Hearing Loss May be a Downside of Viagra

A new study out of the University of Alabama at Birmingham School of Public Health validates the 2007 Food and Drug Administration (FDA) label changes regarding hearing loss and phosphodiesterase type 5 inhibitors (PDE-5i).

PDE-5is medications include Viagra, Cialis, and Levitra. The new study reports the downside of their use is the risk of hearing loss. This downside of Viagra and the other PDE-5is puts the men who use the drugs at twice the risk of hearing loss as men who don’t use the drugs.

The results of Gerald McGwin’s, professor of epidemiology, study are published in the May 18 issue of the journal Archives of Otolaryngology-Head and Neck Surgery

The FDA originally decided to feature warnings about hearing loss on labels for PDE-5i drugs after 29 cases of the problem were reported between 1996 and 2007. The hearing loss was reported to occur within hours to days of taking the drugs.

McGwin’s cross-sectional study used a population-based sample of 11,525 men 40 years or older from the 2003-2006 Medical Expenditure Panel Survey (MEPS), a longitudinal, overlapping panel cohort, with each cohort consisting of approximately 15 000 households, including a subsample of approximately 39 000 individuals chosen from the National Health Interview Survey using a stratified and clustered sample with weights that produce nationally representative estimates.

The overall prevalence of self-reported hearing loss was 17.9% and increased with age. The prevalence among those in their forties was 7.5%, and this increased to 15.0%, 24.4%, 32.9%, and 47.2% in subsequent decades.

Approximately 2% of men reported having used a PDE-5i. Use was lowest among those in their forties (0.8%), steadily increased until men were in their 60s (3.3%), and then subsequently declined to 0.5% for men 80 years or older.

Among those reporting PDE-5i use, Viagra was the most frequently used (80.3%), followed by Levitra (20.2%) and Cialis (12.8%).

The results show that, among 11,525 men over age 40, those who took PDE-5i, were twice as likely to also report hearing loss as were men who had not used the drugs. This relationship was strongest for men reporting use of Viagra.

“”PDE-5i medications work in ED patients by their ability to increase blood flow to certain tissues in the body,” McGwin said. “It has been hypothesized that they may have a similar effect on similar tissues in the ear, where an increase of blood flow could potentially cause damage leading to hearing loss.”

This study represents the first epidemiologic study to evaluate the relationship between PDE-5i drugs and long-term hearing loss. However, it doesn’t find an actually causal relationship, only shows an association. More research is needed to back up the findings.

The FDA urges those who experience hearing problems while on the drugs to stop taking the medications and call their doctor.

Related stories
Risk of Hearing Loss in Men Increased by Regular Use of Analgesics
FDA Changes Labels for Cialis, Levitra, Viagra Due To Hearing Loss

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Priapism Responds to New Treatment

Priapism, which many may know better as an erection that lasts longer than four hours, has responded well to a new treatment tested by researchers at The University of Texas Medical School at Houston. At this point, men who develop priapism have few treatment choices for this painful condition.

Men are warned about the possibility of priapism every time they hear a commercial for prescription medication taken to treat erectile dysfunction (ED), yet the term for this rare side effect of ED drugs is seldom used. Priapism develops when blood in the penis becomes trapped and cannot drain out. The condition can occur in males of any age, including newborns, but it is most common between the ages of 5 and 10 years and 20 to 50 years. It is highly associated with leukemia, sickle cell disease, and other blood disorders.

If priapism is not treated immediately, it can result in penile fibrosis, a condition that involves scarring and permanent erectile dysfunction. Thus the announcement that a new treatment could offer a solution can be encouraging for the thousands of men who are afflicted by this condition. The new treatment is actually a novel use for an FDA-approved (Food and Drug Administration) drug called polyethylene glycol-linked adenosine deaminase (PEG-ADA), which is used to treat people who have a deficiency of adenosine deaminase enzyme (ADA). People who are ADA deficient have a condition called Severe Combined Immunodeficiency Disease.

Researchers at The University of Texas propose that priapism is associated with elevated levels of adenosine, a finding they made during previous research in ADA-deficient mice that had long-lasting spontaneous erections. In that study they showed they could prevent and treat priapism in mice. In this latest study, the investigators used PEG-ADA in a group of mice with sickle cell disease features and another group with ADA enzyme deficiency and showed they could prevent penile fibrosis.

