Guide Health: Sex life is important

You have probably seen the ads on television about erectile dysfunction or ED drugs, and you may wonder if this is a new condition. It’s not, but many people don’t want to talk about it (so they just tolerate or ignore the symptoms) and many health care providers don’t ask about it.

With the availability of a variety of drugs for ED, however, you hear about the condition more often. But remember, these are not aphrodisiacs, because such drugs don’t exist.

Sex life problems fall into two categories: low desire or libido, or performance issues of which ED is an example. It’s estimated that about 80 per cent of sex life problems are the result of either a drug side effect or a disease. The other 20 per cent are attributed to psychological causes such as depression or anxiety.

Before you rush to obtain a prescription for one of the drugs advertised for ED, it’s a great idea to check if a drug or disease might be the culprit. Antidepressant drugs are notorious for reducing libido. Working with your doctor and pharmacist, you may be able to find an effective drug that causes fewer problems.

As well there are coping strategies such as choosing an effective dose with fewer side effects, or timing doses so they interfere less when you are sexually active. Alcohol is often erroneously considered to be conducive for sex; while it may reduce inhibition, it also reduces the ability to perform.

Health conditions like high blood pressure, atherosclerosis, diabetes, and stroke interfere with blood flow, and you do need a good blood flow for an erection. It’s estimated that men with diabetes are three times more likely to be impotent than those without; and men who smoke a pack of cigarettes daily are four times as likely.

Prostate problems and surgery are associated with reduced sexual functioning. Dementia can be associated with impotence as can Parkinson’s disease because of nervous system changes.

The incidence of impotence increases with age, which may be attributed to increased incidence of disease conditions and use of medications.

The class of PDE5 inhibitors includes sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra), all of which are advertised for ED in men. It is estimated at about half of men between 40 and 70 years have some degree of ED.

The drugs act by relaxing smooth muscle in the penis which enables an inflow of blood and an erection. All are considered equally effective, and need to be taken about an hour before sexual activity for maximum effectiveness. Tadalafil is slightly faster acting requiring only half an hour and can be taken at a lower dose on a daily basis.

These drugs require a prescription because you need to be healthy enough for sexual activity. If you have liver or kidney damage, you may not be able to use these drugs, or may need a lower dose. These drugs are contraindicated if you take nitrates for heart pain or angina because the combination can result in dangerously low blood pressure.

For women, the latest drug for increased libido is flibanserin or the “pink pill” because it is a pink tablet. Taken daily, it acts in the nervous system to enhance libido, but it seems more useful premenopausal than postmenopausal. There seems to be only a modest benefit, and adverse effects include severe drops in blood pressure and fainting. As well, alcohol — even alcohol in non-prescription medications or foods — can worsen this drop in blood pressure.

Your sex life is important. If you are having problems, first check to see if the situation is the result of a drug effect or a disease condition. Also keep in mind that there are some effective drugs for men. We come a long way from Spanish fly!

About the author


Marie Berry is a lawyer/pharmacist interested in health and education.


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