Frequently Asked Questions

Q. I've had severe claudication for some time and my legs were diagnosed as 100% blocked in 1996 … Also, my ability to have sex disappeared a few years back! Not even Viagra 50 mg allows it. If I follow your outline and stop smoking entirely plus start an exercise program, can the benefits you describe also include the ability to have sex again...or at age 66 is that now impossible to recover?
A. Thank you for your question that likely others have wanted to ask. Your problem with sexual performance could be a result of the same basic vascular problem that caused your claudication. Erections are produced by a buildup of blood in the shaft of the penis. Poor blood flow into the penis can result in difficulty having erections. Blockage of blood vessels by atherosclerosis (also called hardening of the arteries) can lead to both impotence and symptoms of PAD, such as intermittent claudication, if the disease is in the arteries that serve as inflow for both. Even though both may be a result of hardening of your arteries, the treatments differ. Treating your leg pain with exercise therapy can not be expected to improve your other symptoms and result in return of your sexual function. Your exercise therapy works on the leg muscles, improving leg circulation only. However, if the same blocked arteries are involved in producing both symptoms, it may be possible that they can be opened with a balloon-stent or bypass surgery. In this situation, one treatment could relieve both symptoms. The feasibility of these treatments can be determined by imaging tests showing where the blocked arteries are and if they can be opened up.

Viagra works in approximately 70% of men with vascular impotence who receive prescriptions. Other therapies using medications that widen the blood vessels may sometimes be better alternatives. We highly encourage you to discuss this problem openly with your doctor or request a referral to a physician that specializes in male sexual function. Problems with sexual functioning could arise from a number of causes other than atherosclerosis, such as medications you are taking, nerve damage, diabetes, depression, hormonal imbalances, pituitary gland dysfunction, thyroid problems and other diseases.

We also encourage you to stop smoking. Any treatment or exercise program you would undertake for your claudication would not be totally effective if you still smoked and also makes you more susceptible to heart attack and stroke. Please take some time to read our information on Smoking and PAD on our web site (www.vdf.org/smoking_info.htm) or in our winter newsletter 2002 (www.vdf.org/winter_2002_vol.htm).

Q. I was prescribed a drug with niacin. I thought that was what you took for heart pain, which I don't have. How does it help my leg pain?
A. You may be confusing niacin with nitroglycerin. Nitroglycerin is often prescribed when someone has a discomfort or pain in the chest area that is presumed due to blockages in the arteries that supply the heart muscle. This discomfort is called angina. Niacin is one of the B vitamins. This vitamin, when taken in the right doses, can often improve your total cholesterol, HDL cholesterol, and lipoprotein(a). Improving these risk factors can help reduce your risk for vascular problems including heart disease, stroke and peripheral arterial disease. Niacin is not now known to improve leg pain or claudication, although this is under study.