SexRx: Nicotine and your sex life

Drug:

Common sources:

Nicotine is derived from tobacco and therefore found in these products:

• Cigarettes
• Cigars
• Pipe tobacco
• Smokeless tobacco products
• Nicotine replacement products

How it works:

Sexual side effects:

How it causes sexual problems:

Nicotine is a vasoconstrictor, which means that it causes narrowing of blood vessels and decreases blood flow. Alterations in blood flow can lead to impotence, because rapid influx of blood to the penis is needed for an erection.

Nicotine can also contribute to impotence in the following ways:

• Increases the risk of atherosclerosis (chronic narrowing of the arteries), which decreases the flow of blood into the penis, causing abnormally low penile blood pressure.
• Damages the tiny blood vessels in the penis that normally enlarge to accommodate the rush of blood flow that produces an erection; these vessels constrict and can lose their ability to expand
• Allows blood to flow out of the penis, which makes it difficult for an erection to be maintained

Nicotine will also decrease the blood flow to a woman's sexual organs. However, women do not appear to experience as much sexual dysfunction as men, in relation to nicotine use.

Treatment options:

Quit smoking

It is believed that when men stop smoking, all or most of the erectile capability of the blood vessels in the penis is restored.

There are many methods to quit smoking. Often, a combination of methods is the most likely to be successful:

Scheduled reduction - this involves setting up a schedule of specific times to smoke and not smoke, and allows smokers to regulate and then decrease their smoking until they are completely weaned off of cigarettes.

Nicotine replacement - replacement products, such as a patch, gum, nasal spray, or inhaler, that provide nicotine at diminishing levels. This method minimizes withdrawal symptoms and helps smokers to gradually taper themselves off of their nicotine addiction.

Antidepressant medications - bupropion (Wellbutrin, Zyban) is an antidepressant that affects certain brain chemicals that are involved in nicotine addiction, making it easier to quit.

Hypnosis - typically, a few individual sessions combined with self-hypnosis techniques is the most effective route.

Acupuncture - there have been reports that acupuncture has helped some people quit smoking.

Treat the impotence

While attempting to quit smoking, talk to your doctor about which options for treating impotence are appropriate for you. These include:

• Sildenafil (Viagra) – a drug used to treat male impotence. This option will not work for everyone; people who take nitrate medications to manage angina and other heart problems should never use sildenafil.
• Yohimbine – the only herbal supplement showing evidence for treating impotence, thus far. However, it can raise blood pressure and therefore should not be used by people taking a beta-blocker to manage hypertension.
• Intrapenile injections – a self-administered injection can help men to maintain and sustain an erection, however, there is some discomfort associated with the injection.
• Vacuum devices – these devices help to bring blood into the penis in order to start an erection. However, the mechanics of these devices do not allow for ejaculation.