Side Effects That Go With Sex: Dr. Mistry and Donna Lee Discuss the Most Common Side Effects of ED Drugs

Thanks for tuning in to the Armor Men’s Health Hour Podcast today, where we bring you the latest and greatest in urology care and the best urology humor out there.

In this segment, Dr. Mistry and Donna Lee answer a listener question about headaches after sex with Viagra (Sildenafil). While Dr. Mistry often sees side effects of medications for erectile dysfunction, these are often mild and only last as long as the medicine is effective. Headaches, backaches, and blue/green tinting in the patient's field of vision are common complaints with ED medications. If you consistently experience one or more of these side effects, it is worthwhile to try a different medication--often switching up meds will solve the issue. Again, if you or a loved one has suffered side effects from medications to treat erectile dysfunction, please give us a call and schedule and appointment so we can find a solution that will help you last longer and experience greater satisfaction without the irksome side effects.  

If you enjoyed today’s episode, don’t forget to like, subscribe, and share us with a friend! As always, be well!

Dr. Mistry is a board-certified urologist and has been treating patients in the Austin and Greater Williamson County area since he started his private practice in 2007.

We enjoy hearing from you! Email us at armormenshealth@gmail.com and we’ll answer your question in an upcoming episode!

Phone: (512) 238-0762

Email: Armormenshealth@gmail.com

Website: Armormenshealth.com

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Transcript

Speaker 1: 0:09

Welcome back to the Armor Men's Health Hour with Dr. Mistry and Donna Lee.

Dr. Mistry: 0:16

Hello and welcome to the Armor Men's Health Hour. I'm Dr. Mistry, your host, board certified urologist, certifiable boss.

Donna Lee: 0:25

Oh, Mr. Worldwide, as we call you around here, our stats are worldwide.

Dr. Mistry: 0:29

We do have 10 downloads from New Zealand.

Donna Lee: 0:32

Do we?

Dr. Mistry: 0:32

Yes.

Donna Lee: 0:32

I didn't look at that this week. We have a lot from Ireland and Germany. That's crazy.

Dr. Mistry: 0:36

Well that's good. That's good. It's probably background noise to make people go to sleep.

Donna Lee: 0:41

It's your soothing voice. It's your, your smooth radio voice.

Dr. Mistry: 0:44

Well, that other voice is Donna Lee, co-host office manager of NAU Urology Specialists, professional comedienne.

Donna Lee: 0:52

Yeah, that's right. And I'm super funny, professionally and unprofessionally.

Dr. Mistry: 0:55

Unfortunately, you really take this show off the rails with your inappropriate comments and all of those things. I'm the straight one in this, in this little co- hosting relationship.

Donna Lee: 1:05

In our office, though, that's not the case.

Dr. Mistry: 1:07

Well, that's why I became a urologist. The jokes of course. So if you have jokes, please send them. We'd love to hear from you.

Donna Lee: 1:13

We got another joke the other day. It was the same joke that we keep talking about. The,"Rectum? Damn near killed him." So we talked about earlier. So anyway, there you go. Thank you for sending that.

Dr. Mistry: 1:19

Anyway, if you are confused by that joke, please reference our previous podcast wherever you get your podcast.

Donna Lee: 1:26

For free!

Dr. Mistry: 1:26

I'm a board certified urologist. This is a, a urology show. Well, it's a men's health show, but we are brought, we are brought to you by a urology practice. We have four physicians. We have availability to see you as soon as possible. We try, we really try to strive to see patients within 24 to 48 hours, especially if you have a condition like acute onset testicular pain, a new diagnosis of a tumor or a mass, if you are seeing blood in your urine and you're not having any pain, you think you have an active kidney stone--these are things that we even see a lot of patients the very same day. I spend a lot of my time in the operating room, so I only have clinic three days a week, but we have three other physicians that are in the practice. We have four other mid-level or PA and nurse practitioner that can, that can see you and get your treatment started. And we highly encourage you to come in.

Donna Lee: 2:19

We should remind patients about that. That they're highly qualified. They're not like seeing an assistant.

Dr. Mistry: 2:24

No, they're seeing somebody that I personally trained. And some of them, because of their smaller hands, are actually preferred.

Donna Lee: 2:32

That is correct. And true.

