drugs and erectile dysfunction

It is an interesting dichotomy.  Despite the fact that I am seeing increasing numbers of patients who take no prescription or over-the-counter drugs at all, I am also seeing more people who are taking the proverbial “boatload” of medicine.  Not too long ago, I wrote about the drug explosion that has taken place in the past couple of decades —- something called “Polypharmacy” (HERE).  Although there are all sorts of SIDE EFFECTS associated with Polypharmacy (taking lots of prescription medications), one of the more common is Erectile Dysfunction.  How common is Erectile Dysfunction here in America?

Known by its initials, ED, it;s defined as the inability to achieve and/or sustain an erection that is firm enough for sexual intercourse at least 50% of the time. Despite everything you may have heard or been told, ED is not normal at any age.  However, here in America, it is rampant (as is LOW TESTOSTERONE).   According to the National Institutes of Health (NIH), approximately 1 in 20 40-year-olds and 1 in 4 65-year-olds struggle with ED. And although there are a host of known risk factors (OBESITY, UNCONTROLLED BLOOD SUGAR / DIABETES, Heart Disease, STRESS, DEPRESSION / ANXIETY, etc), one of the more common, but least talked about, is the type and number of medications one is taking.  Some of the offending drugs include……

• Hydrochlorothiazide (Esidrix, HydroDIURIL, Hydropres, Inderide, Moduretic, Oretic, Lotensin)

• Chlorthalidone (Hygroton)

• Triamterene (Maxide, Dyazide)

• Furosemide (Lasix)

• Bumetanide (Bumex)

• Guanfacine (Tenex)

• Methyldopa (Aldomet)

• Clonidine (Catapres)

• Verapamil (Calan, Isoptin, Verelan)

• Nifedipine (Adalat, Procardia)

• Hydralazine (Apresoline)

• Captopril (Capoten)

• Enalapril (Vasotec)

• Metoprolol (Lopressor)

• Propranolol (Inderal)

• Labetalol (Normodyne)

• Atenolol (Tenormin)

• Phenoxybenzamine (Dibenzyline)

• Spironolactone (Aldactone)

• Fluoxetine (Prozac)

• Tranylcypromine (Parnate)

• Sertraline (Zoloft)

• Isocarboxazid (Marplan)

• Amitriptyline (Elavil)

• Amoxipine (Asendin)

• Clomipramine (Anafranil)

• Desipramine (Norpramin)

• Nortriptyline (Pamelor)

• Phenelzine (Nardil)

• Buspirone (Buspar)

• Chlordiazepoxide (Librium)

• Clorazepate (Tranxene)

• Diazepam (Valium)

• Doxepin (Sinequan)

• Imipramine (Tofranil)

• Lorazepam (Ativan)

• Oxazepam (Serax)

• Phenytoin (Dilantin)

• Dimehydrinate (Dramamine)

• Diphenhydramine (Benadryl)

• Hydroxyzine (Vistaril)

• Meclizine (Antivert)

• Promethazine (Phenergan)

• Naproxen (Anaprox, Naprelan, Naprosyn)

• Indomethacin (Indocin)

• Biperiden (Akineton)

• Benztropine (Cogentin)

• Trihexyphenidyl (Artane)

• Procyclidine (Kemadrin)

• Bromocriptine (Parlodel)

• Levodopa (Sinemet)

• Disopyramide (Norpace)

• Cimetidine (Tagamet)

• Nizatidine (Axid)

• Ranitidine (Zantac)

• Cyclobenzaprine (Flexeril)

• Orphenadrine (Norflex)

• Flutamide (Eulexin)

• Leuprolide (Lupron)

• Busulfan (Myleran)

• Cyclophosphamide (Cytoxan)

This list is long, but there are others —- many others.  The July 2012 issue of BJU International (a urologist’s journal) published a study called, “Population-Based Study of Erectile Dysfunction and Polypharmacy,” where some interesting findings came to light.  Records from over 35,000 of Kiaser Permanante’s Health Care System (California) males, aged 45-69, were reviewed for ED. 

Not only did almost 30% of the men in the study have moderate to severe ED, the incidence and severity of the Erectile Dysfunction increased with the NUMBERS OF DRUGS that the subjects were taking. By the way, these stats were adjusted for things like SMOKING, DIABETES, HIGH BLOOD PRESSURE, HIGH TRIGLYCERIDES, peripheral vascular disease, CORONARY ARTERY DISEASE, and obesity. 

• 1 or 2 drugs increases the risk of ED by 16%

• 3 to 5 drugs increases the risk of ED by 20%

• 6 to 9 drugs increases the risk by 25%

• More than 10 drugs increases the risk of ED by 31%