How Does ED Medication Work, And Why Can It Make Things Worse?

Hi!

I'm Dr. Anne Truong, MD

Dr. Anne Truong is a highly respected physician, best-selling author and internationally sought-after speaker on the topics of regenerative cell medicine, pain management, and applications for aesthetics and sexuality.

How Does ED Medication Work? It is important to understand both the condition and the way that medications try to address it. ED is a warning sign about your heart health. The good news is you can reverse it when it is early. ED is not permanent and can be treated.


Episode Table Of Contents

How Does ED Medication Work YouTube Video

Erectile Dysfunction Is a Predictor of Heart Disease

Eventually, a third of men will have a heart attack in 7 to 10 years because erectile dysfunction represents blood flow blockage in the arteries of the penis. After all, the penis artery is small, at only two millimeters. It is affected first because it’s the smallest artery in the body. A blockage follows it in the heart’s artery, which is three to four millimeters in size. Thus, having erectile dysfunction is the predictor of heart condition later on.

The Center for Disease Control and Prevention (CDC) indicates that heart disease is the number one killer for all men. However, ED is reversible if you start early at the onset or when it is mild.

How do you know when it is mild?

Take the International Erectile Dysfunction Questionnaire or the IIEF. If you score 15 out of 25 and above, then you are mild. You can reverse ED by doing lifestyle changes. If you score below 15 out of 25, you may need more intensive treatment. Click here for a link to the test.

The Limitations of Viagra and Similar Drugs

ED medication such as PDE5 inhibitors does not work to treat the cause of ED, which is impaired blood flow. These PDE5 inhibitors work by increasing nitric oxide in the penis muscles or the corpus cavernosum. It works better in men with psychogenic ED. Still, it has many limitations, especially in men with heart disease and in men with prostate hypertrophy. It has a lot of side effects that prevent usage frequently.

PDE5 inhibitors medication is not a long-term solution for ED because it does not treat the nerves or the arteries or the erectile muscles and the veins of the penis. All these four components act together to create an erection. That’s why your ED gets worse over time because these four components of the nerve, arteries, erectile muscles and the veins of the penis get worse over time. After all, it is being ignored.

ED medications do not work if you have diabetes, prostate surgery, Peyronie’s disease, or even a significant blood flow obstruction in the penile artery.

The good news is there are treatment options, such as hormone injection and using your stem cells in your body to help you heal by increasing more blood flow and treating the nerve and the muscles, which then address the cause of the blood flow impairment. This procedure is called the Priapus shot, or the P shot. It therefore can reverse ED naturally and in long term. The P shot and lifestyle modification can be effective for the treatment of mild to moderate ED.

Let’s talk about ED Meds, how they work and why they make your ED worse.

Medications such as phosphodiesterase-5 inhibitors(Viagra): sildenafil, vardenafil, tadalafil, and avanafil, are all phosphodiesterase (PDE-5) inhibitors. They actually work better in men with psychogenic impotence. All four PDE-5 inhibitors enhance penile muscles the corpus cavernosum cyclic GMP levels. Cyclic GMP elevates nitric oxide levels which then promotes an erection in response to sexual stimulation. Most are covered by insurance if it is generic.

I listed the cost and mechanism of the PDE’is. However, these medications are contraindicated in men on nitrates, a medication for angina. Nitrates should not be used within 48 hours after the last dose of erectile enhancement drug use. Alpha-blockers medication for hypertension, and medication for benign prostatic hypertrophy. These medications can cause low blood pressure and impaired ejaculations when used with phosphodiesterase -5-inhibitors. If you don’t have these conditions, it is safe to take but monitor your blood pressure.

The inconvenience factor

These medications have to be taken on an empty stomach. So the inconvenience is that there is no spontaneity and sexual activity has to be planned 1 hour ahead.

Eating a fatty meal before Viagra and Levitra can reduce the effectiveness of the drug. You have to Wait 2-3 hours after eating a fatty before taking these medications.

Common Side Effects of PDE- 5 Inhibitors (Viagra)

  • Headache
  • Flushing in the face, neck, or chest
  • Upset stomach, indigestion
  • Abnormal vision “blue vision”
  • Nasal congestion
  • Back pain
  • Muscular pain or tenderness
  • Nausea
  • Dizziness
  • Rash
  • Diarrhea

Serious Side Effects of Viagra

  • Change or loss of vision
  • Ringing in ears or hearing loss
  • Chest pain or irregular heartbeat
  • Shortness of breath
  • Lightheadedness
  • Malignant melanoma
  • Swelling in the hands, ankles, and feet
  • Pulmonary hypertension

Why ED Medication Is Not A Long-Term Solution

Even if you’ve had success getting or keeping erections while using medication like Viagra, you may notice it doesn’t work as well after 2-3 years. Viagra can lose its efficacy over time, due to changes in your body or changes in your health such as blood flow getting worse due to plaque build-up in your arteries.

