Thursday, January 30, 2014
Some of most commonly prescribed and abused drugs in America belong to a drug family called the phosphodiesterase 5 inhibitors. But you probably know them better as Viagra (sildenafil), Cialis, and Levitra. Unless you never watch TV, it's almost impossible to miss their commercials. 
Viagra and the other phosphodiesterase 5 inhibitors are meant to be taken only bymen who have erectile dysfunction (ED). Since Viagra was introduced in 1998, the number of men diagnosed with ED has gone up by 250 percent. 
Risk factors for ED include older age, obesity, diabetes, heart disease, and high blood pressure. The problem is that men without issues are using these medications. "We are seeing more and more young men without any risk factors for ED asking for ED drugs. They look a lot like the young men dancing around in the TV advertisements, probably too healthy to have ED,” said Rowena DeSouza, MD, associate professor of surgery at the University of Texas Health Science Center at Houston and director of urology at Lyndon B. Johnson Hospital. 
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Recreational ED Drug Use and Abuse 

“Men who are doctor shopping for these drugs and getting more refills than they need are using them not to get an erection, but to get a longer erection. That is recreational use, not appropriate use,” said Dr. DeSouza. 
A review of 46 articles on phosphodiesterase type 5 inhibitor abuse was published in the journal Current Drug Abuse Reviews in 2011. One reason cited for abuse was easy access to ED drugs. A search for Internet drug stores found over six million hits at 7,000 Internet pharmacies. Only 4 percent of the sites were in proper compliance, according to the Verified Internet Pharmacy Practice Sites program. 
Another concern with getting ED drugs at online pharmacies is that the drugs may be fake, contaminated, expired, ineffective, or unsafe to use.

The Dangers of Misusing ED Drugs

“These drugs have known risks that all men need to know about. They can be misused if men are not aware of the dangers,” said DeSouza. Even if you have ED, you can potentially misuse a phosphodiesterase 5 inhibitor and increase cardiovascular risks if you: 
  • Also take medications for chest pain called nitrates
  • Have active coronary heart disease
  • Have congestive heart failure
  • Have low blood pressure
  • Take several medications for high blood pressure
  • Have exercise intolerance

The Dangers of Abusing ED Drugs

“One important danger that men need to know about if they are using ED drugs recreationally is drug dependence. Men who take the drugs for longer and larger erections may find that they actually develop ED without the drugs. This could mean having to use more aggressive treatments like injections or implants to treat ED in the future,” warned DeSouza. 
Reports of dangers from ED drug abuse run the gamut from unsafe sex practices and a heightened sexually transmitted infection (STI) risk to fatal drug interactions. They include these specifics:
  • A five-fold increase in unsafe sex among men who have sex with men 
  • A two-fold increase in STIs 
  • Dangerous and potentially fatal mixing of ED drugs with club drugs such as ketamine and amyl nitrite 
A 2011 survey on recreational use of ED medications published in the journal Archives of Sexual Behaviorincluded responses from 1,994 men attending 497 colleges across the country. Four percent of these men admitted to using ED drugs recreationally. A majority of the recreational users mixed ED drugs with illegal drugs and engaged in risky sexual behaviors. Recreational use was associated with substance abuse and a higher number of sex partners. 
“It is hard to know how many men are using ED drugs recreationally,” said DeSouza. "Studies are hard to do because they rely on self-reporting. Men who want to use these drugs can often get them by answering questions about erectile dysfunction appropriately when they talk to a doctor. They know the symptoms of ED." 

The Bottom Line on ED Drugs: Be Informed

Don’t merely focus on the beautiful, happy people in the ED ads on television. Listen to the voiceover about side effects and contraindications. “If you have not been properly evaluated by your doctor and properly prescribed an erectile dysfunction drug, you should not be taking one,” warned DeSouza. 
Ask your doctor if you are healthy enough to use Viagra or the other ED drugs. Make sure you know the side effects. Tell your doctor about any other drugs you take. Drug interactions are possible with lots of common drugs including drugs for blood pressure, angina, blood thinners, and seizures. 
And, by the way, an erection that lasts four hours is not a good thing. It is painful and dangerous. 
Viagra and the other phosphodiesterase 5 inhibitors are great drugs for the right men. They may induce an erection in over 80 percent of men with ED. Many millions of men have used these drugs safely and appropriately. 
But if you don’t have ED, you don't need them. If you are concerned about ED, talk with your doctor -- searching for Viagra on the Internet can have disastrous consequences.