Regular ED medication users should watch for this
Erectile dysfunction medications have improved the quality of life for millions of men and their partners, but they can also produce some effects that aren’t so pleasing. Vision problems, for example, can be an issue for frequent users.
Based on the health insurance claims of 213,000 men in the United States between 2006 and 2020, researchers at the University of British Columbia found that “regular” users of ED medications such as Viagra, Cialis, Levitra and Stendra were at higher risk than non-users to develop detached retinas, a blood clot in the veins or arteries of the retina, or neuropathy of the optic nerve. In their report, researchers noted that this did not mean the drugs caused eye problems, only that the issues were linked to the effects the drugs had on the body and that users needed to report any vision problems to their doctors.
“I think these medications are generally very safe,” said Evangelos Geraniotis, MD, FACS, a urologist with Urology Associates of Cape Cod in Hyannis. “They’ve been around for 25 years and they’ve been used for millions of doses worldwide, and we’ve seen very few problems. But, like anything else, if you’re on something regularly or daily, you just have to be aware that it’s something that’s in your body. And maybe we find it does things to some people – that it puts them at extra risk.”
The majority of ED issues in men are caused by circulation problems with the blood supply to the pelvic organs and the circulation chambers within the penis, which have to open and close and hold the blood to maintain the erection, Dr. Geraniotis said. ED drugs affect nitric oxide levels, which indirectly regulate the control of the blood vessels, he said. In effect, they create a bigger pipeline for blood flow, although that can cause other problems such as lowering blood pressure too much.
Men are usually warned by doctors not to mix ED drugs with nitroglycerin, which also affects nitric oxide levels and relaxes the blood vessels, lowering blood pressure. Men who use ED drugs but who feel lightheaded when they stand or sit-up, should tell their doctor.
“It’s the nitric oxide effect on the smooth muscle that is inside the blood vessel that has the effect,” Dr. Geraniotis said. “And because these blood vessels are all over the body, there are areas other than the pelvic blood and the penile blood supply where there are receptors that will be affected by these medications.”
That includes the eyes. In the study, men who developed eye issues were more likely to have had chronic medical conditions such as hypertension, diabetes, coronary artery disease, and sleep apnea (which can all contribute to erectile dysfunction). But researchers reported that even accounting for those conditions, men who regularly took ED medications were still 85 percent more likely to suffer one of the three eye conditions.
Vision problems are rare, Dr. Geraniotis said, but men should discuss any changes in the sharpness of their vision, their ability to see in low-light situations or their peripheral vision to their doctor.
“I could just be that your vision is changing,” he said. “But any symptom like that should prompt a visit to the eye doctor. I don’t think it’s much of a concern for a man who takes an occasional pill – more for the man who’s taking it on a regular basis.”
Men also should know that if ED medications cause issues such as headaches, low blood pressure or vision problems, there are other solutions, such as injection therapy or penile implant surgery.
“These work very, very well and are good options for men for whom the pills don’t work, or for men who simply don’t want to take a pill every day,” Dr. Geraniotis said. “So, men shouldn’t feel like medication is their last option or that it’s the end of the road.”
