I’ve been watching a lot of football lately (go Patriots!), and of course, I’ve been seeing a lot of those Levitra ads. I have always found that the warning near the end of the commercial strangely comical. I’m sure you’ve all heard it:

In the rare case an erection lasts for more than four hours, seek immediate medical attention.

I’ve seen some articles refer to this as “the warning that’s actually a selling point.”

So, let’s talk about this so-called selling point.

Priapism is no laughing matter. In most cases, there is no defined cause, but it can be associated with may systemic diseases, including leukemia, multiple myeloma, tumor infiltration, spinal cord injury or anesthesia, amyloidosis, spider bites, carbon monoxide poisoning, or malaria. There are many medications that can be associated with this, including psychotropic medications, cocaine or marijuana abuse.

So, what to do if you have an erection for more than 4 hours? Some say that conservative measures like walking up the stairs (to promote an arterial steal phenomenon) as well as ice packs to the penis and perineum can help. If not, then its off to the ER.

Medications like alpha-blockers, methylene blue, and terbutaline have been used with varying success. If these don’t work, then injection therapy should then be considered as well as a urology consult.

So, next time you wonder about the “erections lasting longer than 4 hours” mentioned at the end of those erectile dysfunction ads, wonder no more.