Art, now 23, was only 18 when he started using illicit drugs, which is something he sees as necessary for him to “keep the fun going.” And despite his age, among the drugs he now regularly takes are erectile dysfunction medications, such as sildenafil (popularly known as Viagra), tadalafil (Cialis), and vardenafil (Levitra).
“I take them to party, as well as before and during sex; it makes everything fun,” Art said.
Art is not an outlier in the gay and bisexual communities. In fact, it is estimated that up to 28% of gay men like him combine illicit drugs with erectile dysfunction medication, with at least 17.4% using them in the past three months.
It appears that gay men are at a higher risk of abusing ED medications, putting them in danger of experiencing unnecessary side effects, and risking becoming psychologically dependent on them to have sex.
Compensating for the negative side effects of other illegal drugs
Like Art, many gay men are using ED medications like Viagra to counteract the side effects of other illicit “party drugs.” Cocaine, for example, causes vasoconstriction (or the narrowing of blood vessels in the body). For erections to happen, blood must flow freely into the spongy tissue inside the penis. And when the blood flow is restricted, an erection becomes next to impossible. So, if you’re taking cocaine but still want to be able to have sex, these types of ED medications might come in handy.
As Art, himself noted: “Meth makes me sexual. And I remain sexual for hours. That’s even after my body, my penis, no longer feel any sensation. This is where erectile dysfunction medications become useful.”
Not surprisingly, a handful of studies noted that most recreational erectile dysfunction medication users who mix erectile dysfunction medication with illicit drugs engaged in risky sexual behaviors. These studies also mention that recreational ED medication use is more prevalent in the gay and bisexual communities.
Dealing with performance anxiety
Anxiety-induced erectile dysfunction is a common issue that happens to most men at some point in their lives. But studies show that gay men are much more likely to experience performance anxiety issues regularly.
Men like Art often believe that taking erectile dysfunction medications “makes sure you can perform on demand,” as Art said, adding that “even when the passion is gone, you stay hard, so you can still perform if you really have to.”
But the truth is that using erectile dysfunction medications does not always work when the cause for the erection issues is anxiety.
Anxiety disrupts arousal, and without arousal, there is no erection, even if you’ve taken a pill.
While ED medication can relax the walls of the blood vessels in the penis, thereby making it easier for blood to flow, the brain still needs arousal to trigger the blood flow to the penis in the first place.
For many men, ED medications act as a placebo. It only works by giving them a false feeling of confidence. This is especially true for younger man, who usually don’t have any blood flow issues to that might hurt their chances of having an erection to begin with.
Ignoring the dangers
Erectile dysfunction medications can have serious side effects, such as headache; upset stomach or diarrhea; dizziness; heartburn; nosebleeds; difficulty sleeping; muscle or back pain; numbness or tingling in the hands, arms, feet, or legs; and sensitivity to light or vision changes.
They can also have serious interactions with other prescription drugs some men might be taking. That is why it’s essential to consult a physician before taking them.
It is worth noting that a big of those who combine illicit substances with ED medications acquire these without a prescription. In a study involving 1,944 American men, 4% reported that their ED medication use was for recreational purposes, but only 1% were prescribed an ED medication by a physician!
Sadly this is an issue that is becoming more common. A recent 2021 study found that more men use ED medications for recreational purposes (66.2%) than for medical purposes (33.8%).
There also exists the risk of developing a dependence. While ED medications are not known to have physically addictive properties, a more serious psychological addiction to these pills can happen, so much so that one may be unable to perform sexually without them. While ED medications can temporarily increase sexual confidence, they can also cause feelings of loss of manhood as they leave users feeling inadequate for not being able to perform without them.
Ultimately, this is an issue for all gay, bisexual, or heterosexual men, particularly those who use ED medications with other substances. Because for as long as the social pressure to perform is there, coupled with the ready availability of ED medications, all the accompanying risks increase. And this is something that needs more attention.