FEAR OF VIAGRA
// October 27th, 2010 // No Comments » // Impotence
“I didn’t use the pills,” confessed Walter, a cherubic sixty-five-year-old pipe smoking academic, when I asked him how the Viagra samples I had given him had worked out.
“My wife wouldn’t let me,” he said in explanation.
“But it was your wife who was most concerned about your impotence.” ( Walter and his wife had not had sex for three years.)
“In fact, she was the one who called to set up your appointment. What happened?” I wanted to know.
“She decided that living with sexual frustration was better than living as a widow.” Walter heaved a regretful sigh, then went on. “It’s in the papers, you know, and on TV, and on radio, about all those men who drop dead right after they used Viagra.”
At this time, late November 1998, just months after this new medication had come on the market, newspaper reports indicated that 130 men died sometime after taking Viagra. Almost all were known to have severe heart problems. Many were taking nitrate medications like nitroglycerin and isosorbide (Isordil) and should not have used Viagra in the first place. I was aware of that, but I also knew that the majority of men who used Viagra successfully experienced no, or only trivial, side effects. Thus, millions of impotent men had had their sexual potency restored with Viagra. The small number of unfortunate men who expired sometime after they used Viagra paled in comparison to the overwhelming majority of men who had used Viagra, achieved erections, had satisfactory sexual intercourse, and had experienced no ill effects.
“More than 6 million men have used Viagra safely and with only positive results,” I explained to Walter. “Those few men who died all had serious cardiac disease. Many were taking medications that were not safe to use with Viagra. Walter, you do not take any of those medications and you have never had any heart problems. For men like you, Viagra can be both safe and effective.”
I double-checked his record yet again to ensure that he had none of the coexistent medical problems and was not taking any of the inappropriate medications that were part of the profile of the unfortunate men who had expired after taking Viagra. Walter simply could not be reassured.
“If you are not comfortable with Viagra, would you be willing to try . . .?” I listed other treatments to help correct his impotence, but his wife’s concerns had so rattled him that he had lost interest in his own sexuality. If he were forced to choose, as he believed he was, between living and dying, he would of course choose living. By rejecting all treatments to retrieve his ability to enjoy sexual intercourse again, Walter made a definitive decision. He opted for what he anticipated would be a long, albeit celibate, life.
“I guess you could say that having life without sex is better than no life at all” was how he put it, before he shook my hand. “Thank you so much for trying to help.”
Then this once ebullient, now dejected, professor dropped his chin to his chest and left so quietly I barely heard the door close behind him.
Evan was next.
A short, balding, beefy-faced retired engineer, Evan was both the father of two grown daughters and a proud grandfather. He had been plagued by years of sexual failures and was as sexually insecure as Walter. Unlike Wal
ter, Evan had actually used the Viagra samples and couldn’t wait to tell me how well they had worked.
“Twice in one night, Doc, I’m telling you, twice in one night! One right after the other! Mary was stunned. She called me her stud. I’m telling you I haven’t been that virile since I was in my twenties.” He beamed.
Glistening perspiration gathering on the dome of his scalp migrated toward his eyes, circumvented the detour created by his plump eyebrows, then coalesced into parallel streams to trickle like cascading sideburns down his face. As a salacious grin split his seventy-four-year-old ruddy and wrinkled face, he leaned across the desk. Like a teenager energized after his first sexual experience, he continued excitedly, determined to elaborate about his further adventures with Viagra.
“Listen to this, listen to this,” he said, barely able to contain himself.
” Mary and I went to the monthly condo meeting the next night, and everyone was talking about Viagra, mainly what they read or the latest Jay Leno Viagra joke. I didn’t say anything at first, but then Myra, this redheaded widow from 12C, started sounding off. She thought it was terrible that there was so much interest in this sex drug and not enough attention paid to more important medical problems like prostate cancer, which had taken her Morrie from her when he was only fifty-nine.”
“Well, that was the night after Mary and I had our double-header, you know what I mean, Doc. I wanted to say something but held my tongue for a while, but then Myra she just kept going on and on, yammering about how the medical profession is interested only in men’s sexual problems but is not paying enough attention to other health issues, and she just wouldn’t shut up, so I finally said, ‘It certainly could help some men who need it.’ ”
“How would you know?” she challenged.
