Introduction: Headaches are a common symptom
affecting individuals worldwide, including in the tropical zone, and have been
extensively studied in Togo. Phosphodiesterase-5 inhibitors, commonly
prescribed for erectile dysfunction, are known to induce headaches, yet there
is a lack of research on this topic in sub-Saharan Africa and Togo. Methods:
A cross-sectional study conducted from February 1st to June 30th, 2023,
including adult patients seeking erectile
dysfunction treatment and prescribed PDE-5 inhibitors. Results:
A total of 28 patients were included in the study, with an average age of 34.46
± 7.5 years. The age group of 30 - 39 years was the most represented (53.57%).
Among the participants, 67.86% had a history of chronic headaches. During the
intake of PDE-5 inhibitors, 71.43% reported the onset of headaches. Among the
19 patients with chronic headaches, 68.42% developed headaches following PDE-5
inhibitor use (RR = 0.88, 95% CI: 0.55 - 1.40, p = 0.484). The characteristics
of the induced headaches were similar to the patients’ pre-existing headaches
in 78.95% of cases. Additional symptoms included nasal congestion (36.84%) and
an urge to have a bowel movement (26.32%). Sildenafil (75.00%) and Tadalafil
(25.00%) were the primarily prescribed PDE-5 inhibitors. The incidence of
headaches did not significantly differ between the two groups (RR = 1.33, 95%
CI: 0.67 - 2.64, p = 0.306). Treatment for the induced headaches involved
self-medication with paracetamol (65.00%)
and nonsteroidal anti-inflammatory drugs (NSAIDs) (35.00%).Conclusion:
Headaches induced by PDE-5 inhibitors are a well-established reality,
emphasizing the need for caution and warning in patients with pre-existing
headache conditions, while individualized approaches are necessary to address
the potential interplay between migraine medications and erectile dysfunction
treatments.
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