Can you take Sildenafil or Tadalafil just “for fun?”! | ED Medications

Summary

Dr. Reena Malik, a urologist and pelvic surgeon, discusses the recreational use of PDE5 inhibitors like tadalafil and sildenafil, medications typically prescribed for erectile dysfunction. She explores the safety and potential risks associated with using these drugs for fun, especially in combination with substances like alcohol, cannabis, and other recreational drugs. Dr. Malik highlights concerns such as prolonged erections, sexual trauma, and an increased risk of sexually transmitted infections. She emphasizes the importance of using these medications responsibly and under medical guidance, particularly when not prescribed for erectile dysfunction.

Takeaways

• 😀 PDE5 inhibitors like tadalafil and sildenafil are primarily used to treat erectile dysfunction (ED).
• 😀 These medications block the PDE5 enzyme, increasing blood flow to the penis, which helps achieve and maintain an erection.
• 😀 Recreational use of PDE5 inhibitors has become common, with many men using them even without ED to enhance sexual performance or endurance.
• 😀 A 2021 review found that 4-66% of men in various studies used PDE5 inhibitors recreationally, often combining them with substances like alcohol, cannabis, or illicit drugs.
• 😀 While generally safe for those with ED, using PDE5 inhibitors recreationally—especially at high doses—can lead to side effects like priapism (a prolonged erection lasting over 4 hours), which requires emergency treatment.
• 😀 Combining PDE5 inhibitors with recreational drugs such as cannabis or opioids can lead to exaggerated physiological responses, including prolonged exposure to the medication and higher risk of side effects.
• 😀 Taking PDE5 inhibitors with certain substances like cannabis can slow the drug's metabolism, potentially increasing its effects and duration.
• 😀 Prolonged sexual activity under the influence of recreational drugs can lead to physical injuries, such as genital trauma or lacerations, due to extended friction.
• 😀 There is an increased risk of sexually transmitted infections (STIs) when using PDE5 inhibitors recreationally, particularly when combined with alcohol or drugs that reduce inhibition and decision-making.
• 😀 PDE5 inhibitors can cause temporary visual disturbances, as they affect the PDE6 enzyme in the retina, but these side effects are generally reversible and not associated with permanent damage if used within recommended doses.
• 😀 Combining PDE5 inhibitors with nitrates (e.g., nitroglycerin) can cause dangerous hypotension (severely low blood pressure), which can be life-threatening.
• 😀 While using PDE5 inhibitors for sexual performance enhancement is generally safe in low doses, using them recreationally—especially with other substances—can pose significant health risks, including addiction to the psychological confidence boost they provide.

Q & A

Can tadalafil or sildenafil be used for recreational purposes even without erectile dysfunction?

Yes, some individuals use these medications recreationally to enhance sexual performance, despite not having erectile dysfunction (ED). Studies have shown varying rates of recreational use, particularly in certain groups like those who are HIV-positive or engage in high-risk behaviors.

How do PDE5 inhibitors like tadalafil and sildenafil work in treating erectile dysfunction?

PDE5 inhibitors work by blocking the PDE5 enzyme, which normally breaks down cGMP, a compound that helps relax smooth muscle cells in the penis. By inhibiting this enzyme, cGMP accumulates, leading to increased blood flow to the penis, which helps men with ED achieve and maintain an erection.

What are the main risks of using PDE5 inhibitors recreationally?

Using PDE5 inhibitors recreationally can lead to several risks, such as an exaggerated physiological response when combined with other substances, including cannabis, opioids, or club drugs. Additionally, high doses can result in side effects like priapism (a painful erection lasting over 4 hours), visual disturbances, or heart-related problems if combined with nitrates.

What is priapism and why is it dangerous?

Priapism is an erection that lasts for more than 4 hours. It is dangerous because prolonged erections can cause blood to stagnate in the penis, depriving tissues of oxygen and potentially causing permanent damage, requiring immediate medical attention.

Can cannabis affect the way PDE5 inhibitors work?

Yes, cannabis can slow the metabolism of PDE5 inhibitors, causing the medications to remain in the body longer and possibly leading to unintended higher doses. This could increase the risk of side effects and exaggerated reactions.

How do club drugs interact with PDE5 inhibitors in enhancing sexual function?

Club drugs like GHB or mephedrone are sometimes used alongside PDE5 inhibitors to prolong sexual activity. While they may enhance the ability to get an erection, they also increase the risk of prolonged sex, which could lead to trauma, infections, or other health risks due to extended periods of friction or unsafe behaviors.

What are the health risks associated with combining PDE5 inhibitors and other drugs?

Combining PDE5 inhibitors with other substances, like alcohol, opioids, or recreational drugs, can increase the risk of side effects. These include a higher chance of experiencing priapism, dangerous drops in blood pressure, and other physiological complications. It also raises the likelihood of risky sexual behaviors, such as unprotected sex, increasing the chance of sexually transmitted infections (STIs).

What kind of visual disturbances can occur with PDE5 inhibitor use?

PDE5 inhibitors can cause temporary visual disturbances due to their effect on the PDE6 enzyme in the retina. These disturbances are usually short-lived, but excessive use or high doses might cause more serious visual issues, though permanent damage is rare.

Can PDE5 inhibitors cause heart problems?

The most significant heart-related risk is the combination of PDE5 inhibitors with nitrates, which are used for chest pain. This combination can cause severe hypotension (low blood pressure), which could be life-threatening. It's important to avoid using these medications together without a doctor's supervision.

Is it safe to use PDE5 inhibitors regularly if you're healthy and don't have ED?

Generally, using a low dose of PDE5 inhibitors on a regular basis is considered safe for healthy individuals, though it may not provide additional benefits beyond what your body naturally achieves. Taking high doses or using them in conjunction with other substances, however, can increase the risk of side effects and complications.