First off, what is erectile dysfunction?
Erectile dysfunction (ED) is the constant inability to get and maintain a satisfactory erection during sex.
How many men are affected by ED?
While younger men can certainly experience ED, men over 40 years old are most commonly affected. There are two major studies that have been done that have provided results on the demographics of ED—the Massachusetts Male Ageing Study (MMAS) and the European Male Ageing Study (EMAS). The MMAS revealed that 52% of men aged 40-70 had mild to moderate ED, while the EMAS reported that there was an overall average of 30% prevalence of men with ED across various age groups. In a Canadian study published in 2006, men aged 40 to 88 years old were surveyed and an overall prevalence of ED was found to be 49.4%. The reported percentages for incidence and prevalence of ED may vary depending on what studies are being looked at, but overall, there is a general consensus that ED increases with age.
Did you know some medications can cause ED?
There are actually some medications that are commonly prescribed that can potentially cause ED. Here is a non-exhaustive list of some of the medications that can cause ED:
  • Antidepressants
  • Zoloft (sertraline), Paxil (paroxetine), Abilify (amitriptyline), Aventyl (nortriptyline), Effexor (venlafaxine)
  • Medications used to treat epilepsy
  • Phenobarbital, phenytoin
  • Antiandrogen medications
  • Leuprolide, goserelin
  • Analgesics, e.g., opioids
  • Cardiovascular agents, e.g., digoxin
  • In addition to these prescribed medications, alcohol, tobacco products, and illicit drugs can also cause ED. Several medications used to treat hypertension (high blood pressure) are also associated with causing ED. The ones most associated with ED include a few distinct classes of antihypertensive medications, which include:
  • Beta-blockers, e.g., bisoprolol, metoprolol, carvedilol
  • Diuretics, e.g., hydrochlorothiazide, chlorthalidone
  • Alpha blockers, e.g., doxazosin, prazosin
  • Spironolactone
  • However, while some of these blood pressure medications can cause ED, hypertension itself is also associated with ED. This makes sense because ED actually shares some risk factors with cardiovascular disease (CVD). Some of these shared risk factors include smoking, type 2 diabetes, obesity, and high cholesterol levels. Hence, while the medications you take can certainly play a part, the physiological changes that occur as you age have an influence as well. ED also has a psychological component to it with depression, stress, performance anxiety, and relationship issues being some of the associated causes. Another important point to note and keep in mind is that while the medications listed above can cause ED, it is not an overarching pattern seen in all men and not every male taking these medications will experience ED. Each and every person is different in their genetic make-up and thus, an individual may respond to a drug differently from someone else.
    What can you do to mitigate your risk of getting ED?
    As stated earlier, ED shares many risk factors with CVD. Lifestyle modifications, especially when initiated early on in life, can not only have a major role in lowering ED risk, but also lowering overall risk as well as improve control—for those already diagnosed—of diabetes, high cholesterol, and cardiovascular disease. These include changes to diet, weight loss, and regular exercise, which can all help in decreasing the likelihood of getting ED. Quitting smoking is also a step forward in lowering your risk for cardiovascular disease, as well as ED. In fact, quitting smoking can actually have a beneficial effect for restoring erectile function.
    Bottom line:
    Before considering whether you should stop a certain medication you are on, have a discussion with your physician or pharmacist first. They can evaluate your risk of getting ED as well as assess whether it is indicated and/or appropriate to stop therapy and help you decide what will work best for you.
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