It may have been harder to talk about erectile dysfunction up until 1999 when Viagra first reached the market. But once different prescription oral ED medications became available, ED grew somewhat more easy to discuss—at least between men and healthcare professionals. Stigma and misconceptions still remained about the condition, though, probably making it difficult for many of the 30 million or so men with ED in the U.S. to discuss their situations with their partners. However, now that a topical gel for ED, Eroxon, is available over-the-counter without a prescription, a big question is whether discussions about ED will become more, well, topical, natural and open before and during sex.
One major misconception is that erections can be like the TV show Cobra Kai—on demand and available at a moment’s notice. “Both men and women subscribe to the idea of on-demand erection,” lamented Emily Jamea, PhD, LMFT, a Houston, Texas-based sex and relationship therapist. “We need to do more work to debunk this misinformation.” Jamea pointed out that it’s more widely known and accepted that women can take a while to warm-up and require a fair amount of foreplay. Yet, with men, there is frequently the belief that they should, umm, up for anything at any time. “Many men have [felt that they] had to hide erectile difficulties,” Jamea explained. This can lead to too much pressure on the guy, which can then make it “pretty much guaranteed that a guy will not be able to get an erection,” in the words of Jamea.
This has been compounded by the notion that men are just running around trying to have sex and procreate. TV shows, movies and other types of video entertainment—including those that you may not tell others that you are watching—typically fast forward from the pants off to the getting it on stage. You don’t see too many love scenes in TV shows and movies featuring ED, unless it’s some kind of ha-ha-look-at-what’s-going-on-or-rather-not-going-on situation. All of this has probably reinforced the unnecessary stigma and shame associated with ED.
Jamea believes that the availability of Eroxon could help change that. In June 2023, I wrote for Forbes about how the U.S. Food and Drug Administration had approved the topical gel as an OTC medication. Of course, speaking of things not being available immediately, it’s naturally taken a while for Haleon to get everything in order after the approval so that the gel can make its debut at major retailers around the country and online via Amazon this month, October 2024. “Since it is available without prescription, Eroxon is easier to get,” said Jamea. “Anything OTC can reduce stigma as you can just put in on the shopping list.” That can be quite different from having to see a medical doctor and get a prescription.
“One of the barriers to dealing with ED is shame and not wanting to go to the doctor,” said Joshua R. Gonzalez, MD, a urologist and sexual medicine specialist who practices West Hollywood, California. “Having this available to men over the counter will help men access it in the real world.” Yeah, men and doctor’s offices don’t always go together like hot dogs and relish.
Studies have found that many men don’t quite relish seeing and talking to medical doctors in general. For example, in a 2019 Cleveland Clinic survey, 77 percent of partnered male respondents indicated that they would rather go shopping with their significant others than go to the doctor and 20 percent indicated that they had not been completely honest with their doctors in the past. And you can imagine where “shopping with the significant other” might rank on different men’s lists of preferred activities.
“Many men aren’t great at taking care of their health,” Gonzalez indicated. “Sometimes they will wait 5 to 10 years after struggling with ED for quite some time before seeing a doctor.” He added, “This can be especially true for younger men in their 20s since ED is incorrectly thought of an issue only aging men. It can happen to men of any any age from their early 20s onwards.”
Having an ED medication in a gel form could help things gel more between partners too. After all, it’s easier to play around with a gel than with a pill. You can do more stuff with the stuff. Jamea recommended having a partner apply the gel. “It can encourage collaboration with everything out in the open,” said Jamea. “You can incorporate it into foreplay.” Plus, while Viagra can take 30 to 60 minutes to get things looking up, Eroxon is supposed to take effect within 10 minutes of application.
The packaging does warn that “It may take 3-4 product uses before you achieve the desired effect.” Therefore, if you want to use the gel, you may want to try it yourself at least once before using it in prime time. A failed experiment may not be what you intend when you tell your partner that you like to be experimental with sex. At the very least, tell your partner in advance what to expect and not to expect with the gel.
Moreover, keep in mind as well that no product works for everybody, and no product is 100% effective. Clinical trials and studies can show what may happen with particular groups of people. But the results don’t always apply to everyone. So, before getting expectations up, it’s better to see what will actually happen with your you know what.
The gel comes in single-use tubes to help guide how much gel should be used each time. Whenever the FDA considers a medication for approval as OTC, it has to take into account how people may screw things up in different ways. That’s because people can be quite creative in not following directions, especially when not under a doctor’s care. If it’s a gel, you figure that someone somewhere will smear it on all kinds of things in all kinds of amounts. Therefore, there has to be greater leeway with an OTC medication than a prescription medication in terms of safe uses. Nevertheless, even though studies have suggested that it’s OK if the gel gets on different parts of your body and your partner’s body, that doesn’t mean that you should deliberately use it as a face moisturizer or something like that.
Another concern is that the availability of such OTC medications may keep men from seeing doctors to get their ED properly evaluated when necessary. Experiencing ED is not necessarily a sign of some other underlying medical condition. Stress and anxiety certainly can lead to erectile challenges, so can daily life and the luck of the draw. It can also be a side effect of medications. However, at the same time, you don’t want to miss the possibility of a chronic medical condition like cardiovascular disease, diabetes or hormonal imbalance causing the issue. Therefore, one challenge will be to reduce stigma while making sure that men get properly checked out medically when they should.
It will probably be only a matter of time before other topical treatments for ED become FDA-approved for OTC use. Having more FDA-approved OTC options is certainly preferable to a situation where men rely on questionable stuff pushed on social media and TV. And having more such options that can be applied to the surface of the penis rather than have to be ingested could bring conversations about ED more to the surface.
