- How reliable is the online store where I’m planning to buy Cenforce?
- Do I need a prescription to purchase Cenforce, and if so, how do I provide it?
- What payment methods are available when purchasing Cenforce online?
- What is the price of Cenforce 200 mg on this online store compared to other sellers?
- Does this online store have reviews from customers that confirm the quality and safety of the product?
Objectives:
This study aimed to analyze the usage patterns and influencing factors associated with Cenforce among individuals purchasing it from community pharmacies in Gondar, Ethiopia.
Methods:
A facility-based cross-sectional study was carried out between March 20, 2017, and May 10, 2017, targeting male clients visiting community pharmacies in Gondar, North West Ethiopia. Data collection was performed using a structured, self-administered questionnaire among Cenforce users aged 18 and above, who had been using the drug for at least six months before the study period. Regression analysis was applied to assess relationships between study variables, with a significance threshold set at P-value < 0.05.
Results:
A total of 65 men participated in the study. Among them, 33.8% were aged between 25 and 34, and approximately 40% reported having multiple sexual partners. Recreational use of Cenforce was reported by 66.2% of participants, surpassing its medical use (33.8%). A shorter usage duration (<1 year) was significantly associated with recreational use (AOR = 34.086, 95% CI [2.90, 401.37]), as well as a 2-year duration (AOR = 21.42, 95% CI [2.10, 218.82]). The non-recreational use of Cenforce 100 mg was primarily linked to erectile dysfunction associated with diabetes mellitus (27.1%), heart disease (9.2%), hyperlipidemia (4.2%), and relationship difficulties caused by stress and poor communication (3.1%).
Conclusion:
Most men using Cenforce do so for recreational reasons, with a higher likelihood of recreational use within the first two years of consumption. A coordinated effort involving pharmacists, healthcare professionals, and policymakers is needed to promote the rational use of Cenforce.
Cenforce, a selective phosphodiesterase type 5 (PDE5) inhibitor, is an effective oral medication for treating erectile dysfunction. During sexual stimulation, cavernous nerves release nitric oxide (NO), which facilitates the formation of cyclic guanosine monophosphate (cGMP) and leads to smooth muscle relaxation in the corpus cavernosum. Cenforce enhances the erectile response by inhibiting PDE5, preventing the breakdown of cGMP.
Cenforce is among the most widely prescribed and utilized medications today. In the U.S., the fastest-growing demographic of PDE5 inhibitor users comprises men aged 18–45. Shortly after Cenforce was introduced in Great Britain, recreational use was observed in 10% of young men aged 19–34. Similar trends have been reported elsewhere.
A cross-sectional survey conducted in U.S. undergraduate institutions found that 4% of participants had used erectile dysfunction medication (EDM) recreationally at least once, with 2.2% reporting current use. Most recreational users combined EDMs with illicit substances, particularly during high-risk sexual activities.
In Ethiopia, weak regulatory enforcement allows Cenforce to be easily obtained from pharmacies without a prescription. A qualitative study in Addis Ababa revealed that widespread Cenforce use was driven by the desire to enhance sexual confidence and alleviate anxiety related to masculinity concerns.
Cenforce has been associated with various side effects, primarily due to its vasodilatory effects. Caution is advised for individuals with cardiovascular or cerebrovascular risk factors, including myocardial infarction, cardiac arrest, angina, ventricular tachycardia, and hypertension. The simultaneous use of Cenforce with organic nitrates (e.g., glyceryl trinitrate, isosorbide dinitrate) has led to fatal cardiac events, likely due to enhanced hypotensive effects.
Frequent use of EDMs has been linked to reduced erectile confidence, potentially leading to psychogenic erectile dysfunction. Recreational Cenforce users may face an increased risk of psychological dependence, exacerbating erectile dysfunction symptoms.
