Pain, Painkillers, Erectile Dysfunction and You

In the Big Blog that started all this blather, there’s a section on pain medications and their side-effects. This page is the logical progression from that section. Once again I am not a medical professional. What I write is from personal experience, conversations with my peers and over 60 years on this planet observing the Human Condition.

When it comes to Erectile Dysfunction, popularly called ED so you won’t feel so bad when you have it [Right…] most men never thought this would happen to them. The ability to achieve and keep a big fat erection is considered part of being a MAN. If you can’t, somehow you’re not as much a Man as you should be. Call it what you want, that’s the way we’re wired. No man want’s to hear from his mate: “That’s OK baby, it happens to everybody sometimes.”


While some women seem to think men are just sex machines that will start snorting and pawing the earth like a bull in heat at the slightest come-on from a semi-attractive woman – and bang ’em like a cheap drum all night long at the drop of a hat – they are a little off the mark.
Most men would also like to think this is true.
And in our younger days, for some of us it was true.
However… Even under the best of conditions, sex for men is as much psychological as it is physical – perhaps even more-so.

It’s not as much fun for either partner if it’s over almost as soon as it started. And most men will freely (though not happily) admit they are not up to the “ideal” 10-15 minutes of rutting like pigs in heat before both partners lie panting, glowing and sticking to the sheets. If most men can make it to 3 minutes it’s a real accomplishment, requiring mentally ticking off baseball scores from the 50s in reverse order, designing a spreadsheet or building a honey-do list in their heads – all while trying to appear lusty, virile and focussed – and saying just the right thing at the right time.

This is a lot of pressure. Both mental and physical. And when your plumbing starts to not do it’s job like it used to, you can’t have any part of the equation stop operating at peak efficiency or there’s going to be a failure somewhere.

And then somebody’s left unfulfilled.


Copyright 2012

Now let’s just complicate all this with P.A.I.N. shall we?

When you’re in chronic pain, especially low back or leg pain, think about the impact on good old-fashioned sex. Even more-so with some kinky sex that requires better balance… Now how easy is it to achieve and keep that Manly erection do you suppose? I’ll tell you one thing. I sure didn’t get any better. Now you’re in Pain while trying to maintain an erection and do all those other things that make for a happy, satisfied mate – and self. And the pressure mounts.

For many of us, the only solution to our Pain problem is Painkillers. And like with any other medication, most high-powered prescription painkillers come bundled with side-effects. And several of these side-effects have both direct and subtle effects on the ability to have and enjoy sex. The big list of side-effects is right here in the Big Blog, but let’s enumerate some specific physiological side-effects of painkillers here:

  • Sexual dysfunction
  • Constipation
  • Swollen prostate
  • Incomplete urination

Let’s start at the top: Sexual Dysfunction: The more painkillers you have coursing through your bloodstream, the more it depresses not only your libido, but your respiration, blood flow and a lot of other fairly critical components. If you’re heavily medicated enough, even if you wanted to actually have sex, getting it to happen is not only complicated, but at some point, just not worth the planning, timing and effort. Especially if there’s a better-than-average chance at it not being”successful”.

There are plenty of medications for ED on the market. None of them are covered by your medical insurance and they’re all pretty expensive. Do they work? Depends on the exact nature of your problem. Viagra, Cialis and their kin, work by increasing the blood flow to your genital area. In addition, it increases the blood flow in most other places as well, making you look / feel flushed and sometimes resulting in headaches. All of these have the potential to solve the “plumbing” issue by just dramatically increasing the blood flow – and voila! An Erection. A BIG Manly erection!
Swell <rimshot>
Now what do we do with this thing? Well hopefully you know the answer to that question or you shouldn’t have taken the little blue (or orange) pill in the first place. The result lasts for a few hours and then things return to normal.

