DR THOMAS STUTTAFORD SAYS:
Valentine’s Day was marked this year by a change in legislation. This will
save the Treasury cash and increase sexual fulfilment in those households
where the male partner’s sexual prowess is dwindling. Since Valentine’s Day,
Boots has been allowed to sell four tablets of Viagra over the counter for
£50 without a doctor’s prescription. In the price Boots will be including a
blood pressure check and a test to exclude diabetes, because declining
potency is often the first sign of a generalised cardiovascular or metabolic
disease.
Boots customers will also fill in a questionnaire to make certain that they
don’t have any conditions that would make a PDE-5 inhibitor (an
antiimpotence drug of the Viagra type) unsuitable. If such a patient wants
to continue to use Viagra, the chemist will refer him back to his GP. A GP
can prescribe these drugs for patients with some conditions and can give
others private prescriptions. If the impotence is a new, or previously
uninvestigated problem, the doctor may well suggest a more intensive
cardiovascular assessment than the simple tests done at the pharmacy.
Several drugs commonly used to treat heart disease may increase impotence.
Discuss your medication with your doctor, as others may not have this
side-effect.
So far as the heart is concerned, sex is only another form of exercise, as Dr
Graham Jackson, a consultant cardiologist at Guy’s and St Thomas’ Hospital,
has taught for years.
Even so, exercise taken when emotions are running high, or when it is coupled
with excitement, puts a greater load on the heart than normal. For example,
when you are rushing to catch a train, or in competitive exercise, or taking
exercise at high altitude, or having sex, your heart is under more pressure
than it would normally be for the same amount of exercise.
It has been noted that death during sexual intercourse is more likely when
with a new or illicit partner than with a longstanding one. As Dr Jackson
says in his book Heart Health: “Sex is normally not unduly stressful
for couples in a longstanding relationship and should be enjoyed as much by
those with heart disease as those without.”
When any additional factor is discounted, the stress that having sex puts on
the heart is equivalent to walking briskly, within ten seconds, up and down
two flights of household stairs with 13 steps in each staircase, or walking
a mile in 20 minutes. Your GP will advise you if your heart is fit enough to
walk a mile in 20 minutes, and, therefore, for sex.
Viagra was developed to treat angina, but was found to be rather inefficient.
However, a serendipitous side-effect was noted: the coronary arteries of the
volunteers did not become dilated, so the angina didn’t disappear, but their
penile ones did, and the volunteers noticed an unaccustomed youthful
erection.
There are some dangers in taking any of the PDE-5 inhibitors, Viagra, Cialis
and Levitra. When taken with the long-term nitrates prescribed to prevent
attacks of angina, or the short-term, quick-acting nitrates taken as a spray
or as a tablet, the drop in blood pressure caused by a combination of Viagra
and the nitrates can prove dangerous. Long-term oral nitrates such as Ikorel
(or nicorandil) must be stopped one week before Viagra, and the
under-the-tongue nitrate tablets or spray should not be used for 12 hours
before or after sex.
SUZI GODSON SAYS:
The first death from an overdose of Viagra was announced recently. A man took
12 Viagra tablets. And his wife died. Boom boom! Since their invention, the
blue, diamond-shaped pills have been responsible for almost as many bad
jokes as they have erections but, for 2.3 million men in the UK, erectile
dysfunction is no laughing matter.
However, I get the feeling that you are not one of them. Forgive me if I am
wrong but since you haven’t mentioned any specific sexual difficulties, I am
presuming that you are one of a growing number of men who is curious to try
Viagra to see whether it might “enhance” rather than “enable” sex.
Viagra is not meant to be used recreationally but, having said that, within
two weeks of its UK launch, news of Viagra sales in gay clubs were being
reported, and the ease with which it can be bought online means that only
about 10 per cent of men with erectile dysfunction get their prescriptions
from GPs, so no one knows how many men are taking it or whether they do so
safely. (Viagra shouldn’t be mixed with medications or illegal drugs and it
can be dangerous if it is taken by people who have serious heart conditions,
angina or low blood pressure.)
It’s a market trend that has not been lost on drug companies. When Pfizer
first launched Viagra in the US, its advertising campaign had a serious,
educational tone and was fronted by Senator Bob Dole. By the time Viagra’s
first rival, Levitra, was launched, Bayer, the manufacturer, was unashamedly
targeting those seeking to enhance sexual satisfaction. Its ad campaign
featured a young man who fails to shoot a ball through a tyre until the word
Levitra is mentioned. At which point he is joined by his beautiful smiling
wife and begins to score repeatedly.
To maintain its lead in the market, Pfizer is fighting back. Its latest
campaign plays up the brand’s Nascar auto-racing sponsorship and shows
handsome young drivers in race cars, while a voiceover announces:
“Gentlemen, start your engines.” As Viagra and its competitors become
increasingly acceptable as “lifestyle” drugs it is important for men to
realise that the side-effects of a Viagra habit are not just physical. Men
take “thrill pills” because they believe that they will make average sex
into something more special. For a horny 25-year-old male that belief is
usually enough (30 per cent of men in clinical trials of Viagra had better
erections despite taking only a placebo) because they don’t have a problem
with erection anyway. The addition of Viagra just ensures that they can get
a hard-on after ten pints, but if they start to rely on it, they are at risk
of developing a dependency. Yes, Viagraholics Anonymous (www.viagraholics.com
) already exists.
For men of your age, taking Viagra can be slightly more complicated. The drug
certainly enables men to get a firmer, more reliable erection, but only if
they feel turned on. In other words, if they feel no desire for their
long-term partner, there will be no erection. Couples can find that Viagra
creates sexual disparity between them because while the wife’s libido may be
undergoing a natural decline, the husband’s interest in sex suddenly
rebounds.
Though nobody claims that Viagra causes affairs or divorce, one prominent New
York divorce lawyer says that Viagra is mentioned in at least one divorce
case in every 15 he handles. So be careful what you wish for.
