What Side Effects Are Possible From Common Erectile Dysfunction Treatments?

Erectile dysfunction is a common condition diagnosed in millions of men, with a variety of options available to treat the condition. But there are potential side effects with these treatments that patients should understand. 

Erectile dysfunction, or ED, is the inability to achieve or maintain an erection. Various treatments, including medicinal and those that do not use drugs, help men suffering from ED achieve an erection and can help them maintain their erection for several hours.

Each therapy approaches the condition differently, but they all work to increase blood flow to the penis to produce a firm erection. All treatments include possible side effects, ranging from a mild rash to prolonged erections that damage the penis.

Before you choose the erectile dysfunction treatment that is best for you, review the following potential side effects and cautions raised about each treatment. It’s important to discuss any erectile dysfunction treatment you choose with your medical provider to ensure that you are receiving the best information possible.

Side effects of oral ED medications

Oral medications are the most common treatments for erectile dysfunction. While they generally promote better flow into the penis, they have documented side effects.

  • Sildenafil (Viagra): One of the most well-known medications, sildenafil became popular under the brand name Viagra. Some of the common side effects include headache, flushing, congestion, vision changes, and upset stomach, which are typically mild and often resolve on their own. More rare side effects include priapism, or an erection that lasts longer than four hours that can be painful and cause long-term damage to penis arteries and tissue. Others include sudden loss of vision or hearing, and a severe allergic reaction.
  • Vardenafil (Levitra): Another oral medication, vardenafil, also includes mild side effects that resolve on their own, like headache, flushing, stuffy nose, dizziness, and vision changes. Rare side effects include severe allergic reactions, sudden decreased vision or blindness in one or both eyes, sudden decreased hearing or deafness, and priapism that could threaten long-term damage to the penis. Avoid drinking grapefruit juice when taking the drug because it can increase the likelihood of side effects. Vardenafil cannot be used with the drugs Flowmax, Hytrin, and Cardura.
  • Tadalafil (Cialis): Tadalafil, also known as Cialis, includes similar mild side effects to other oral ED medications, including headache, stomach upset, back pain, muscle pain, stuffy nose, flushing, and dizziness. Rare side effects include sudden loss of vision or hearing, a severe allergic reaction, and priapism that could do damage to the penis. Cialis and grapefruit juice should not be taken together. The reason is that it can interfere with the medication’s metabolism and increase the risk of side effects. The medicine cannot be taken with drugs like Hytrin and Cardura. Flomax in doses of 0.4 mg is well tolerated.
  • Avanafil (Stendra): This medicine includes mild side effects, such as headache, flushing or dizziness. This oral ED medication also has potential rare side effects of sudden loss of vision or hearing, priapism, and severe allergic reactions.

These oral medications may not help address ED in some men and could prove dangerous in those who also take:

  • Nitrates: Medications often prescribed for chest pain called angina. Nitrates include nitroglycerin (Nitro-Dur, Nitrostat, others), isosorbide mononitrate (Monoket), and isosorbide dinitrate (Bidil).
  • Alpha-blockers: Medications commonly prescribed for an enlarged prostate or male pattern baldness, including dutasteride (Avodart, Jalyn) and finasteride (Propecia, Proscar).
  • CYP3A4 blockers: Medicines prescribed to block the CYP3A4 enzyme, including itraconazole (Sporanox, Tolsura), ketoconazole (Extina, Ketozole, others), and ritonavir (Norvir).

Side effects of vacuum erection device treatment

vacuum erection device, or VED, is used to help pull blood into the penis for men suffering from erectile dysfunction. Also known as a penis pump, a VED pumps air into the device to create suction around the penis.

After the erection emerges, a tension ring is placed on the base of the penis. This ring can be worn for up to 30 minutes to maintain the erection. Physicians recommend using the tension ring around the penis for only 30 minutes at a time to resume normal blood flow through the body and to avoid bruising and rashes around the base of the penis.

Mild side effects that typically resolve quickly can include slight bruising on the penis, skin irritation from the ring, small red spots along the skin of the penis, and discoloration of the penis. A more serious side effect of misusing the VED is applying too much suction pressure to the penis or keeping the ring on for too long, which can cause more serious bruising and pain in the penis.

Testosterone replacement used to treat erectile dysfunction

For some men, erectile dysfunction is the result of reduced hormones produced by the body during the aging process. This can contribute to difficulty in achieving and maintaining an erection. Your physician can test your testosterone levels to determine if you are suffering from low levels.

Your doctor may recommend testosterone replacement if you are diagnosed with low levels of the hormone. Testosterone replacement can be offered in the form of a topical cream or pellets inserted under the skin that slowly dissolves over time to produce a consistent level of the hormone in the body. Testosterone replacement also can be administered in the form of an injection into the body as well.

Possible side effects of testosterone replacement include increased sleep apnea, acne and other skin reactions, enlarged prostate, breast growth, reduced sperm production, shrinking testicles, and increased risk of blood clots.

Penile injections to treat erectile dysfunction

Penile injectionsuse a medication, or a combination of drugs, to increase blood flow in the penis much more quickly and with greater success than pills without all of their side effects, like flushing and congestion. The medication is self-injected into the base of the penis with a small needle.

Possible side effects can include fainting, dizziness, and low blood pressure. Improper injection by patients can cause infection, bruising, scarring, and pain.