What’s Up with OTC Erectile Dysfunction Drugs?

Over the Counter ‘Male Enhancement’ Medicine Can be Risky

Since millions of Canadians will experience some form of erectile dysfunction in their lifetime, it stands to reason that men would seek medicinal support in this domain. And given the potential for stigma associated with sexual performance issues, and men’s overall disinclination towards seeking any kind of professional medical help, purchasing over-the-counter sexual drugs could be seen as “easier” than scheduling an appointment with a doctor or pharmacist.

But the potential dangers of reaching for these types of supplements — often marketed as “male enhancement” pills or supplements — might be far greater than their ease of access.

Late in 2019, Health Canada put out a safety advisory highlighting 65 unauthorized health products, ranging from sexual performance enhancers to workout supplements, to “poppers”.

The advisory doesn’t suggest that these products are necessarily ineffective. But some were found to contain active medical ingredients not listed on the labels. Even if all the ingredients are included on the label, the potential for drug interactions can pose serious health risks to Canadians.

The most common concern with the sexual enhancement products — whose hilarious and virility-invoking names range from “Black Mamba Platinum” to “Rush Hour 72” and “Lucky Lady” — is their inclusion of proven erectile dysfunction medicines like sildenafil and tadalafil. Many of the unauthorized products on Health Canada’s safety advisory also included yohimbine, a drug that has been approved for treatment of ED in the US, but whose effectiveness is controversial. Some products contained a combination of all three.

Sildenafil, tadalafil and yohimbine are all prescription drugs that should only be taken at the direction of a qualified health professional. And there’s good reason for this: despite the relative safety of sildenafil and tadalafil, serious complications can occur when they are taken in conjunction with other medications, or by men with pre-existing medical conditions like hypertension, HIV, and kidney or liver problems.

This doesn’t mean that erectile dysfunction should go ignored — far from it. The ability to get and maintain a firm erection has been linked to feelings of overall emotional well-being and sexual satisfaction. What’s more, ED could be an indicator of even graver health issues.

There are significant associations between erectile dysfunction and potentially deadly cardiovascular issues. An inability to get and maintain an erection is also prevalent among diabetics, with at least half experiencing impotence.

So it is not a question of should men seek treatment for erectile dysfunction, but how. And it doesn’t always have to involve medication. For some men, changes to habits, diets and lifestyle can help to improve blood flow to the penis and decrease instances of erections.

For example, a 2015 study of over 3,700 men found that caffeine equivalent to 2–3 cups per day reduced the odds of prevalent ED. Regular physical exercise has also been shown to improve erectile function (as little as 30 minutes of walking per day). And by focussing on heart-healthy food like fruit, vegetables, nuts and oily fish, men might be able to avoid the medicinal route all together.

But men for whom changes to lifestyle and diet don’t succeed in treating erectile dysfunction can look to prescribed medical alternatives. A qualified doctor or pharmacist may decide that drugs like sildenafil, tadalafil or vardenafil could play an important role in this treatment. In some ways, seeking treatment for ED is easier and more discreet than ever. Men can visit an online pharmacy, schedule an appointment with a doctor, and if prescribed, have the medicine shipped to their home.

What Health Canada — and common sense — make clear is that taking unauthorized “sexual performance” supplements is simply not worth the risk. Not only could additional, unlisted ingredients find their way into these products, they could be produced in unregulated and perhaps even unsanitary conditions.

Men, of whom there are millions, seeking medical assistance for an important sexual performance issue like erectile dysfunction should feel confident in doing so. It’s a common problem with real solutions. Just make sure the right solution for you is one that is determined with the help of a doctor or pharmacist.