“Well, you know, just what I read about.”
“Have you ever tried Viagra?” Myra was dogged and persistent.
“Yes,” I admitted, “I guess you could say that I am the Man from Viagra.”
“Really?” she pulled her chair closer. “How does it work?”
“Very well, I would say.”
“How well?” Myra wanted to know. “She was determined to get details, and I was wondering how I would avoid telling her any more, when . . . ‘Myra, how nice to see you,’ Mary boomed. ‘I couldn’t help noticing you’ve been having such a nice long chat with my husband. Whatever did the two of you find to talk about for so long?’ ”
A week later, Evan called to say that his wife Mary thought they would both be better off if he stopped taking Viagra.
What transpired after the condo meeting was that Evan, the self-proclaimed Man from Viagra, and his wife Mary were now, thanks to the talkative Myra, unwilling condominium celebrities. Neighbors who barely spoke to them all year were now seeking them out. Mary was invited to a series of
coffees, and Evan, who had always been something of a loner, was now in demand as a companion. Suddenly, extra sports-event tickets materialized for Evan, and Mary was suddenly in demand as a bridge partner. At the time, Viagra was so new that both the men and women wanted more information from “experts.” But their curiosity was gender-specific.The men were more interested in process and mechanics — How long did it take to kick in? Was it really guaranteed to work? Did Evan wake up with a headache . . . or indigestion . . . or see blue?The women were more interested in feelings and wanted to know what it was like for Mary after all these years. She told them that she was surprised at the sudden rekindling of Evan’s interest in her as a sex partner. They had of course been faithful to one another for years, and even without sex, each had been totally committed to and dependent on the other. Mary was actually quite pleased at how things had turned out. Then, the others, women who were widowed like Myra, told Mary over and over again how fortunate she was and wondered whether Evan, who was, after all, so handy, could come over and fix a faucet, help with their taxes, or just drop by. All of this sudden attention and the news reports started Mary wondering.
| 1. | Can Viagra cause otherwise healthy men to keel over and drop dead after sex? |
| 2. | Will impotent men who become potent after taking Viagra turn into senior citizen Lotharios and, as Mary feared, menace the condominium subculture and disrupt the fabric of every elderly couple’s otherwise tranquil life? See “Philandering After Viagra: Fantasy, Fears, and Reality” below. |
Concerns about Viagra’s safety surface at both the doctor’s and the patient’s level.
| 1. | Doctors are concerned that the patient for whom Viagra is prescribed be an appropriate candidate for this medication. Always cautious, doctors avoid giving a Viagra prescription if there is a high probability of a medication-induced side effect. They have been advised not to prescribe Viagra to any man with severe heart disease, particularly if he is taking medications like nitroglycerin or isosorbide (Isordil). Others for whom the use of Viagra would be unwise include those men with very high or very low blood pressure or those with an inherited eye disorder called retinitis pigmentosa.2. Men with sexual problems are understandably troubled by reports of sudden death occurring in men shortly after they take Viagra. |
The disquiet of physicians and their patients is ultimately translated into the number of men who actually walk out of the doctor’s office with a Viagra prescription. One of my colleagues, Dr. Andre Guay, who is director of the Sexual Dysfunction Program at the Lahey Clinic in Peabody, Massachusetts, has kept a running tabulation of the numbers of men he has seen in consultation in the first six months after Viagra was approved by the FDA.
| Evaluated | 551 patients |
|---|---|
| Medically unsuitable | 44 (8.6%) |
| Fear of Viagra | 65 (12.8%) |
| Lost to follow-up | 13 (2.6%) |
| Total not using Viagra | 122 (24%) |
| Using Viagra | 429 (76%) |
| SOURCE: Andre Guay, M.D., F.A.C.E. | |
Even when doctors try to identify only those men who are appropriate candidates for Viagra and weed out others for whom Viagra might pose a substantial health risk, a third group surfaces. They are the men who are so frightened by the press reports of death after Viagra that they refuse Viagra treatment on their own. Indeed, at the Lahey Clinic more men opted out of Viagra treatment on their own than were disqualified because of any known risk to their health.
Why would impotent men reject a treatment that might allow them to have sex once again? Which is more perilous, sexual intercourse or Viagra?
