Erectile Dysfunction

Sep 22, 2020

By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy

What happens when a lawyer takes Viagra? He gets taller. What's the difference between the first Honeymoon and the second? First honeymoon, Niagra. Second honeymoon, Viagra. A woman calls a pharmacy and asks the pharmacist to write an article about erectile dysfunction. Two of the three of these statements are jokes.

It is easy to make light of erectile dysfunction or ED. But about half of men over the age of 40 will experience ED. The percentage of ED sufferers goes up as guys get older. Erectile dysfunction is very common, but before Viagra and Viagra jokes, we just didn't talk about it very much. I think all the Viagra jokes have actually done a great service for guys and their partners who used to suffer with ED in silence.

There really isn't one cause of erectile dysfunction. Doctors call erectile dysfunction a disease of multifactorial etiology. We used to think erectile dysfunction was mostly psychological, or all in a guy's head. But now we think purely psychological ED is quite rare. However, even guys with a physical cause of ED may have an associated psychological component.

There are lots of conditions that are associated with ED. These include diabetes, high blood pressure, heart disease, benign prostatic hypertrophy, epilepsy, stroke, multiple sclerosis, sleep apnea, COPD, thyroid problems and depression. Basically, any disease that affects small blood vessels, nerve signals or hormone levels can affect erections and thus be associated with ED. If you needed another reason to watch your diet, eat more vegetables, get some exercise, keep your high blood pressure, high cholesterol and diabetes under control, maybe avoiding ED will catch you attention.

It is not just diseases that are associated with ED. Some blood pressure meds like beta-blockers, some antidepressants like SSRI's, some antipsychotics and some BPH drugs like finasteride and dutasteride can all contribute to ED.

What do you do if you think you have ED? Talk to your doctor. They are first going to do an exam and try to rule out other things like ejaculation problems, physical problems with the penis, relationship problems and problems reaching an orgasm. Once they've ruled out other causes, they will probably try a PDE5 inhibitor (a drug like Viagra). If the PDE5 inhibitor doesn't work, they'll make sure you are taking it properly. If you take a PDE5 inhibitor with food, it can delay the effect for hours. Alcohol can contribute to ED. So, taking alcohol can counter-act the effects of a PDE5 inhibitor. If PDE5 inhibitors don't work, next step is usually a vacuum device a guy can use at home. If that doesn't work, there are surgical options that can include implants

Viagra or sildenafil is the most famous of the PD5 inhibitors. PD5 or phosphodiesterase 5 inhibitors also include tadalafil or Cialis and vardenafil or Levitra. Sildenafil and vardenafil should be taken about 30 minutes prior to sexual activity. They both can work for about 4 hours. Fatty foods can delay how long sildenafil and vardenafil can take to kick in by an hour or more. Tadalafil has to be taken at least 2 hours before sexual activity. You might think that is very inconvenient, but tadalafil has a trick up it's sleeve. It can hang out in your system, ready to do its thing for about 36 hours. You could take one at 3 pm on a Friday and be ready for sexual activity any time until 3 am on Sunday. All the PDE5 inhibitors can cause headache, flushing, heart burn, runny and stuffy nose. If you are on nitroglycerin of any form, you shouldn't take PDE5 inhibitors. That combination can cause an unsafe drop in blood pressure. And if you have an erection that lasts longer than 4 hours, that is a serious problem. Go to the emergency room. A prolonged erection can cause permanent damage.

A gentleman walked into the pharmacy wearing a black hoodie. On the front it had a skull and cross bones logo. The hoodie had the words "Union Erectors" above the logo and "Scaffolding" and "Shoring" on either side of the logo. On the back of the hoodie it said, "Erection Specialist". I don't think the hoodie was a joke. I think it was a serious commentary on how important the job of an erection specialist is. Erectile dysfunction is serious too. ED can be the first sign of things like diabetes, BPH and heart disease. If you or your partner have ED, go get it checked out with the doctor. It can be embarrassing, but it also can be treated. If you need something to break the tension of an embarrassing situation, Viagra jokes work great.

As always if you have any questions or concerns about these or other products, ask your pharmacist.

The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.


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