I was asked by MEL Magazine to weigh in on the latest installment of their series, The ‘Normal’ Couples’ Guide to Sex. The article below outlines the advice I gave to their person needing sexual expert advice.
A Sex Guide for People Whose Meds Are Messing Up Their Sex Lives: The latest installment of our series, The ‘Normal’ Couples’ Guide to Sex
By Lynsey G
Not ecstatic about your current sex life? Don’t have hours every day attempting to decipher all the Sanskrit in the Kama Sutra? Unable to bankroll a shopping spree (or a single purchase for that matter) at Jimmyjane? Here’s a sex help guide for you, fellow regular human who wants to be better in bed.
David, Everett, Washington
Goal: To have and maintain an erection during sex
The Sex Situation: “I’m on Escitalopram [an SSRI, which is a form of antidepressant/anti-anxiety medication], as well as Lisinopril and Amlodipine [for high blood pressure],” says David. “My Veterans Affairs doctor has prescribed Vardenafil [an erectile-dysfunction drug] for me, but if I take a whole pill, I wake up with a headache and not feeling all that hot. I’m in a steady relationship with a woman, and I get frustrated when I feel aroused and nothing happens — especially because my girlfriend has a high libido, and I’m not able to keep up with her.”
The Obstacle: “I try to have an erection, but halfway through lovemaking, it just goes away. It’s aggravating! My girlfriend gets frustrated because she doesn’t know what to do to help me maintain my erection to finish inside her.”
What He’s Tried: “I’ve discussed this with my doctor, who took me off my previous anti-anxiety medication and gave me Escitalopram. But the doctor also prescribed Gabapentin to ease the pain I have from a pinched nerve in my shoulder. I looked up the side effects, though, and the first one is erectile dysfunction. The doctor said there’s only a one in 49 chance of that happening… I think that’s a load of crap, but what do I know?
“I’ve used half of a Vardenafil [to try to avoid the headache but still maintain an erection], but it doesn’t seem to work. I’m so frustrated that nothing is happening, and my girlfriend is getting more and more frustrated — to the point of not caring if we have sex at all.”
The Goal: “It’s simple: I’d like to have a strong, hard erection throughout the whole act.”
Examine Those Meds: “Let’s discuss some tips that may be helpful to you,” says Sunny Rodgers, an ambassador for the American Sexual Health Association. “I’m a clinical sexologist, sex coach and sexual health educator, so I will always first refer you to a physician for medical issues. But since your doctor has already prescribed Vardenafil, obviously you’ve already tried that route.
“While Vardenafil is known to give users headaches, one of the physicians I normally refer out to informed me that Escitalopram also has a possible side effect of headaches, while Lisinopril and Amlodipine can [cause] dizziness and lightheadedness, too. Worse yet, now Gabapentin has been thrown into the mix, which I was informed can cause dizziness and may contribute to headaches as well. So perhaps the Vardenafil alone isn’t solely responsible for your headaches. It could be the combination of medicines you’re currently taking that are interacting to amplify this side effect.
“Also worth considering is the fact that the two medications you’ve been prescribed to treat your high blood pressure might be interfering with the blood flow to your penis (since an erection is made by blood flowing into your penis).”
Chill Out: “It’s clear from the medications you’ve been prescribed that you’re currently experiencing a highly stressful period of your life. This is common and normal and may be what’s creating your erectile dysfunction. With that in mind, you may need to focus on stress reduction and stress management in order to get the results you’re seeking.
“Often, sex itself is the best stress reliever. But perhaps you also should consider trying acupuncture, exercise, meditation, cognitive therapy or adaptogenic herbs, which can recharge your adrenal glands to help you better respond to stress. Since both you and your current girlfriend are experiencing this stress and frustration, maybe both of you can try one or more of these activities together, to help with bonding.
“Regarding the herbal options, Rhodiola rosea may be helpful in improving energy, thereby amping up your sexual energy. DHEA is a natural hormone that can be converted to testosterone and may be able to help with achieving and maintaining an erection. I do, though, recommend running these past your physician before you start using them [to vet them for any possible interactions].”
Invest in Some Hardware: “Now let’s talk about another option that I frequently recommend — erection rings (also known as cock rings, love rings, c-rings, penis rings and shaft rings). I think since you’re able to get an erection but not maintain it, an erection ring may be the perfect item to solve your dilemma: Once you attain an erection, place the erection ring around the base of your penis, and it’ll help hold the blood in your penis for longer. And as long as vibration doesn’t bother you — it does for some men — you could even try a vibrating erection ring that’s designed to stimulate your partner, as well. Be sure to choose an erection ring made from stretchy material to start with, so that it’s easy to put on. Also, to be on the safe side, I don’t recommend using an erection ring for longer than 30 minutes at a time.”
One Thing at a Time: “Please, don’t attempt to try every one of these recommendations at the same time!” advises Sunny. “Try one or two to start — take your time and explore erection rings and other options, and make sure to find time to slow down, relax and enjoy the good parts of life. Most of all, don’t put too much pressure on yourself. Sex play is just that — play.”
Do You Think Maybe It’s Not the Vardenafil Causing the Headaches? “I understand about the combinations of the drugs with the Vardenafil. The doctor said that [I could] maybe use half a pill, but I found that it doesn’t work that well, either. I just don’t think Viagra is the answer for me.”
What Do You Think About Trying DHEA? “I’ve heard about DHEA, but I didn’t know it was a testosterone booster,” says David. “I’ve used other testosterone supplements before and they worked for a while, but they got costly over time.”
How About the Other Holistic Options? “I may see if [they’re] helpful. I didn’t know about rhodiola rosea — and it certainly sounds like a few of the organics could be useful. I’ll do my research and read about all the information that the doctor gave me.”
Is Stress Management a Realistic Option? “I’m working on reducing my stress levels, and things are beginning to change in my life. I’m going back to work, and I’m seeing my VA mental health counselor in a week to review what steps to take next to improve my life.”