• Photo by Rana Sawalha

Why I hate Little Blue Pills

It is estimated that half of all men will experience difficulty achieving or maintaining an erection at some point in their lives.  This means several million men in the UK are suffering from erectile dysfunction at any one time. Yet despite how common this condition is, unfortunately, only a small percentage of sufferers actually see their doctor about it and even fewer men receive the appropriate erectile dysfunction drugs or appropriate therapies.

The occasional failure to establish an erection can often be induced by the stresses of daily life, tiredness, anxiety, or excessive alcohol consumption and it is generally nothing to worry about. In fact, worrying about your erection can increase the likelihood of it happening again due to the fear of failure. When younger men suffer from ED, the likely cause is psychological; if this is definitely the case then erectile dysfunction drugs are a really effective tool in combating the symptoms.

Dr Jeff Foster
Dr Jeff FosterMedical Director & Male Health Lead

Dr Jeff Foster is a Men’s Health specialist and one of the founders of H3Health.

You can find out more about Dr Foster by viewing his latest articles and biography .

Ageing and Erectile Dysfunction

However, as we age, physical problems and illnesses start to play an increasingly significant role in the causes of erectile dysfunction, which makes getting to the bottom of why it has occurred so much more important.  A good example of this is the way cardiovascular disease can affect erectile function.   In men over 40, the penis is often a barometer of male health and when it stops working effectively, the root cause is commonly atherosclerosis, a disease in which plaque builds up inside your arteries. Arteries are blood vessels that carry oxygen-rich blood to your heart and other parts of your body, and as the arterial size of the penis is very similar in the arteries that supply the heart, erectile issues can be an early warning sign of a much bigger problem. So, the temptation to fix a symptom, namely the erection malfunction, with over-the-counter erectile dysfunction drugs should be avoided at all costs.  This is why I hate little blue pills.  Of course, blood vessel narrowing is not the only cause of ED, and the more common physical causes are listed below.

Common physical causes of erectile dysfunction

  • Vascular conditions (conditions that disrupt blood flow to the penis) – these include cardiovascular disease (high blood pressure, raised cholesterol), and diabetes
  • Neurogenic conditions (affecting the nervous system) – these disorders include multiple sclerosis, Parkinson’s disease, stroke, diabetes, and spinal injuries.
  • Hormonal conditions – these ailments include an overactive thyroid gland, an underactive thyroid gland, low testosterone, Cushing’s syndrome (high cortisol level), and head or brain injury recently or in the past.
  • Anatomical conditions (affecting the structure of the penis) – these can include Peyronie’s disease (occurs when fibrous scar tissue develops on the penis and causes curved, painful erections), surgery and radiation therapy for bladder, prostate or rectal cancer, or injury to the penis
  • Side effects of prescribed drugs
  • Recreational drug use
  • Excessive alcohol consumption

Erectile dysfunction is also more likely to occur in people who smoke, are overweight and with low activity levels.

Photo by Shawnee D

So how do we treat the symptoms of erectile dysfunction?

Achieving an erection is actually a highly complex physiological process that requires successful function and stimulation of neurological, hormonal, vascular, muscular, and of course psychological components. But ultimately, erections are all about blood flow, and the most widely used ED drugs work by interfering with the chemical process that lets blood leave an erect penis.

Medication can be a useful way to treat the symptoms of erectile dysfunction.  If using a little blue pill-like drug, it is best to take it around 60 minutes before sexual activity, and its effects can last up to 4 hours.  However, newer drugs can last around 48hrs, or have a faster onset of action than an hour.  Therefore, it is worth speaking to your doctor about which medication is right for you.  It is worth stressing that no PDE-5 inhibitors can cause an erection if there is a lack of sexual arousal or if the problem is not fixed by a dilation in blood vessels.  Therefore, it is imperative that if you have been suffering from ED for more than a few weeks, that you see your doctor rather than opting for the over-the-counter quick fix of erectile dysfunction drugs.

The take-home message is that yes, erectile dysfunction drugs are a great way to re-establish your erection and to enjoy your sex life once again, but before you treat the symptom you need to find the underlying cause. Therefore, it is essential to visit a doctor who understands the processes and conditions that can affect erectile function, and get yourself checked.  Buying over-the-counter little blue pills is like buying a plaster without ever knowing why you were bleeding in the first place.