Dr. Mistry: 2:34

It, it does hurt my feelings a little bit when a long term patients like,"Do you mind if we don't do the exam today and Leanora does it next time?" I said,"Okay."

Donna Lee: 2:42

That's pretty funny, and that is, that is true. Now we still have some patients that don't understand the role of a mid level, and that's a physician assistant or a nurse practitioner, and they want to see you.

Dr. Mistry: 2:51

I understand.

Donna Lee: 2:52

And it's really difficult to explain to them that seeing Leanora is like seeing a female Dr. Mistry.

Dr. Mistry: 2:57

Because I mean, Leanora has been with me for years. She even sounds like me when she's talking to patients. Her notes look like what I would write. And years ago I would have her be in my clinic one time every month, just to make sure that we're on the same page, and she's teaching me things. And I was like,"Oh boy, Leanora."

Donna Lee: 3:14

You know, she recently had a birthday, and then somebody wrote, we had all the employees sign the card. And one of the first comments was,"You're the only person I trust with my va-jay-jay."

Dr. Mistry: 3:21

Oh, very good.

Donna Lee: 3:23

We're a family group around here.

Dr. Mistry: 3:25

Well, thank you. Thank you very much, everyone. So if you want to send us your questions, if you want to make an appointment, if you want to talk about a clinical issue that you have some concern about, please reach out to us. Donna, how do people reach out to us?

Donna Lee: 3:37

You can call us during the week? Well actually we're a little busy. I'd rather you email us: armormenshealth@gmail.com. But our phone number during the week is(512) 238-0762. But yeah, those questions go to armormenshealth@gmail.com. And we are so excited to have these questions.

Dr. Mistry: 3:53

And if you mentioned the show and you make a new patient appointment, there may be a t-shirt waiting for you.

Donna Lee: 3:57

There may be,'cause they got a few.

Dr. Mistry: 3:59

We do have a few thousand t-shirts. We were really planning on some kind of t-shirt thing.

Donna Lee: 4:04

It's going to happen. The, it's, I call it the great t-shirt explosion of 2020. So call us, we'll give it, we'll give you a tee shirt.

Dr. Mistry: 4:10

Well give us a question, Donna.

Donna Lee: 4:11

This question, I have never heard this before, so I was excited to ask you about this. Maybe this is common and I don't know, cause I don't take Viagra, but this patient said,"Dr. Mistry, I use Viagra, 100 milligrams. I use it sometimes. After sex is over, I have a terrible headache. Why?"

Dr. Mistry: 4:27

Well, that's a great question. And I'll expand that question for the sake of what we're, of the show to first start with you saying that you don't take Viagra. That's maybe obvious, right? You don't take Viagra.

Donna Lee: 4:38

I don't. I have a prescription for it, though.

Dr. Mistry: 4:38

So, and so what's interesting is that men and women both can have what are called arousal difficulties, which is difficulty with the biologic response that leads to sexual arousal. Now in a man, we got a big flagpole that tells us when we're aroused.

Donna Lee: 4:57

When the wind is blowing, y'all are aroused.

Dr. Mistry: 4:59

That's right.

Donna Lee: 4:59

When I see dishes in the sink, I'm not aroused.

