Should I use phosphodiesterase-5 inhibitors for erection problems?
Introduction
This information will help you understand your choices, whether you share in the decision-making process or rely on your doctor's recommendation.
Key points in making your decision
There are a number of treatments for erection problems. However, phosphodiesterase-5 inhibitors (PDE-5 inhibitors), such as Viagra, Levitra, or Cialis, are generally tried first because of the success rate, ease of use, and convenience of these medications. If you have already tried one of these medications and it has not worked for you, see your health professional.
Consider the following when making your decision:
- PDE-5 inhibitors (such as Viagra, Levitra, or Cialis) may not be an option if you have heart disease that may require you to take nitroglycerin or other medications containing nitrates.
- If you and your partner have decided that sexual intercourse is an important part of your relationship, you may want to use PDE-5 inhibitors. About 80% of the men who use Viagra have an erection and successfully have intercourse.1
- The decision about whether to treat an erection problem is often based on your and your partner's preferences.
Medical Information
What is an erection problem?
An erection problem (also called erectile dysfunction and sometimes impotence) refers to a man's consistent inability to get or maintain an erection sufficient to have satisfactory sex. It does not mean a lack of sexual interest or desire or the occasional difficulty achieving or maintaining an erection that affects all men at some time in their lives.
What causes an erection problem?
The cause of erection problems may be physical (such as an injury to the nerves or loss of blood flow to the penis) or psychological (such as anxiety or depression). Medications you take for other conditions, alcohol consumption, smoking, or illegal drug use can cause erection problems.
Certain conditions may affect blood flow or the nervous system, increasing the risk for erection problems. These include diabetes, high blood pressure, high cholesterol, atherosclerosis, multiple sclerosis, and Parkinson's disease.
Erection problems can occur at any age but are more common in older men, who often have additional health problems or who may be taking medications that can interfere with normal erectile function. Treatment of erection problems in older men can be as effective as in younger men.
Why treat an erection problem?
The decision about whether to treat an erection problem may not be as straightforward as the decision about whether to treat many other medical conditions. An erection problem is not life-threatening, yet it can seriously affect your emotional health and sense of self-worth. It also can make it difficult to father a child, if that is your desire. Therefore, the decision about whether to treat an erection problem is often based on personal preference.
Very often, this decision is also based on how intensive or invasive the treatment is and its chance of succeeding. Medications can make treating an erection problem simple and convenient. Still, you should think carefully about whether you want to treat your erection problem before committing to trying one of these medications.
Your Information
Your choices are:
- Use a PDE-5 inhibitor (such as Viagra, Levitra, or Cialis).
- Try counseling or sex therapy.
- Seek other ways to express intimacy.
The decision about whether to use PDE-5 inhibitors takes into account your personal feelings and the medical facts.
Deciding about medication for an erection problem Reasons to use PDE-5 inhibitors (such as Viagra, Levitra, or Cialis) Reasons not to use PDE-5 inhibitors (such as Viagra, Levitra, or Cialis)
- Easy and convenient to use
- Effective for many different causes, including erection problems resulting from diabetes, high blood pressure, spinal cord injury or other problems that affect nerve function, prostate surgery, side effects of medications, emotional or psychological causes, and unknown causes
- Enhanced self-esteem because of your ability to have intercourse
- Fulfills the need to show intimacy through sexual intercourse
- You want to have children.
Are there other reasons you might want to use a PDE-5 inhibitor?
- Cannot use them if taking any type of nitrate medication
- Ability to have intercourse usually does not solve relationship problems
- Lack of sexual spontaneity (have to take a pill 30–60 minutes before having sex)
- Must be sexually excited for it to work
- Potentially dangerous for those with heart conditions such as coronary artery disease, angina, and heart failure, men who have low blood pressure, and those who take many different drugs for high blood pressure
- Potentially expensive, if insurance does not pay
- Side effects, including headache, facial flushing, indigestion, and nasal congestion
Are there other reasons you might not want to use a PDE-5 inhibitor?
These personal stories may be helpful in making your decision.
Wise Health Decision
Use this worksheet to help you make your decision. After you and your partner complete it, you should have a better idea of how you feel about taking a PDE-5 inhibitor. Discuss the worksheet with your doctor.
Circle the answer that best applies to you.
PDE-5 inhibitors are safe to take along with my current medications.
Yes No Unsure I don't have a heart condition such as a blocked artery, angina, high blood pressure, or heart failure.
Yes No Unsure We have the finances and/or insurance to pay for these medications.
Yes No Unsure Sexual intercourse is important to us.
Yes No Unsure Being able to have sexual intercourse will help my or my partner's self-esteem.
Yes No Unsure We don't mind "planning" our sex.
Yes No Unsure We don't expect sex to solve a relationship problem.
Yes No Unsure We don't mind taking a pill.
Yes No Unsure We don't worry about the side effects of these medications.
Yes No Unsure Use the following space to list any other important concerns you have about this decision.
What is your overall impression?
Your answers in the above worksheet are meant to give you a general idea of where you stand on this decision. You may have one overriding reason to use or not use a PDE-5 inhibitor.
Check the box below that represents your overall impression about your decision.
Leaning toward taking a PDE-5 inhibitor
Leaning toward NOT taking a PDE-5 inhibitor
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| Author: | Ralph Poore | Last Updated: June 13, 2006 |
| Medical Review: | Adam Husney, MD - Family Medicine E. Gregory Thompson, MD - Internal Medicine Christopher G. Wood, MD, FACS - Urology/Oncology | |
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