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Using medication for impotence without indication can impair erection

Using medication for impotence without indication can impair erection

Erectile dysfunction is the difficulty of maintaining an erection with a quality sufficient for sexual activity. It presents high prevalence in men after 40 years and is associated to different causes: psychological, arterial alterations, diabetes, hormonal changes, age, obesity, surgeries, among others. In general, we consider that erectile dysfunction is usually associated with multiple causes.

There is a group of drugs called phosphodiesterase-5 (PDE-5) inhibitors. Through its action, this drug leads to the increase of substance within the corpora cavernosa (erectile tissue of the penis) that provide vasodilation and in this way increase blood flow, facilitating erection.

Approved for use in the treatment of erectile dysfunction in 1998, sildenafil, one of these medicines, has quickly become popular all over the world. Subsequently, other drugs of the same family were marketed, which, despite some differences in side effects and half-life, presented basically the same form of action.

The great revolution of PDE-5 inhibitory drugs was the possibility of using of a really effective oral medication for the management of erectile dysfunction. Previously the medical treatments for erectile dysfunction were based on the use of vasodilators administered through direct injections into the penis or through absorption through the urethra. Another option was the use of prostheses. Both treatments are still widely used and are part of the armamentarium (arsenal) of erectile dysfunction management, but are used only after failure of initial oral drug treatment.

Use without indication

Despite the recommendations, we now have a generation of young patients with no complaints of erectile dysfunction who use this type of medication to improve sexual performance and often associate their use with alcohol and other illicit drugs. There is a direct risk associated with the use of a vasodilator in patients that even young people may have undiagnosed cardiovascular disease, in addition to the use associated with other drugs that may have potentiated effects, which can lead to serious complications, including sudden death.

Many men even undergo the use of medications that have side effects that can impair the quality of sexual intercourse (headache, visual changes, tinnitus) without a real medical need, just for the desire to prove to their partner their " sexual quality ". In this case, an association with alcohol, for example, may impair the beneficial effects of medication on erection, leaving only the side effects of the medication.

Another concern is that many of these young men may develop some kind of psychological dependence to the use of the drug, considering that they can only have erection with their use, and develop different degrees of psychogenic erectile dysfunction after discontinuation of the use of these drugs.

General drug contraindications

The most common side effects in the use of PDE-5 inhibitors are: headache, facial flushing, low back pain, nasal congestion, tinnitus, hypersensitivity to light, palpitations visual disturbances and tachycardia. Its combined use with nitrates (vasodilators used in the treatment of heart diseases) may potentiate hypotensive effects leading to serious cardio-circulatory complications. Priapism (prolonged and painful erection) that can lead to definitive and severe erectile dysfunction is rare with the use of PDE-5 inhibitors alone, but the associated use of drugs may potentiate this possibility, and there are reports of this occurrence in young patients who used these medications along with drugs like cocaine.

Care should be taken in the use of PDE-5 inhibitors in patients using nitrate in the presence of severe hepatic impairment (decreased liver function), severe renal insufficiency, hypotension (low blood pressure), and also in people who have experienced Stroke or infarct and hereditary degenerative retinal disorders.

The use of this medication should be performed only after a medical visit so that the best form of treatment for erectile dysfunction, the best type of drug suitable for the patient's needs can be defined. and especially for the identification of risk factors, preventing complications.


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