According to the guidelines of the World Health Organization, the frontline treatment for erectile dysfunction involves drugs that facilitate erection, such as phosphodiesterase inhibitors. Even when the causes are psychogenic, combining sex therapy with these drugs is recommended, as better erection quality often correlates with improved emotional well-being in men.
Simultaneously, partners of men using these drugs often report enhancements not only in their sex lives but also in their relationships. However, the efficacy of these drugs sometimes leads many men to circumvent the healthcare system to obtain erection pills without a medical diagnosis or prescription.
A large online study conducted in the UK, Germany, and Italy, involving 11,599 men, revealed that 1 in 10 used such pills. Of these, 1 in 3 obtained them without ever consulting a doctor, despite 65.5% experiencing erectile issues.
The primary reasons cited were the embarrassment associated with discussing the problem and the cost of medical consultations and pharmacy purchases compared to online sources. The authors estimated that more than 6 million Europeans take erection pills without a doctor’s diagnosis.
This practice entails several risks:
Failing to address an underlying, yet undiagnosed, medical condition causing the erectile problem (e.g., coronary artery disease).
Keeping individuals with psychological issues reliant on medication indefinitely, whereas psychological treatment could potentially resolve the issue (modern treatments typically last around 3 months).
Acquiring counterfeit medications from the internet, which are neither effective nor safe.
Using over-the-counter preparations (such as herbal products or dietary supplements) promising to restore erections without proven effectiveness.
Moncada I, Martinez-Jabaloyas JM, Rodriguez-Vela L et al. (2009) Emotional Changes in Men Treated with Sildenafil Citrate for Erectile Dysfunction: A Double-Blind, Placebo-Controlled Clinical Trial. J Sex Med 6:3469-3477.
Schnetzler G, Banks I, Kirby M et al. (2010) ED Pharmacotherapy: Characteristics, Behaviors, and Attitudes of Men Bypassing the Healthcare System When Obtaining Phosphodiesterase Type 5 Inhibitors. J Sex Med 7:1237–1246.
