I am sure you have all heard about it. It is often said that heart attacks and deaths, especially of media and famous people, are caused by erection pills. Can these pills really cause heart attacks and death?
I need to explain this differently for two different groups of patients:
- There is no such risk in men who have never had heart disease before. Studies show that in this group of patients the pills do not increase the risk of heart attack.
- Men who have had a heart attack (infarction), severe hypertension attack or heart rhythm problem in the last 1 year and men with severe eye problems (retinitis pigmentosa) and severe liver failure may be at risk.
Choice of medicines: Choosing or preferring different medicines
The choice of sexual function-enhancing PDE5i inhibitor medication varies according to the frequency of sexual intercourse (casual or regular intercourse) and the patient’s personal experience with the medication. Patients’ choice may be related to the desired frequency of sexual intercourse and/or the desired duration of action. For this purpose, they need to know whether the medication is short- or long-acting, its possible disadvantages and how it is used.
Although these medicines were initially marketed as an “as-needed” treatment, in 2008 the active ingredient tadalafil was licensed for low-dose, continuous every day use.
Who do I recommend continuous medication for? Is it harmful?
In 2008, the introduction of long-acting drugs brought the use of continuous medication to the agenda. In this way, it was possible to get rid of the stress of “as needed” use. Continuous use of low dose and daily medication (tadalafil) has become an alternative to as-needed treatment for people who prefer spontaneous sexual activity or frequent sexual activity rather than planned sexual activity. As the side effect profile has been found to be good in the studies conducted over the years, “continuous use” has become the most preferred method of use in my patients. With this method of use, the concern of timing is eliminated and there is no psychological pressure.
What is penile rehabilitation?
Continuous use of low-dose and long-acting erection-enhancing drugs has been researched for many patient groups and has been defined as “penile rehabilitation” over time. The reason for this was that the active ingredient tadalafil, used continuously and for a long time, was proven to have a positive and lasting effect on penile vascular function (endothelial function). No such lasting effect had been found with “as needed” use. I perform long-term (several years) “penile rehabilitation” especially in patients who have undergone surgery for prostate cancer and have problems afterwards, in patients with erection loss due to diabetes and in patients with erection loss due to neurological problems. Penile rehabilitation creates an effect like “killing two birds with one stone” in prostate patients, both improving erection and improving urinary problems.