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A box of Viagra, typically used to treat erectile dysfunction, is seen in a pharmacy in Toronto in this Jan. 31, 2008, file photo. (Mark Blinch/Reuters)

A box of Viagra, typically used to treat erectile dysfunction, is seen in a pharmacy in Toronto in this Jan. 31, 2008, file photo.

(Mark Blinch/Reuters)

Our sex life is great, so why does he want to take Viagra? Add to ...

The question: My boyfriend wants to take erectile dysfunction medication to enhance his performance. Why would he want to do that? I think our sex life is great, and I don’t want medication to make it unnatural and weird.

The answer: There may be a number of reasons as to why your boyfriend feels the need to take erectile dysfunction medication – getting to the root is key. Relationships thrive on communication and that includes speaking to our partners openly about our sex lives.

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Erectile dysfunction is the inability to develop and/or maintain penile erection during sexual performance. It certainly affects a percentage of the male population. Psychological impotence (complication with erection due to stress or performance anxiety, rather than physical impossibility) is the most common contributor to erectile difficulties. The issue often gets resolved when a man’s anxiety dissipates.

Most men will experience this at some point in their life, especially when they are highly stressed or are in the early stages of a relationship. But the difficulties are often short-lived and do not create continuing problems in a relationship. In these circumstances, pharmaceutical intervention is not necessarily successful and I would not recommend it.

Erectile dysfunction caused by physiological or medical reasons – such as a health condition or side effect from other medications – is less common. In this scenario, age is a primary contributor. The National Institutes of Health estimate that about 5 per cent of 40-year-old men will experience erectile dysfunction on an ongoing basis, whereas the number rises to 15 to 25 per cent among 65-year-olds.

Your partner does not have a medical reason for taking this medication as you have alluded, which means he’s part of a growing number of men who use erectile dysfunction medication in a recreational manner.

There could be a number of contributing factors for this. Your partner may be curious about the extent to which his performance will be enhanced; he may be experiencing peer pressure; or if he has had too much to drink, he may take the medication to combat the negative impacts of alcohol on performance.

I have two main concerns with recreational usage. For one, erectile medications have side effects. They place stress on the major organs – in particular the heart, liver and kidneys – and the long-term effects are unknown. Second, there is some emerging evidence that men may experience adverse impacts on their sexual function and become psychologically reliant on the medications.

Start by explaining these concerns to your boyfriend – especially the latter as it may serve to be the strongest deterrent. Then try and understand where your boyfriend is coming from. Perhaps he has some insecurities about his performance that he’s been reticent to share.

Having an open conversation about your perceptions and feelings surrounding your sex life may serve to ease his mind. Tell him how great you feel about your sex life and suggest ways to add spontaneity and excitement to your intimate relationship without the use of medications.

Dr. Joti Samra, R.Psych., is a clinical psychologist and organizational & media consultant. She is the host of OWN: Oprah Winfrey Network’s Million Dollar Neighbourhood and is the psychological consultant to CITY-TV’s The Bachelor Canada. Her website is www.drjotisamra.com and she can be followed @drjotisamra .

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The content provided in The Globe and Mail’s Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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