There have also been reports linking Cenforce use to recurrent nosebleeds (epistaxis), which may become more prevalent due to PDE5 inhibitor misuse in non-medical settings. Additionally, cases of type A and B aortic dissection have been associated with Cenforce abuse. Some patients have reported vomiting, diarrhea, and abdominal pain shortly after ingestion, with subsequent hospital admissions revealing aortic dissection.
Background
In Ethiopia, the sale of phosphodiesterase type 5 inhibitors (PDE5Is) without a prescription is prohibited. These medications are only allowed to be dispensed in licensed pharmacies with a valid prescription, and even drug stores—pharmacy retail outlets managed by diploma-certified pharmacy professionals (commonly known as druggists in Ethiopia)—are not authorized to stock these drugs. However, regulatory enforcement is weak, leading to widespread illegal drug sales, making it difficult to monitor usage and improve patient outcomes. Additionally, the easy accessibility of these drugs increases the risk of adverse effects, especially for individuals taking other medications or those with underlying health conditions.
This study aimed to assess the utilization pattern and contributing factors associated with Cenforce use among individuals visiting community pharmacies in Gondar, Ethiopia.
Methods
Study Design, Period, and Location
A facility-based cross-sectional study was conducted among male clients who visited community pharmacies in Gondar, a town located 738 km from Addis Ababa, the capital of Ethiopia. At the time of the study, Gondar had 20 pharmacies and 34 drug stores. According to projections based on the 2007 National Census, the town’s population was estimated at approximately 249,851, with a male-to-female ratio of 1.5:1. The study was conducted between March 20, 2017, and May 10, 2017.
Target Population
- Source Population: All men in Gondar who use Cenforce for sexual function.
- Study Population: All Cenforce users in Gondar who met the inclusion criteria.
Sampling and Recruitment
All Cenforce users who met the inclusion criteria and visited community pharmacies during the study period were included, eliminating the need for sample size calculation. Although all available community pharmacies in the town were approached, only seven agreed to participate in the study. Drug stores were excluded because selling PDE5 inhibitors, including Cenforce, is illegal in these outlets, despite reports suggesting their unauthorized sale.
Inclusion and Exclusion Criteria
Inclusion Criteria
- Male Cenforce users aged 18 and above who were willing to participate in the study.
Exclusion Criteria
- Cenforce users who had been taking the drug for less than six months before the data collection period.
Study Variables
The dependent variable was the recreational use of Cenforce, analyzed in relation to independent variables such as:
- Socio-demographic factors (age, marital status, partner status, education, occupation, religion).
- Other influencing factors (illicit substance use, duration of Cenforce use).
Data Collection Process
A structured, self-administered questionnaire was used for data collection. The questionnaire was initially developed in English, then translated into Amharic (the local language) to ensure clarity and minimize misinterpretation. It was then retranslated into English to verify consistency in meaning.
The questionnaire consisted of 36 questions divided into three sections:
- Socio-demographic and clinical characteristics (age, marital status, education, occupation, religion, etc.).
- General perceptions of Cenforce use.
- Usage patterns of Cenforce.
Two trained data collectors, familiar with both the questionnaire and study objectives, conducted the data collection.
Data Quality Assurance
To ensure reliability, data collectors underwent a one-day training session on study objectives and data collection procedures. A pretest was conducted with five Cenforce users from two randomly selected pharmacies. Based on the pretest findings, modifications were made to the questionnaire (e.g., removing impractical questions and simplifying wording), and pretest participants were excluded from the final study. Collected data were checked daily for completeness and consistency before being entered into analysis software.
Data Processing and Analysis
Statistical analysis was performed using IBM SPSS version 20. Descriptive statistics were presented in tables. Binary logistic regression and multivariable logistic regression analyses were conducted to assess associations between dependent and independent variables. Variables with a P-value of <0.05 in the binary logistic regression were selected for multivariable logistic regression. In the final model, variables with a P-value of <0.05 and a 95% confidence interval were considered significant factors contributing to the recreational use of Cenforce.
Operational Definitions
- Recreational use: Using a drug to enhance certain activities (such as sexual performance) without a specific medical need or underlying condition.
