Over the last year, there have been numerous reports of men experiencing tinnitus – ringing in the ears. The cause of this problem is generally associated with over-the-counter (OTC) drug use, and more specifically, with the administration of sildenafil (commonly known as Viagra) in combination with a nitrate medication (such as amyl nitrate, but not limited to it). More specifically, it is believed that nitrates interfere with the effectiveness of Viagra, resulting in insufficient dosing and lack of therapeutic effect. Additionally, it has been suggested that the combination of the two substances causes vasospasm – a constriction of blood vessels that supplies the penis (particularly the corpus cavernosum), resulting in decreased blood flow and the potential for permanent damage (nerve damage and erectile dysfunction, among others). Further discussion of these issues can be found below.
Symptoms
Tinnitus is generally described as a noise in the ear that is not externally attributable. While many people experience tinnitus, it is not a usual or common symptom and, for that reason, may be overlooked as a potential side effect of prescription or OTC drug use.
The exact mechanism of how sildenafil in combination with a nitrate medication causes tinnitus is unknown. However, it is believed that the interactions between these substances can result in decreased blood flow to the ears and, therefore, in a sound heard usually described as ‘high-pitched ringing’. Some researchers have stated that this side effect is probably due to a combination of vasospasm (particularly in the vessels supplying the ear) and direct trauma to the auditory nerve during sexual activity.
Risks
Although tinnitus is not a dangerous condition on its own, it can be a symptom of something more serious. Men experiencing tinnitus should visit their doctor immediately. Furthermore, the use of medication containing nitrates, in combination with Viagra, has the potential to cause or aggravate other health issues. Individuals taking part in such activities should consult their doctors about any existing health concerns before participating in such treatment. Additionally, amyl nitrate has been known to cause gastrointestinal (GI) effects, including:
- Dizziness
- Headaches
- Nausea
- Vomiting
- Diarrhea
- Stomach cramps
- Tightness in the chest
- Flushing (hot or cold)
- Difficulty breathing
- Paradoxical sensations (bizarre feelings such as burning or freezing, along with blurred vision, dizziness, and headaches)
For that reason, men taking part in sexual activities, particularly those involving anally-inserted materials, should consult a physician before starting a treatment plan. The risk of these side effects is probably higher for individuals already suffering from cardiovascular disease (CVD), hypertension, diabetes, or prostate problems. Additionally, anyone using organic nitrates (such as those found in nature) should avoid taking Viagra as it can cause severe and potentially dangerous interactions with vitamin C.
Treatment
Men experiencing tinnitus should consult their doctors about treatment options. There is no specific treatment prescribed for tinnitus, however, there are various remedies that can be used to relieve its symptoms.
For some people, the ringing in the ears is bothersome and does not go away even with regular use of earmuffs or headphones. In these cases, prescription ear medication may be advised. Another treatment option is masking, which involves playing music or other sound to ‘dumb’ down the noise. Finally, there are various natural supplements advertised to ‘boost’ blood flow to the penis and, therefore, increase arousal and the potential for sexual satisfaction. Some men find that these supplements, taken in conjunction with a sexual stimulant such as cayenne pepper or yohimbe, help them get ‘in the mood’ for lovemaking. In the case of yohimbe, it is also recommended that men with prostate problems should avoid it, as yohimbe has been shown to increase prostate size.
For individuals experiencing tinnitus, the use of nitrates with Viagra has the potential to cause or aggravate other health issues. Due to this risk, men engaging in sexual activities with a nitrate medication should consult their doctors about any existing health concerns before starting a treatment plan. Further research about this subject is needed to establish the long-term safety of these drug combinations.