Men who have sickle cell disease have a 40 percent chance of developing priapism. The current treatment options for priapism include pain control medication, hydration, and surgery. None of these choices are especially effective. Introduction of a medication that would prevent or treat this condition would be most welcome.

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Erectile Dysfunction Drugs Linked to Higher Rates of HIV, Chlamydia

Researchers have found a link between men using drugs to treat erectile dysfunction (ED) and higher rates of the sexually transmitted diseases HIV and Chlamydia. Men who use drugs like Viagra, Cialis and Levitra may also be engaging in high risk behavior suggest the scientists. Findings from a study of more than 1.4 million men revealed two to three times the rate of sexually transmitted disease among men who request drugs for erectile dysfunction, with HIV being the most prevalent STD.

Study author Dr. Anupam B. Jena, an internal medicine resident at Massachusetts General says, “Our findings suggest is that just by virtue of asking for an ED drug, these men are identifying themselves as being at two to three times higher risk of STDs.” The authors suggest that physicians counsel men taking drugs for erectile dysfunction about safe sex practices. The study did not take into account sexual preferences.

The researchers also say most physicians don’t counsel older men who take drugs for erectile dysfunction about STD risk and safe sex, reserving those talks for younger men. The authors obtained the information from insurance records examined between 1997 and 2006 that included approximately 34,000 male beneficiaries.

After the first prescription for erectile dysfunction was filled, the men studied were found to have a two to three time higher rate of sexually transmitted disease compared to men over 40 not using ED drugs. The most common STD among men using ED drugs was HIV, followed by Chlamydia.

One of the reasons HIV was the most prevalent disease linked to men using ED drugs may because symptoms of HIV drive them to their healthcare provider. Dr. Jena explains, “The symptoms that are associated with a primary HIV infection are the kinds of things that make men more likely to show up to a doctor, rather than go to a free clinic where they know they can get tested for an STD anonymously.”

Dr. Peter Leone, a professor of medicine at the University of North Carolina and board chair of the National Coalition of STD Directors says the findings are no surprise. Doctors have suspected it’s not just men with erectile dysfunction taking the likes of Viagra, Cialis and Levitra. Dr. Leone says, “… they’re also men in high risk groups who take it to enhance sexual activity.”

He suggests that physicians should screen men who use erectile dysfunction drugs for sexually transmitted diseases, adding that repeated follow up for STD testing is also important unless men are using condoms or in a monogamous relationship. He also says it’s not erectile dysfunction drugs leading to higher rates of the STD’s HIV and Chlamydia – “it’s really the other way around”. The study concluded, “Men who use ED drugs have higher rates of STDs, particularly HIV infection, both in the year before and after use of these drugs.”

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Recognizing Link between Heart Disease and Erectile Dysfunction Urged

Men with erectile dysfunction or ED are urged by experts to have thorough medical exam to screen for coronary artery disease that can lead to heart attack. Problems obtaining or maintaining an erection are closely linked to risk of heart disease, making it important for men experiencing erectile dysfunction to have a complete medical exam.

Findings show that many men with erectile dysfunction experience heart attack within 3 to 5 years after developing impotence. Cardiologists from UK, Italy, Greece and the USA say a complete medical exam is warranted before physicians consider any type of treatment for erectile dysfunction, based on findings from over 100 studies linking heart disease to ED.

In one study, men with erectile dysfunction age 30 to 39 were found to develop coronary artery disease that can lead to heart attack within 10 years. The risk increased with age.

Men with impotence and family history of heart disease and elevated cholesterol levels of just 20 points are also found to be at increased risk for heart attack.

The research team, led by Dr Graham Jackson, a London-based cardiologist and Chair of the Sexual Advice Association says when blood flow that becomes restricted to the penis causes impotence, men are also at increased risk for heart disease and heart attack from restricted blood flow that can occur in larger blood vessels.

“The evidence supporting the relationship between ED and cardiovascular disease has continued to increase over recent years and yet recognition of the association remains limited among healthcare professionals and the general public” concludes Dr Jackson.

Jackson adds that recognizing the link between heart disease and erectile dysfunction will “improve and save lives”. Erectile dysfunction is an important predictor of heart disease, and experts are urging that men undergo complete medical exam, testing and follow up before treatment for ED is initiated by clinicians.

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