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Erectile Dysfunction Worse When Men Take Multiple Drugs


If you are a man with erectile dysfunction (ED), could medications be making your condition worse? Results of a new Kaiser Permanente study report that men who take multiple drugs are likely to have more severe ED.

Multiple drug use can impact erectile function

Failure to achieve an erection occasionally is not uncommon and can occur for a number of reasons, ranging from having had too much to drink to emotional stress or fatigue. When ED happens more than half the time, however, that is typically a sign of a more serious problem that requires an examination and treatment.

Erectile dysfunction affects about 10% of men around the world, and an estimated 30 million men in the United States. Given the rising number of baby boomers and the tendency for older adults to take multiple medications, the findings of this latest study could be important for a great number of men, both now and in the future.

The study involved 37,712 ethnically diverse men ages 46 to 69 who were part of the California Men’s Health Study. Data analyzed from the men included medication use between 2002 and 2003, severity of ED, age, body mass index, diabetes, cholesterol and blood pressure levels, depression, and smoking history.

After taking other factors into account, the investigators found that as the number of medications men took increased, so did the severity of their erectile dysfunction. For example, for men who were taking 0 to 2 medications, 15.9% had moderate ED. That number rose to 19.7% among those taking 3 to 5 drugs, 25.5% among men taking 6 to 9 drugs, and 30.9% among those taking 10 or more medications.

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The study’s lead author, Diana C. Londono, MD, of the urology department at Kaiser Permanente Los Angeles Medical Center, noted that “the findings from this study suggest that a crucial step in the evaluation of ED would be to review the current medications the patient it taking and their potential side effects.” Doctors could then make changes to a man’s medication use as appropriate.

Medications typically associated with ED are also those that are commonly prescribed, including antihypertensives (e.g., beta-blockers, clonidine, thiazides), antidepressants (selective serotonin reuptake inhibitors, tricyclics, lithium, monoamine oxidase inhibitors), and drugs that can interfere with testosterone pathways.

More than half (57%) of the men in the study were taking more than three medications, and multiple drug use was greatest among men ages 60 to 70. One quarter of the men used at least 10 medications.

Erectile dysfunction can be caused by a variety of factors, including diabetes (about 50% of men with diabetes have ED), depression, alcoholism, prostatectomy, thyroid disease, atherosclerosis, smoking, and trauma. While multiple drug use can cause ED, taking yet another drug—a phosphodiesterase-5 inhibitor-- is the most common way to treat the condition. The three drugs in this category include sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra).

The results of this study may serve as a wake-up call for doctors to reconsider multiple drug use among their patients who have erectile dysfunction. According to Michael Kanter, MD, regional medical director of Quality & Clinical Analysis for the Southern California Permanente Medical Group, “These men would benefit from lifestyle changes such as changes in their diet, regular exercise, and not smoking which would help control their hypertension, diabetes, and stress and reduce erectile dysfunction risk.”

Kaiser Permanente

Picture credit: Wikimedia Commons