Is there a pill that will cure sexual problems?

Sildenafil citrate (Viagra), vardenafil (Levitra), and tadalafil (Cialis) are drugs that are used to treat impotence. All of these drugs help a man get and keep an erection by causing more blood to flow to the penis. About half of men with impotence due to medical (rather than psychological) problems are helped to some extent by these drugs.

Studies suggest that problems due to nerve damage from prostate cancer treatment may not respond as well to these drugs as some other physical causes of impotence. But recent research suggests that using one of these drugs within weeks of surgery, on a regular basis, does improve the rate of spontaneous erections after nerve-sparing radical prostatectomy. (See “Early sexual rehabilitation after surgery” in the “Erections and pelvic surgery to treat cancer” section.) Some men who don’t get a good enough result with one of these drugs may do better when they use it along with the penile injection. (See “Penile injections” in the next section, “Is there a way to restore erections if the nerves or blood supply of the penis has been damaged?”)

Many drugs are known to interact with this group of drugs. For example, nitrates (like nitroglycerin and other drugs used to treat heart disease) may interact to cause very low blood pressure, and this can be fatal. Be sure your doctor knows about all medicines you take, even those you take rarely.

The most common side effects of these impotence drugs are headache, flushing (skin becomes red and feels warm), upset stomach, sensitivity to light, and runny or stuffy nose. In rare cases, these drugs may block blood flow to the optic nerve in the back of the eye. This could lead to blindness. Men who have had this problem were more likely to have been smokers or had problems with high blood pressure, diabetes, or high levels of cholesterol or fat in their blood.

Other medicines to treat impotence are being studied. You might want to ask your doctor about any new medicines or treatments for erection problems.