Dr. Roach

Dr. Keith Roach

DEAR DR. ROACH: I am a 78-year-old male in reasonably good health, but I do have some issues. I exercise daily and eat a fairly balanced, healthy diet. I am a Type 2 diabetic with an A1C of about 6.4%, and I take metformin. I also take triamterene, lisinopril and atorvastatin for blood pressure and high cholesterol. In addition, I take metoprolol for atrial fibrillation.
I have recently heard about CBD gummies that could clear my blood vessels to a healthy status. My first question is, are they right for me, and would they benefit me?
I am also concerned that the three heart medications I take are a direct cause of my erectile dysfunction (ED). I do not want to take Viagra or similar medicines, as I hear way too much about them causing strokes and heart attacks. That is just too scary for me, but I desperately would like to fix the issue.
My second question is, am I correct in assuming that some of my issues are related to those heart medications? The internet and social media are jammed with so-called cucumber tonics and other quick fixes for ED, but I am skeptical about them. Is there a natural remedy that is reliable without the blue pill? — J.
ANSWER: Let me answer your second question first. It is certainly possible that the medications you take could be affecting your ability to get an erection. Metoprolol, triamterene and lisinopril may all have an effect, but none of them are likely to. Only a small percentage of men have this side effect.
It’s also possible that if you do have blocked blood vessels, those could be the cause of your ED. There are still other causes, such as a low testosterone level, but the most common cause of all is that many men in their late 70s just develop ED without any clear medical issue.
Your second question is about CBD and ED. There is no evidence to show the effectiveness of CBD on erectile function. Moreover, there is strong evidence that cannabis users are at a substantially higher risk to develop ED than nonusers. This is thought to be due to the THC, not the CBD; however, there are no data to prove or disprove this conclusively. CBD is being marketed for many conditions right now, but there aren’t always good data to support it.
There are no safe and effective over-the-counter treatments for ED, so please just save your money. (There is a placebo effect available, which can be effective for about 1/3 of men.) But I ask you to rethink the use of sildenafil (Viagra) and similar drugs, which are pretty safe.
There’s no such thing as a perfectly safe medicine, and there have been strokes reported in recreational users who take much higher doses than what is recommended. It’s not safe to take them if you are on any kind of nitroglycerin drug or in some men with heart disease. However, it’s the exertion of sexual activity that’s unsafe, not the drug, so I urge you to rediscuss this with your doctor.
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Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.
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