In the past we have discussed the
importance of keeping patients informed about side effects of their treatment.
A good example of that can now be seen in the use of prescription painkillers.
It is commonly known that chronic use of these treatments has been associated
with various risks ranging from sleep apnea to fatal overdoses. However, up
until now there was little evidence indicating that this might also apply to
erectile dysfunction. Now, a study suggests that erectile dysfunction may be
added to the list of side effects related to excessive use of prescription
painkillers.
The study, which was published in
the journal Spine, included a total
of 11327 men who had visited their doctor to get treatment for chronic back
pain. The researchers scoured the participants’ pharmacy records for
prescriptions of opioids or erectile dysfunction medication six months before
treatment and six months after treatment. The levels of treatment were then
categorised into one of five categories, ranging from none to high dose (use
equal to 120 mg morphine). The key findings indicated that there was a strong
relationship between being prescribed high dose usage of prescription
painkillers and erectile dysfunction treatments among 19 per cent of their
participants.
There are many areas related to
these findings that warrant further attention. Perhaps the most obvious one
comes from establishing how widespread the problem is. Given the nature of ED
symptoms it is likely that not all the individuals affected by these problems
were keen to discuss it with their clinicians. Moreover, as the data were
collected from secondary sources, it is not possible to establish whether there
were men that sought alternative treatments for their ED, or who did discuss it
with their clinicians but were not prescribed ED treatments due to
contraindications in their medical history. As such it is worth asking whether
there is a dose-response relationship between the amount of prescription painkillers
and treatment for erectile dysfunction or whether other areas need to be taken
into account.
Another
critical flaw from the current study came from the fact that it did not paint a
complete picture of the heterogeneous group of men that experience chronic
pain. Some of the key factors that were likely to affect the result, such as
development of depression, were not included in the analysis. As such, it made
it difficult to establish the direction of the association. Yet the authors
were vocal in the media about advocating exercise programs and cognitive
behavioural therapy as first line of treatment for this patient group. Whilst
the feasibility of successfully implementing such regimes is debatable, the
authors did manage to successfully emphasize the importance of telling patients
about these side effects so that they would be able to make an informed
decision about their treatment. This, in combination with the novelty of the
topic, clearly reflects the clinical value of the research. Therefore it is our
hope that the current findings are given due attention in both the clinical and
the research community