To those with penile venous leak: have you had luck with ED meds?
February 15, 2015 5:20 AM   Subscribe

Though I'm excited that there's a chance my ED (Erectile Dysfunction)—which was caused by venous leakage which mysteriously and suddenly occurred in my teens—can be controlled with Cialis, I'm scared to go on it due to bad experiences with meds in the past. Could someone who's been on Cialis, Viagra, etc. chime in? Would love to hear what people's experiences on it have been before 'taking the plunge.'

Ten years ago I, for reasons unknown to me and urologists, suddenly and out of nowhere developed ED. It's due to venous leakage, a common cause of ED that I've been told a surprisingly large amount of people aged 18 to 40 have (current estimates are 5% to 7% of American men in this age group; that's a lot of men!). For reasons not yet known to urologists, it's far more prevalent in younger folks than in older ones.

Anyway, as I absolutely can't 'get it up' nor 'keep it up' without lots of manual stimulation and always only ever wind up with a fairly weak erection I, like most others diagnosed with this condition, was recommended Cialis, the more popular alternative to Viagra which is supposed to allow one to easily achieve an erection for a period of 36 hours as opposed to Viagra's mere 6-hour lifespan. But, as I've had bad experiences with prescription meds in the past, I'm scared shitless to take the plunge and would first like to see what others who, like myself, have fairly serious cases of venous leakage who've tried it have to say about it.

A few questions regarding Cialis and ED in general that come to mind:

Are there any alternatives to drugs to treat ED that I should be looking into? Penile rings? Pumps? Surgery? Etc.

What, if any, negative side effects have you experienced while on Cialis? (Lots of drugs have a profound effect on my mood and can turn me into a big asshole. Is there any risk of this happening to me while on Cialis? I'd rather not lose friends like I have in the past while on meds)

While on Cialis will I almost certainly be able to maintain an erection without manual stimulation and have it last? Can this really happen in those with fairly serious cases of venous leakage? (Note that my libido is fine)

Finally, is it likely that ED treatments will eventually become far more advanced than they currently are? I've read that stem cell surgery may eventually become the ideal way of treating ED. This makes me hopeful that eventually I won't have to rely on meds, something I'd rather not have to be on for the rest of my life)

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posted by anonymous to Health & Fitness (5 answers total)

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posted by taz (staff) at 5:22 AM on February 15, 2015

I have used both Viagra and Cialis. My ED was caused by radiation for prostate cancer, so my experience of effectiveness is not necessarily relevant. The side effects would be similar, though.

The standard dose of Viagra was too strong for me causing headache and the blue vision side effects you can read about. Since there is some slight chance of disastrous effects on the vision it was worrisome. Fortunately, 1/4 of the 100mg tablet was an effective dose, which also helped with cost. It also causes a feeling of stuffiness in the nose and sinuses which a doctor told me is common with all the ED meds.

Cialis comes in a low dose "for daily use" and you can use 2, 3, or 4 in a on-demand situation. There may also be a high dose meant for on-demand but maybe not. For me, Cialis is the better med. The side effects seem milder, so it just seems safer, and it works, but in a gentler way. It's pretty easy to get a free 30 tablet trial of Cialis, and I'd try it first for that reason if no other.

I've never noticed an effect on mood with either drug.
posted by SemiSalt at 7:20 AM on February 15, 2015

If you end up cutting pills, some - especially generics - can have the active ingredient heterogenously distributed within the pill. So, if you cut a pill into quarters, each of the quarters may contain different amounts of the active ingredient.

Grinding then cutting the powder can help achieve a more replicable dose.

Or go for the low-dose version, although those can end up costing more per affect desired.
posted by porpoise at 1:53 PM on February 15, 2015

I know men who take Cialis for age-related ED and they are quite happy with the results. (I don't know anyone with venous leakage.) It seems to work better than Viagra, both the longer lasting action and the general effect. I've never heard of any major psychological side effects. As SemiSalt says the "standard dose" of 20mg Cialis is more than many men need, it's common to chop a full pull in half. Or buy a lower dose (although check the price). There is also a continuous-use version which is 5mg daily.

I'm totally reading this into your question and don't know you or your health history, but it sounds to me like you may be unduly concerned about side effects. Not all prescription meds are the same! Talk to your doctor about your concerns, he or she should be able to answer them. Then you can try it once, at a lower dosage. You might find the result is great. Certainly worth a try if your doctor thinks it is safe.

To answer your other question, there are several common mechanical treatments for ED that were more popular before the drugs. A simple cock ring is something you might want to try, pick one an adjustable strap at your local sex shop or online for about $10. A vacuum pump + rubber band is another option, either as a sex toy or as therapy. Never tried it but it seems awkward. Surgical methods include implanting an inflatable or extendible device inside the penis. I knew a man with one of those ~10 years ago who was grateful for it, but again it seemed very awkward. And invasive surgery to implant.
posted by Nelson at 11:17 PM on February 15, 2015

Expanding a bit on Nelson's remark about cost: AFAIK, these meds are all priced per pill, not per dose. The 100mg Viagra costs the same as the 50mg Viagra, so cutting the pill in two halves the cost (which the patient is probably paying himself). And they are expensive. I think the price of Viagra has gone up 30% since I tried it a few years ago. Viagra is almost out of the patent period, so there may be generics withing a couple years, but big Pharma is very clever in keeping the lid on.

Due to the cost, there a lots of men out there cutting these pills up, and I've not heard they have a problem with not getting a good dose with a partial pill. Porpoise's remark that it may not work so well with other meds is certainly correct, though, and that would apply to a generic Viagra until proven otherwise.

By the way, get a pill cutter if you don't have one. V is a tough pill to cut with a paring knife. $5 at your local drugstore.
posted by SemiSalt at 7:40 AM on February 16, 2015

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