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Anti-Viagra: The Drugs Prescribed to Prevent Erections

And the better question, why would you ever need them?

The global erectile dysfunction industry is worth nearly $4.5 billion. After all, Viagra costs nearly $70 a pill. But what about the erectile function industry? Or rather, the industry for helping erections go away.

That’s right, there are actual drugs prescribed by actual doctors to help prevent erections rather than kick-start them. “We can give patients two classes of medications to help them avoid erections: Valium (benzo) or Nitrous poppers,” Jamin Brahmbhatt, a board-certified urologist, tells me. “Valium is like having a drink. It relaxes you and may help you avoid erections. Amyl nitrite poppers are categorized as a depressant so it’s the same theory.”

Brahmbhatt admits, though, that neither drug was specifically designed to help prevent erections, which is why dick deflation isn’t considered their first order of business (or what they’re known for). That’s also probably why, per a 1995 study, they’re not all that effective. “Amyl nitrate, narcotics, refrigerant sprays and dorsal nerve blocks are usually initiated after the erection has begun, frequently provide incomplete relief and their effects are short-lived.” Adds Brahmbhatt, “They’re not perfect, and most doctors probably won’t prescribe them.”

He’s right, of course: Two other urologists I reached out to had no idea what I was talking about when I asked them about anti-erection medications.

Let’s, however, get to the more pressing question: Why would anyone want to prevent an erection in the first place?

The most common answer: Adult circumcisions and any other surgical procedure involving the penis.

“That’s the only reason I’ve ever prescribed those medications,” Brahmbhatt explains. “Getting an erection after you’ve been circumcised can be very painful.”

To that end, one such drug that showed promise in helping keep postoperative erections at bay for men who’ve undergone circumcision or penile and urethral reconstruction is ketoconazole, a medication that’s generally used to treat fungal infections like athlete’s foot, jock itch and ringworm. “Ketoconazole is a reliable method to prevent postoperative penile erection,” wrote the authors of the 1995 study cited above. “With the proper monitoring of liver function tests and the avoidance of drug interactions, ketoconazole therapy also appears to be safe.”

According to another study on the drug in 2004, the way ketoconazole works is by inhibiting the production of testosterone. As such: “[It’s] been used by urologists to treat refractory bone pain and impending neurologic injury in patients with advanced metastatic prostate cancer,” wrote the study’s authors. Unfortunately, though, whatever potential researchers originally saw in ketoconazole was disproved in 2008 after a double-blind study. “While prior retrospective reports showed promise for this medication, our study suggests that ketoconazole is not effective in preventing postoperative erections.”

Now, that’s a real boner killer.