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Do the Drugs on TV Really Fix ED?
It may be tempting and easier to order something online to fix erectile dysfunction, but experts warn that it isn’t safe
Jon Krause
We’ve all been barraged by junk email and ads on late-night TV shouting, “Male enhancement!” “Max size!” “Rock-solid!” “Last longer!”
This week’s question is from a man who has erectile dysfunction (ED) and wonders about sampling one of those products that promise to help.
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I especially like this one because it gives our medical experts the opportunity to set the record straight about the marketing blitz directed at male enhancement.
I see ads all the time for supplements that amp up your sexual drive, like ones claiming to improve blood flow to various parts of the body. I’m a 75-year-old man with ED. Are these drugs worth exploring? — Submitted by F.F.
Evelin Dacker, a physician in Salem, Oregon, who specializes in sexual health, understands the products’ allure.
“They offer something incredibly appealing: privacy,” Dacker says. “Many men would rather click ‘buy now’ than tell another human being, even a doctor, that they’re having trouble getting, or keeping, an erection.”
Dacker adds that when erections change, many men don’t consider it a medical condition — but they should. “They experience it as personal failure,” she says. “That shame keeps far too many men from seeking care.”
Men should also know that it’s a common issue. According to urologist Irwin Goldstein, director of San Diego Sexual Medicine, the percentage of men experiencing at least some ED is roughly the same number as a man’s age, starting around 40. So, approximately 40 percent of men in their 40s experience ED; 50 percent in their 50s; and so on. By 80, Goldstein adds, it’s about 100 percent.
What the ads get wrong. Urologist Dock G. Winston says erections are about more than blood flow. Nerve function, hormones, medications and overall health each play their own part. “A product that claims to improve blood flow may sound medical, but that phrase is often more marketing than medicine,” says Winston, assistant physician in chief at Mid-Atlantic Permanente Medical Center in Washington, D.C. In other words, it’s about making the sale.
ED is also rarely caused by just one thing, Winston continues. Blood pressure, diabetes, obesity, heart disease, low testosterone, prior radiation, pelvic surgery, prostate cancer treatment, sleep quality, alcohol use and side effects from medication can all play a role. Another consideration: ED can be an early warning sign of diabetes, vascular disease, heart disease, low testosterone or problems related to medications.
When a supplement promises better performance, stamina, vitality or male enhancement, says Winston, it is often simplifying what is likely a more complicated health issue, and without a medical diagnosis, there is no way to know what will help and what won’t.
Be skeptical. Winston says his patients ask him all the time about products they see advertised online. Some have small studies that back up the efficacy behind them, but Winston says the evidence in no way compares with the research on prescription ED medications like Viagra and Cialis, which have been on the market for decades.
Dacker stresses that people should be highly skeptical of the countless male enhancement pills, gummies, chocolates and honey packets that are advertised online and sold at gas stations and convenience stores. Many claim to be “all-natural,” but testing by the Food and Drug Administration (FDA) repeatedly reports otherwise.
“You simply don’t know what you’re taking, and that’s a gamble I wouldn’t recommend,” says Dacker.
Safety concerns. These supplements can be inconsistently dosed, underregulated or contaminated, says Winston. Indeed, the FDA released a series of warnings notifying consumers that products claiming to treat sexual dysfunction — such as male enhancement supplements and energy and stamina pills — are likely to be contaminated with “dangerous” undisclosed ingredients.
“These products pose a serious health risk and are not guaranteed to work,” the organization stated. “They can lead to severe health issues and hospitalization.”
(For the record, the FDA treats sexual enhancement products as “dietary supplements.”)
What to watch out for. Winston says that undeclared ingredients in some supplements can be especially dangerous for some people.
For example, if you’re taking nitrates, such as nitroglycerin, the combination of that with the ingredients in prescribed meds for ED can cause your blood pressure to drop to dangerous levels, he warns.
Consult a physician. Goldstein says ED is highly treatable in men who are our questioner’s age, but it requires a careful, doctor-guided approach.
FDA-approved drugs such as Viagra and Cialis are evidence-based to increase penile blood flow during sexual stimulation. “Their safety profile is established,” says Goldstein.
If those don’t work, Dacker says there are other effective treatments to consider, such as vacuum erection devices, injectable medications placed directly into the penis, urethral suppositories, penile implants and, in carefully selected men, low-intensity shock-wave therapy. Pelvic-floor physical therapy can also be effective.
Bottom line. Dacker says ED is one of the most common conditions she sees, and among physicians who treat it, there is no judgment.
The goal shouldn’t be to find the latest supplement that promises better blood flow, she says. It should be to understand why your erections have changed, then look into a solution with your doctor.
“Your erection isn’t just about sex. It’s information,” says Dacker. “It’s your body telling a story about your overall health, and that’s a story worth listening to.”
Do you have questions about sex or relationships as a 50-plus adult? Send them to sexafter50@aarp.org.
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