ED Medication does not address the blood flow problem from your groin to your penis, it just makes the blood stay in the penis. Viagra does not help you get arouse it only helps with blood flow to get an erection.

Remember erections occur when there is a net increase of blood flowing into, as compared to blood exiting, the erectile spongy bodies of the penis.

Four crucial steps

In order to have a net increase in blood flow, four crucial steps must take place. But if there’s a problem with any of these four steps on the way to an erection, Viagra won’t work. The four steps are nerves, arteries, erection muscles, veins.

  1. First, the nerves in the pelvis must send neurotransmitters to the arteries of the penis, directing increased flow.
  2. Second, the arteries must respond to the command of the nerves by dilating and widening their diameter to allow for increased flow.
  3. Third, the erectile spongy bodies of the penis must be compliant, able to stretch out and elongate to accommodate the increased blood flow.
  4. The veins of the penis must allow for a net increase in blood flow by closing their drainage valves to keep blood in the penis.

Additional conditions that impact the effectiveness of ED medications

  1. ED medications do not work if you have Diabetes or prostate surgery – because of damaged nerves. Or
  2. Significant obstruction in the blood flow in the penile artery for atherosclerotic heart disease (plagues). Or
  3. Peyronie disease, nodules in the penis that cause bending of the penis. I’ll talk more about this condition in later episodes.
  4. Venous leak in the penis.
  5. Psychologic: anxiety, depression, stress, relationship issues

In the end, I view ED meds as like taking pain medication like oxycodone for pain, it may work short term but not long term.

So What Are Alternative Treatment Options?

So what happens if the medications do not work? You have options such as

  • Testosterone hormones: topical, troches, injections, pellets
  • Intra-penile injection: Alprostadil
  • Penile Injection on demand: Trimix
  • Penis pump
  • Penile implant
  • Use your stem cells in your blood to treat ED!

Stem cells are the newest innovation where your blood or more the Platelets from your blood is placed in the penis to restore your erection. It works by increasing more blood flow from nerves, and the blood vessels make the penis tissue healthy.

It is the best long-term solution. This is called the Priapus shot or P shot.

LifeStyle changes

In addition to medical interventions, make lifestyle changes a priority it’s important to address lifestyle factors that play a role in ED. Some common factors that can lead to conditions affecting blood circulation include:

  • Lack of activity
  • Smoking habits
  • Stress
  • Drinking alcohol
  • Not having sex frequently
  • Lack of sleep
  • Frequently taking common medications, even some over the counter like ulcer medication and even ibuprofen, anti-inflammatory medications.

I will put the list of medications that can affect your erection capacity.

Talk to your health care provider if you think that a drug is having an effect on your sexual performance. Never stop taking any medicine without first talking to your provider. Some medicines may lead to life-threatening reactions if you do not take care when stopping or changing them.

Episode Resources & Links

Join our e-newsletter where thousands of men achieved their sexual performance mastery

YOU MAY ALSO LIKE...

FEATURED CONTENT

Swingers, Sex, and Orgasms with ‘Accidental Swingers’ Hosts Myrina and Tristan

Putting the Vitamin D Back in ED

What is Qigong and Why is it Essential to Your Sexual Health

RELATED POSTS

Putting the Vitamin D Back in ED cover

Putting the Vitamin D Back in ED

Throughout my career, I’ve noticed something very telling. About 97% of men who come in for ED treatment have one thing in common: they have low vitamin D levels. So why is this vitamin so essential for men’s health, and how do we make sure to get more of it in our bodies?

Read More »
Putting the Vitamin D Back in ED cover

Putting the Vitamin D Back in ED

Throughout my career, I’ve noticed something very telling. About 97% of men who come in for ED treatment have one thing in common: they have low vitamin D levels. So why is this vitamin so essential for men’s health, and how do we make sure to get more of it in our bodies?

Read More »

Join thousands of men on their journey to achieving sexual performance mastery.

Reader Interactions

Leave a Reply

Your email address will not be published.