Dr. Mistry: 5:01

No, but, but--wash the dishes, Michael, please. So what I'm saying is that, so we have a very easy to identify test of when we're aroused. It's an erection. Women also have that same kind of test. It's more subtle, though. It is lubrication, it is clitoral engorgement, and it is kind of that tingly feeling in the genitals. When a woman is lacking in that when they have an arousal disorder, that is an appropriate use of Viagra or any of these medicines, even in women, because women may not know that. And especially if you're on an antidepressant, an SSRI--Lexapro, Effexor, Zoloft, Celexa, Paxil--if you're on one of these medications and you're finding it difficult to both enjoy intercourse or to get aroused or to orgasm, it's a great example of study supported use of low dose Viagra to help, to help improve intercourse. But getting onto this patient's or this caller's question of why or why is he getting a headache after taking the Sildenafil or Viagra, it's an extraordinarily common side effect. Each of the most common medicines that we use for erectile dysfunction have their own unique type of side effect. And it has to do with the fact that the phosphodiesterase receptor that's being inhibited by the, by the medication there's, there's multiple types of this, this particular biologic target of this medication. Although there's one PDE5 that's in the erectile bodies, PDE1 through 12 or however many there are, are located all throughout the body. Although Viagra and Cialis and before, Levitra, what would work on PDE5 to give us an erection. It would also work on other ones as well. So, and that's where the side effects happen. Viagra in particular can lead to headaches and it can lead to blue/green alterations in vision. Those are going to be the most common things. And because it affects vision, there were reports in the past, very, very, very rare reports of acute onset blindness with the use of the medication. And that's why in the product insert, it actually mentioned them. Cialis, the most common type of side effect that I've noticed men report is backache, because one of the PDEs is located in the large muscles of the back. When it gets inhibited, those men can feel like a soreness in the back. Now, interestingly, the side effect usually follows the path of how long the medicine stays in your system. So Viagra lasts for about four hours, so that headache and that blue/green tinting can last about four hours, but Cialis can last 36 hours. So if you do get that side effect of backache, it can last for a, you know, a day and a half. If you get a side effect with one medicine, it doesn't mean you're going to have a side effect with another medicine. Certainly if you haven't tolerated one of them, it's definitely worthwhile to try another one. When it comes to Cialis, because of the dosing and the side effects, that's why we're such big fans of daily use medication. It reduces side effects. It's a lower dose. It's very effective. It reduces the spontaneity factor, because you're taking a little bit every day, so you're kind of always ready to go. That's a great prescription for success is having that medicine on board all the time. If you haven't been offered it, it's cheap nowadays, only maybe$30 a month nowadays.

Donna Lee: 8:29

Right? It used to be like six bucks a pill. Something crazy back then.

Dr. Mistry: 8:33

Yeah. They used to really ration out our, our ability to have intercourse. Now, nowadays they made it cheaper.

Donna Lee: 8:40

This, I'll remind listeners to that Sildenafil we refer to often is Viagra, and Tadalafil is Cialis. They know the commercial names...

Dr. Mistry: 8:49

The generic and the commercial names.

Donna Lee: 8:50

Yeah. So I just wanted to remind people of that.

Dr. Mistry: 8:52

And don't get confused when you go to the pharmacy and are buying kind of the generic version of Viagra or Sildenafil. They usually sell it in 20 milligram tablets when the Viagra was sold as 25, 50, and 100 milligram tablets. So you're going to need five of those little 20 milligramers to make up what a hundred milligramer would've been.

Donna Lee: 9:11

Do you think that listener could back down and have less headaches?

Dr. Mistry: 9:14

Certainly. I think that's usually what we recommend first. And almost always, if you take an 800 milligram Ibuprofen or a 650 milligram Tylenol with the Sildenafil, you won't get the headache.

Donna Lee: 9:28

Well, that's smarty pants of you. You sound like a doctor.

Dr. Mistry: 9:31

Yes. But I mean, you know, you hear that and it's, it's headache after sex. If it was headache before sex...

Donna Lee: 9:37

You're just out of luck?

Dr. Mistry: 9:39

Yeah, that's right.

Donna Lee: 9:39

That's your marriage.

Dr. Mistry: 9:39

That's right. That's right. Donna, are you taking Sildenafil just to get the headache?

Donna Lee: 9:43

Yeah. I enjoy the headache.

Dr. Mistry: 9:45

"Honey. I am not interested right now. I'm having a headache. I already took my Viagara. Dammit."

Donna Lee: 9:50

See all these things again are my motto, remember? Another reason not to have sex.

Dr. Mistry: 9:54

Oh my Lord. You're the worst mascot for this show.

Donna Lee: 9:58

I really am. But I love the show. And thank you for sending these amazing questions. You can reach us during the week at(512) 238-0762. Even if you're in Germany or Ireland, just give us a call. Just make sure that we're open at the right time. Our email address is armormenshealth@gmail.com. And where can we listen to the podcast, Dr. Mistry?

Dr. Mistry: 10:15

Anywhere you get your podcasts: Apple Podcasts, Spotify, you can ask Alexa, and our Buzzsprout page.

Donna Lee: 10:21

That's true. We're so famous in our own minds. So thank you all for helping us with our ego, and tell your friends about the podcast. Thanks, Dr. Mistry!

Dr. Mistry: 10:29

Thank you, Donna.

: 10:29

The Armor Men's Health Hour is brought to you by Urology Specialists for questions, or to schedule an appointment, please call(512) 238-0762 or online at Armour men's health.com.