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Dear Healthy Men: Is there any danger to taking Viagra if I don’t have problems getting an erection?

Yes there is.

Like it or not, the ability to produce a firm erection on demand is a pretty important component of men’s identity—both to us and to our sexual partners. So it’s no wonder that when that ability wanes (as is the case for more than 30 million American men who suffer from erectile dysfunction—ED), many guys rush to the nearest doctor to get medical help. That help often comes in a prescription bottle containing Viagra (sildenafil), Levitra (vardenafil), Cialis (tadalafil), or Stendra (avanafil).  Taken as directed, these drugs usually produce the desired effect, which is great. But taking excessive amounts of these drugs or mixing them with other medications could actually kill you. Or worse.

Most ED drugs relax muscles in the penis, thereby increasing blood flow, which causes an erection. But the effects go way beyond the penis. They can, according to the Mayo Clinic, cause a variety of unpleasant symptoms, including blurred vision, confusion, dizziness, faintness or lightheadedness, sweating, back pain, tiredness, and weakness. Taken with certain other medications (especially blood-pressure-lowering drugs), ED meds can cause serious heart problems, including irregular heartbeat, stroke, cardiac arrest, and even heart failure.

In one (in)famous case, 28-year old Sergey Tuganov took a $4,000 bet from two female friends that he couldn’t keep up with them sexually for 12 hours. He swallowed a bottle of Viagra and won the bet. Unfortunately, his erection lasted longer than he did. A richer, prouder Sergey died of a heart attack right afterward. Hundreds of other men have died from ED OD.

Recreational ED drug use (as opposed to having a genuine medical need) may have some unexpected psychological side effects. A young man who gets used to pharmaceutically-enhanced erections may become psychologically dependent on the drug (there’s no evidence that it’s possible to become physically dependent) and may worry that he won’t be able to have an erection if he were to find himself without his prescription stash.

Recreational ED drug use is also associated with other health risks. Several studies of college-age men have found that ED drugs are often taken at parties where illicit drugs and alcohol are also being consumed in large amounts. Drug and alcohol use tends to increase the chance of risky behavior (such as unprotected sex). And because ED drugs decrease the refractory period (the “down time” most men have after orgasm and before they can have another erection), there’s an increased likelihood that the man will have unprotected sex with multiple partners, potentially leading to more sexually transmitted disease and unwanted pregnancy.

There are also some interesting differences between straight men and gay and bisexual men (also known as “men who have sex with men” or MSM). MSMs are significantly more likely than straight men to use ED drugs recreationally. And MSMs who do, are two to six times more likely than those who don’t to engage in unprotected intercourse with a partner.

Fate Worse Than Death?

Okay, back to that whole blood-rushing-to-the-penis thing. For most men, all that blood rushes right back out immediately after orgasm. But in some chemically induced erections, that doesn’t happen. The result is what commercials for ED drugs always warn about: a painful erection that could last for more than four hours. This is called a priapism (after Priapus, the Roman god of fertility, often depicted with an enormous erection). While a four-hour erection might sound like fun, it can actually cause permanent damage to the penis, which could, ironically, lead to erectile dysfunction.

In some cases, all that excess blood will have to be surgically drained. And then there are extreme cases, such as Gentil Ramirez Polania, who popped a few dozen Viagra, and had an erection that lasted so long that his penis developed gangrene and had to be amputated.

Bottom line? If you’re not having trouble getting and/or maintaining an erection, don’t take any ED medication. It’s that simple. You may see some short term benefits, but the risks are just too high.

Photo by Myriam Zilles on Unsplash

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