Medicines Linked to Impotence: Classification and Remedies
Erectile dysfunction (ED) is a common condition that affects males of all ages and varying levels of health and fitness. This article explores the various factors that may contribute to ED, including common medications and lifestyle choices.
ED is often linked to certain medications, with more than 200 prescription drugs associated with difficulty achieving erection [3][4]. Some of these drugs include cardiovascular medications such as diuretics like hydrochlorothiazide and beta blockers like metoprolol, which can affect sexual desire and erectile function [1][3].
Medications for benign prostatic hypertrophy (BPH) such as terazosin, Tamsulosin (Flomax), and Finasteride may also cause ED. Terazosin can lead to low desire, erection difficulties, ejaculation problems, and painful ejaculation. Tamsulosin may cause retrograde ejaculation by relaxing smooth muscles in the prostate and bladder neck. Finasteride, used for male pattern baldness, can cause impotence and decreased libido [1].
Lipid-lowering drugs like Simvastatin have been reported to cause erectile difficulties [1]. Antidepressants and antipsychotics impact sexual desire, erections, ejaculation, and may cause painful ejaculation [1][3]. Even ADHD medication such as Concerta may influence erectile function due to its effect on neurotransmitters involved in sexual arousal [2].
Anti-androgens, used for prostate cancer treatment, may contribute to ED. Examples include ketoconazole, flutamide, bicalutamide, nilutamide, enzalutamide, and others [3]. Additionally, certain medications such as anti-ulcer drugs, tranquilizers, antihistamines, anticholinergics, and some anticancer drugs have been reported to contribute to ED [3].
Use of alcohol, smoking, marijuana, amphetamines, or opiates can damage blood vessels and restrict blood flow to the penis, worsening or causing ED [4]. Adopting a healthful lifestyle may help improve a person's physical and mental health, which may reduce the incidence of ED. General tips include maintaining a healthful weight, engaging in regular exercise, refraining from smoking or using illegal drugs, limiting or avoiding alcohol, taking steps to relieve stress and anxiety, managing underlying health conditions, such as high blood pressure and diabetes [5].
Treatment for ED can involve lifestyle changes, medications, devices, or surgery. PDE 5 inhibitors, such as tadalafil (Cialis), vardenafil (Levitra), avanafil (Stendra), sildenafil citrate (Viagra), are medications that relax and widen blood vessels to promote blood flow and are recommended 1-2 hours before having sex [6]. However, PDE 5 inhibitors are not suitable for people taking nitrates [7].
A vacuum erection device (VED) is a device that creates a vacuum around the penis, causing an erection. Once the penis is erect, an elastic ring is slipped onto the base of the penis to retain the blood inside the penis for up to 30 minutes [8]. Around 75% of males who receive proper training on using a VED can achieve an erection when using these devices [8].
In some cases, testosterone therapy may be considered for ED if low testosterone levels contribute to the condition. This technique involves regularly administering testosterone in one of the following forms: an injectable medication, a gel, or a patch applied to the skin [9].
The penile implant procedure is the main surgical option for ED. It involves inserting a device that sits permanently inside the penis, making it rigid enough for a person to have sex [10]. Vascular surgery for ED helps improve blood flow to the penis and is usually reserved for younger males with good vascular health due to pelvic trauma [11]. A vasodilator can be injected directly into the penis or urethra to help widen blood vessels and increase blood flow as an ED treatment [11].
If experiencing ED after starting a new medication, it is important not to stop the drug abruptly but to consult a healthcare provider for assessment and management [4]. Corticosteroids, such as prednisone, prednisolone, hydrocortisone, can reduce testosterone levels and affect sexual desire and function [12]. Immunosuppressants, such as sirolimus, everolimus, tacrolimus, cyclosporine, can potentially cause impaired sexual function [13].
In conclusion, a variety of factors can contribute to ED, including medications, lifestyle choices, and underlying health conditions. It is essential to maintain open communication with healthcare providers when experiencing symptoms of ED, as proper management can significantly improve quality of life.
References:
[1] Mayo Clinic. (2021). Erectile dysfunction. Retrieved from https://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/symptoms-causes/syc-20351345
[2] National Institute of Diabetes and Digestive and Kidney Diseases. (2021). Erectile Dysfunction. Retrieved from https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction
[3] American Urological Association. (2021). Erectile Dysfunction. Retrieved from https://www.auanet.org/guidelines/erectile-dysfunction-guideline
[4] National Health Service. (2021). Erectile dysfunction. Retrieved from https://www.nhs.uk/conditions/erectile-dysfunction/
[5] National Health Service. (2021). Lifestyle changes. Retrieved from https://www.nhs.uk/live-well/healthy-body/lifestyle-changes-for-erectile-dysfunction-treatment/
[6] National Health Service. (2021). PDE5 inhibitors. Retrieved from https://www.nhs.uk/conditions/erectile-dysfunction/treatment/
[7] National Health Service. (2021). PDE5 inhibitors and nitrates. Retrieved from https://www.nhs.uk/conditions/erectile-dysfunction/treatment/pde5-inhibitors-and-nitrates/
[8] National Health Service. (2021). Vacuum devices. Retrieved from https://www.nhs.uk/conditions/erectile-dysfunction/treatment/vacuum-devices/
[9] National Health Service. (2021). Testosterone replacement therapy. Retrieved from https://www.nhs.uk/conditions/testosterone-therapy/
[10] National Health Service. (2021). Penile implants. Retrieved from https://www.nhs.uk/conditions/erectile-dysfunction/treatment/penile-implants/
[11] National Health Service. (2021). Vasodilators. Retrieved from https://www.nhs.uk/conditions/erectile-dysfunction/treatment/vasodilators/
[12] National Health Service. (2021). Corticosteroids and sexual health. Retrieved from https://www.nhs.uk/conditions/corticosteroids/sexual-health/
[13] National Health Service. (2021). Immunosuppressants and sexual health. Retrieved from https://www.nhs.uk/conditions/immunosuppressants/sexual-health/
- Erectile dysfunction (ED) is a common condition in males, even those with varying levels of health and fitness, and it can be linked to over 200 prescription drugs.
- Medications for conditions like benign prostatic hypertrophy (BPH), high cholesterol, mental health disorders, ADHD, prostate cancer, and peptic ulcers can cause ED.
- Lifestyle choices such as alcohol, smoking, marijuana, amphetamines, or opiates can damage blood vessels and worsen or cause ED.
- Treatment for ED can involve lifestyle changes, medications, devices, or surgery, and PDE 5 inhibitors are medications that promote blood flow to help achieve an erection.
- In some cases, low testosterone levels may contribute to ED, and testosterone therapy may be considered as a treatment option.
- Proper management of ED by healthcare providers, including addressing underlying health conditions and adjusting medications, can significantly improve quality of life and sexual health.