However… If your receptors are soaked in narcotics to the point that you’re falling asleep at dinner, you may still have problems even ED medications can’t solve. Like now you have this big fat erection and it just won’t last. Or it does last but again – there’s no Big Finish. Dammit! All that planning, work (healthy complexion) and no Big Finish. Now if you just want some cardio exercise and a mighty sweaty and (hopefully) satisfied mate, go for it! But you could just buy her some chocolate and get on the exercise bike too…

Constipation: Just consider that when it feels like you have a cinderblock in your belly, you’re not likely to feel all that sexy. If you’re physically uncomfortable, sex isn’t going to be very high on your priority list. It can be downright painful and a complicated juggling act to remain regular while adjusting your pain meds as your symptoms change. This is something you really want to get under control for every possible good reason and keep it that way. Start with lots of water and start adding stool softeners, fiber capsules, Magnesium, etc., until you have a balance. It’s well worth it.

Swollen Prostate: The Prostate is a very important little organ. Several medications can cause it to become swollen (just like prostate cancer can). When this happens, urination and sexual function are both adversely affected. There are 3 components that make up semen and the prostate contributes one of them. The prostate is also partially responsible for the pressure with which that sticky white stuff comes squirting out. More pressure = more fun for everyone, especially if you’re in a contest for distance… In addition, the urethra passes right through the prostate. So when it’s swollen, none of these functions work at full potential. Some, if not all, can barely function at all.

Incomplete and frequent urination, dribbling and general unsatisfactory emptying of the bladder all go along with an enlarged prostate.
(It used to sound like someone was running a garden hose into the toilet when you were in there and now it’s a lot of dribbling and splattering and you need a paperback to amuse yourself while waiting to finish…)

But wait – there’s more!
Difficulty in achieving / maintaining an erection
Pain in the back, thighs, hips…

So if / when you have an enlarged / swollen prostate, you’re going to want to fix this pronto, aren’t you? Well… Not so fast there, buddy. Sometimes the cure is worse than the original problem. There are some products on the market, including Flomax to reduce an enlarged prostate and solve these problems. And some of them work for some people. And then there are the side effects
Like you’re able to get and keep an erection (at least better than before) but now you put in “a full day’s work” and no Big Finish if you get my drift. Now wait just a darned minit here! All this work for no Big Finish? WTF? So now at least One of you is (potentially) happy and the other one is just exhausted.
Not exactly the desired effect, but not an uncommon outcome <rimshot> in many cases.
It’s just frequently the other way around…

Something to consider. And this doesn’t happen to everyone so once again, Your Mileage May Vary.

Telling both men and women that this is “normal” under these conditions does not always do a lot to fix the self-esteem issues that go along with what is popularly called “ED” for Erectile Dysfunction. Something that, in this case, is frequently caused by the very painkillers needed just to get through the day – and complicated further by the medications meant to fix the side-effects of these painkillers.

So what’s the answer?

First and foremost, as a couple you both need to understand both sides of the equation. You need to sit down and discuss your needs, expectations and concerns. Men can have a particularly difficult time of this. When you’re so busy worrying about the outcome of trying to successfully have sex, that you cannot get it up, keep it up, and / or finish up, you need to convey this to your mate.

Secondly you need to talk with your doctor and rule out any other physical problems that could be causing your particular case of ED. Prostate cancer is something most men will face if they live long enough, I’m told. Certainly a consideration, it’s not part of this article, so get yourself checked out by your doctor to find out what’s going on before you start trying ED medications.

Third and most importantly, you need to work on this together. And can you think of a any project that is more fun to pursue? If I had to pick any one thing I was going to practice until I mastered it, it wouldn’t be my guitar. Knowwhattamean?

Just because you now have a problem doesn’t mean all the fun is gone from your relationship – and it certainly doesn’t mean this is permanent. Maybe you need to get creative. Perhaps it’s time to sit down and figure out some options, boundaries and things to experiment with. Sometimes a change of pace makes a big difference. There are some things that get better with practice and sex is definitely one of them. It’s easy to fall into a rut in your sex life and it’s always the same old thing. Not bad, but not fireworks either. So what happened? Talk it out and make it a couples project. Sounds like fun to me.


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