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Seven percent of 18- to 29-year-old men and 9 percent of 30- to 39-year-olds are unable to achieve orgasm, according to a study in the Journal of the American Medical Association.
But is a pill the answer for you?
What Can You Expect from Drugs?
The class of drugs that Levitra, Viagra, Stendra, and Cialis belong to are called PDE5 inhibitors. They work by relaxing tight blood vessels, allowing more blood to surge into the penis and cause an erection, says Gregory Bales, M.D., an associate professor of urology at the University of Chicago.
The little pills do the trick for more than two-thirds of men with erectile dysfunction (ED). They also work for guys who simply need them for a short time to get their “confidence back,” says Michael Eisenberg, M.D., director of male reproductive medicine and surgery at Stanford University.
ED drugs also reduce the recovery period between bouts of sex, which can be helpful for the 40 percent of men who suffer from premature ejaculation and come in 1 to 2 minutes, says Harry Fisch, M.D., clinical professor of urology and reproductive medicine at Weill Cornell Medical College/New York Presbyterian Hospital, and author of Size Matters. “Even if it is premature [the second time], at least it’s another 2 minutes. You can have overall more erections.” And guys who take the long-acting Cialis, particularly if they get the daily dose, can have them with more spontaneity, says Dr. Fisch. “You don’t have to take a pill two hours before you have sex.”
No drug is without side effects. Viagra, Cialis, Stendra, and Levitra may cause headaches, dizziness, facial flushing, a runny nose, and indigestion. But many men either don’t experience side effects or don’t mind them. “If you have real erectile dysfunction,” Dr. Fisch says, “you’ll put up with nasal congestion.”
To decrease the risk of potential side effects, take the lowest dose that works for you. Your doctor will probably start you on a low dose, and then up it until it works. And don’t worry about jonesing for your Viagra. “These drugs are not addictive,” Dr. Eisenberg says. “You’re not going to form dependency.”
What’s Going On Down There?
The big culprits to blame for erectile dysfunction: heart disease, diabetes, hypertension, and high cholesterol. With these diseases, vessels are constricting rather than opening to let blood flow to extremities, such as the penis, says Dr. Fisch. In fact, men with severe erectile dysfunction are 35 percent more likely to be hospitalized for cardiovascular disease in a 2-year period compared to men without erection issues, according to a study released January 29 in PLOS Medicine.
If you have sex scheduled into your iCalendar because you and your partner are trying to conceive, drugs might also help you. “Scheduled sex is stressful,” says urologist Paul Turek, M.D., who runs The Turek Clinic for male fertility. “This avoids that stress. You can get a reliable erection with less willpower.”
Strengthen Your Erection without Drugs
“Nobody has to be impotent,” says Dr. Bales. “There’s always a way.” The easiest ones:
Throw out your cigarettes. “It affects the ability of the vessels to relax,” which is necessary for an erection, says Kevin T. McVary, M.D., chairman of urology at Southern Illinois University School of Medicine. “Stopping smoking is better than any ED drug,” says Dr. Bales.
Lose weight. Do anything you can to lower your blood pressure. “With hypertension, you lose the ability of the blood vessels to dilate appropriately,” says Dr. McVary. “Losing weight is the best, least costly method to control high blood pressure.”
Drink in moderation. Have you ever heard the term “whiskey dick?” “Alcohol increases the desire to have sex but decreases the ability,” says Dr. Fisch. Cap your drinks at two a day maximum.
Pass on Sudafed. The nasal decongestant, which contains the blood vessel-constricting chemical pseudoephedrine, can kill erections. (In fact, doctors inject epinephrine into the penis if a man suffers from a prolonged erection.)
Check your other medications. A long list of drugs—including anti-hypertension meds such as thiazines and beta blockers, and antidepressants such as Prozac—can reduce blood flow and contribute to ED. Don’t ever go off your medications on your own, but mention the sex life-busting side effects to your doctor.
Switch from night to morning sex. Erections are usually better then, says Dr. Bales. “It’s a physical activity, and you’re better rested, and your testosterone level tends to spike in the morning.”