- Abuse: Prolonged or excessive use of a drug (Cenforce).
Ethical Consideration
The study protocol received approval from the Ethical Review Committee of the School of Pharmacy, University of Gondar, Ethiopia, under approval number SoP 826/09. Prior to data collection, the study’s purpose and procedures were explained to all participants, and verbal consent was obtained. The questionnaire did not contain personal identifiers, and confidentiality was maintained, ensuring that collected data was only disclosed for the study’s purpose.
Results
Socio-Demographic Characteristics
A total of 65 men participated in the study. The average age of participants was 37 years (ranging from 22 to 67 years). Over half of the participants (52.3%) were married, and 41.5% had completed secondary education (Grades 9–12). Regarding employment, 24 (36.9%) of the participants were employees, and 42 (64.6%) identified as Orthodox Christians (Table 1).
Sexual Characteristics
The majority of participants (58.4%) reported having engaged in unsafe sexual practices at least once. Of the respondents, 39 (60%) had one stable partner, while 26 (40%) had occasional or multiple partners. In terms of substance use, more than half of the participants used alcohol (63.1%), followed by cigarettes (36.9%) and khat (23.1%) along with Cenforce.
Cenforce Utilization
Regarding sources of information about Cenforce, many participants cited multiple sources, with the majority (70.6%) mentioning friends as their main source. As for obtaining the drug, 89.3% of participants reported acquiring Cenforce without a prescription (Over-The-Counter). In this study, 43 participants (66.2%) reported using Cenforce for recreational purposes (Table 2).
In terms of timing, 40 (61.5%) participants took Cenforce 30 minutes before sex, 13 (20%) took it whenever they thought of having sex, and 12 (18.5%) took it immediately before sex. Most participants (84.6%) found Cenforce to be affordable, and 67.7% said it was easily accessible at community pharmacies.
The duration of use showed that 33 (50.8%) users had been using Cenforce for a year or less, 18 (27.7%) had used it for 2 years, and 14 (21.5%) had been using it for over 2 years. Most participants (84.5%) reported not experiencing societal pressure, and 83.1% were interested in using Cenforce again. For information dissemination, 69.2% preferred written materials, 33.8% preferred radio and TV, and 10.8% preferred audiovisual recordings. The most common side effects reported were dizziness (69.2%), followed by headache (49.2%), blurred vision (29.2%), prolonged erection (9.2%), and stomachache (4.6%).
Factors Associated With Cenforce Use
Binary and multivariable logistic regression analyses were conducted to assess the relationship between independent variables and recreational Cenforce use, treating medical use of Cenforce as a constant. Duration of Cenforce use, partner status, marital status, and age were all found to be significantly associated with recreational Cenforce use in the binary logistic regression analysis (P < 0.05). These significant variables were further analyzed in the multivariable logistic regression, which showed that only the duration of Cenforce use was significantly associated with recreational use. Men who had used Cenforce for less than 2 years were more likely to use it for recreational purposes than those who had used it for more than 2 years. Specifically, men who had used Cenforce for less than 1 year were 34 times more likely to use it recreationally (AOR = 34.086, 95% CI [2.90, 401.37]), and those who had used it for 2 years were 21 times more likely to use it recreationally compared to chronic users (AOR = 21.42, 95% CI [2.10, 218.82]) (Table 3).
Some users also took Cenforce for medical reasons, including diabetes (27.1%), heart disease (9.2%), hyperlipidemia (4.2%), and relationship issues due to stress and poor communication (3.1%).
Discussion
This study revealed a widespread use of Cenforce for non-medical (recreational) purposes among younger individuals. The findings are consistent with similar studies conducted in other countries, where younger participants were more likely to use PDE5 inhibitors recreationally. This is likely because erectile dysfunction (ED) is more common in older adults and those with chronic conditions such as hypertension or type 2 diabetes. Since these conditions are less prevalent in younger individuals, they tend to use Cenforce to impress or satisfy their partner rather than to treat ED.