about your relationship with your sexual partner. Does your partner know you are seeking help for this problem? If so, does your partner approve? Is this a major issue between you? Is your partner willing to participate with you in the treatment process?

Your doctor will want your candid answers to questions like these so you can discuss the best treatment for you.

A physical examination is necessary. The doctor will pay particular attention to the genitals and nervous, vascular, and urinary systems. Your blood pressure will be checked because several studies have demonstrated a connection between high blood pressure and erectile dysfunction.

The physical examination will confirm information you gave the doctor in your medical history and may help reveal unsuspected disorders such as diabetes, vascular disease, penile plaques (scar tissue or firm lumps under the skin of the penis), testicular problems, low male hormone production, injury, or disease to the nerves of the penis and various prostate disorders.

You can achieve a satisfactory erection and sexual health, and working with your doctor or a specialist (urologist) is the best way to get help.

Medically reviewed by Michael Wolff, MD; American Board of Urology

REFERENCE:

Edward David Kim, MD, FACS, et al. "Erectile Dysfunction." Medscape. 16 Sep 2013.


Medically Reviewed by a Doctor on 11/16/2016
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