Erectile Dysfunction: characterized by the inability to develop or maintain an erection of the penis sufficient for satisfactory sexual performance) 

We compound a prescription preparation for erectile dysfunction (ED). It is given by injection and if the numbers of refills requested demonstrate anything at all, the treatment works. But, I'm not going to discuss that treatment. Instead, I think it's important to mention that many of the men who pick up the treatment smell - like cigarette smoke. We don't sell any of the oral ED treatments in our compounding pharmacy, so I don't know if the users of Cialis, Viagra, etc. also smell. I think the observation is significant and I did a little research to see if there's a connection between ED and the use of tobacco, particularly cigarette smoking.

I discovered that a study was done at Tulane University (research university located in New Orleans, Louisiana). The researchers studied men in China between the ages of 35 and 74 who did not have other forms of cardiovascular disease. They discovered a significant statistical link between the number of cigarettes a man smoked and the likelihood that he would experience ED. The conclusion was that of the men with ED, almost 25% of the cases could be attributed to cigarette smoking. The more they smoked, the more serious their ED.

The average cigarette delivers about 1mg of nicotine to the system. Nicotine has long been known to cause blood vessels to constrict. It crosses the blood-brain barrier and exerts actions on practically every cell in the body. It causes the release of epinephrine and norepinephrine, which are responsible for increasing blood pressure, heart rate, and breathing rates. It causes the body to release stores of fat and cholesterol into the blood, and is also associated with increased blood glucose levels. Nicotine has a powerful effect on the arteries, the vessels that carry blood and oxygen to the tissues. It causes them to constrict, to become smaller. Cigarette smokers frequently complain of cold fingers and toes.

Nicotine is cleared from the body through the liver. As we age, the liver loses some of its abilities and the clearance of nicotine declines. Also, the use of alcohol further impedes the actions of the liver. Therefore, it stands to reason that male smokers who regularly consume alcohol can find themselves falling prey to ED - and search in earnest for a "cure".

Instead of looking at these causes of ED, modern medicine has discovered numerous ways to counteract the effects of blood vessels that have been constricted by drug use. We use other drugs that are stronger at dilating arteries than nicotine to reverse the constricting actions of the cigarettes, alcohol, and age.  Nobody can make themselves younger, regardless of what some personalities say about regaining their youth by using hormones. Still, it seems rational that a man who suffers from ED would look seriously at what parts of his lifestyle might be part of the cause of his distress. Then again, it is far easier to pop a pill to get an erection. Nevertheless, I cringe just thinking that injecting drugs directly into the penis is a reasonable alternative to cutting back on tobacco and alcohol.

I can't leave this discussion with the above admonition without also acknowledging that nicotine has been shown to be a very addictive substance, one that is almost impossible to kick. Yes, some people can successfully stop using tobacco, but many of them will also tell you that they still have cravings for a cigarette, even years after smoking their last one. In the end, though, it is important to know that ED isn't really a drug deficiency. It may easily be caused by drug use, particularly when the drug in question is nicotine.

Other references;

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