Despite TV Ads, It’s hard To Talk About ED

Q. I know erectile dysfunction is discussed on TV, but some of us are still too embarrassed to ask about it. Could high blood pressure contribute to this problem? What about medications for hypertension?
My understanding is that medicines like Viagra or Cialis increase blood flow. But if there is no desire, why even take the medicine? Any information you could send would be helpful to give us the courage to approach our doctor.
A. Erectile dysfunction is no longer embarrassing-as long as it is somebody else’s problem. But despite TV commercials for Viagra, discussing sexuality with a doctor can still be intimidating.
High blood pressure, diabetes or heart disease can all contribute to the development of ED. So can depression or thyroid dysfunction. That’s why this problem should be brought to your doctor’s attention, so the underlying issue can be addressed.
Some medications may also lead to trouble with erections or with libido, a separate problem entirely. We have listed some of these in our Guide to Drugs That Affect Sexuality, and we discuss solutions in our Guide to Treating Sexual Dysfunction. We would like to send them to you. Anyone who would like copies may send $3 and a long (#10) self-addressed, stamped (60 cents) envelope to: Graedons’ People’s Pharmacy, Dept. YP-96, P. O. Box 52027, Durham, NC 27717-2027.
Q. You recently wrote about trichotillomania, and here’s my two cents’ worth. I am a 47-year-old female pharmacist who has suffered with this horrible condition for 40 years.
The only thing that has helped me is buspirone. I haven’t pulled my hair in the years I’ve been taking it. It has been a godsend, but you failed to mention it. Please let others know.
A. Buspirone (Buspar) is prescribed for generalized anxiety disorder. A letter to the American Journal of Psychiatry (April, 1992) suggested its use for compulsive hair-pulling in anxious patients. We are delighted it has worked well for you.
Q. What can be said about a craving for baking soda? Several times a day I get an uncontrollable urge to eat baking soda straight out of the box. I don’t think I am addicted, but I am concerned.
A. Baking soda contains sodium bicarbonate. Eating too much could lead to sodium overload and change the acid balance of the body.
Uncontrollable urges to eat something that is not food is termed “pica.” Some people report a similar craving for laundry starch.
We don’t know why, but such behaviors are often associated with a deficiency of iron or zinc, and usually go away when the deficiency is corrected. Ask your doctor to check your levels of these minerals.
Q. I have been taking Vioxx for menstrual cramps. It works beautifully. I am extremely disappointed that I will no longer be able to get a prescription for this medicine. Do you have any suggestions about what I could use after I run out of Vioxx?
A. Before Vioxx, doctors used to prescribe pain relievers like naproxen (Anaprox, Naprosyn) for menstrual cramps. This anti-inflammatory drug is now available over the counter as Aleve. Ibuprofen is another possibility for cramp relief. If OTC products don’t help, ask your doctor whether one of the many prescription NSAIDs might do the job.