Block-buster
By Kumudini Hettiarachchi
It's the most hush, hush subject in town but many slink in to
see their doctor on this vital aspect of their lifestyles. Rarely
accompanied by their partners, they look embarrassed and even
want the female nurse away from the room before stammering out
their problem. It's all to do with sex and now there is hope,
they feel, with a "wonder pill".
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Viagra
copy-cats
Viagra
copy-cats have now appeared on the market, some even
sold under the Pfizer label.
"Those
who buy Viagra should check the data on the leaflet,
as the counterfeit drug has incorrect information and
spelling mistakes," warns a spokesperson for Astron.
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Impotence
is the much-dreaded word and numerous are the patients who
consult urologists or genito-urinary surgeons. But Sri Lankan
men need not feel stigmatized as they are not alone. There
are 100 million men worldwide who suffer from erectile dysfunction
(ED), as it is known medically and doctors are trying out
Viagra on them after proper checks on their health.
"Women's
gynaecological problems are discussed quite openly. But when
it comes to men, there is a feeling of inadequacy, even though
it is a legitimate medical problem. Yes, we do try out Viagra
after looking into their medical history," says Dr. Neville
Perera, consultant urological surgeon at the National Hospital
in Colombo.
"But,"
stresses Dr. Perera repeatedly, "it is not an aphrodisiac.
You must have the normal sexual stimulants such as desire.
Viagra approved by the Health Ministry over one year ago can
be bought on prescription. There is no improvement in sexual
drive or appetite with Viagra. It is a pill, which swallowed
one hour before the act, just improves erection."
Impotence
or ED is caused by the nerve impulse from the brain not reaching
the penis the normal way due to disease or injury to the spinal
cord, nervous problems, paralysis, heart problems, diabetes
and pressure. People with severe blood vessel problems such
as the vessels, especially in the legs being destroyed are
also vulnerable. "Sometimes the nerve pathway maybe normal
but the blood vessels could be damaged due to hypertension
and smoking. Then the victim does not get an erection,"
explains Dr. Perera, underscoring the hidden danger of smoking.
Others on various medication for pressure and peptic ulcers
could experience ED as a side-effect.
It is
not a malaise of any particular age and could affect anybody
from as young as 25 to 70-year-olds. Adds retired urologist
Dr. Lalith Perera that ED could be due to psychogenic (mental)
or organic (physical) causes. "The patients could be
among the unmarried or newly-married. Then there could be
men whose partners' expectations exceed what they can give.
Many come because they are anxious, just before their wedding
night. Some of them have never had a physical relationship
or are worried because the marriage is arranged."
There
are also those who think they cannot have sex because they
have compared their organ to others and feel it's "short".
Some are convinced they will not be able to perform because
they have masturbated when they were younger. "Counselling
and psycho-therapy for such men are important, as psychological
inhibitions have made them impotent," says Dr. Lalith
Perera.
In Sri
Lanka, statistics are hard to come by on impotence. Or how
many are on Viagra. "We write about 20 to 30 prescriptions
per month and about 70 percent of men have reported success
in getting erections. Viagra seems to work quite well with
people who have nerve diseases, spinal cord injuries and partial
paralysis of the legs," says Dr. Perera of the National
Hospital.
How does
Viagra (Sildenafil Citrate) work? It increases a chemical
in the penis which leads to the dilatation (expansion) of
blood vessels, as impotence is caused by the chemical breaking
down before there is an erection. It just acts to keep the
chemical concentration up, thus contributing to the penis
filling up with blood and getting an erection.
"As
Viagra distends blood vessels, the side effects could be that
it can happen in other places of the body too causing headaches,
vision problems such as blue-tinges, nausea or vomiting and
stomach cramps," says Dr. Perera. "It could be very
dangerous to take Viagra with other medication. Especially
in the case of heart patients, it can lead to a drop in pressure
resulting in death. That's why it is important to see a doctor
who knows about erectile problems, who could study the case
history and then get Viagra prescribed."
What of
Viagra deaths? "The media have reported a few deaths
due to Viagra, but we have not come across any in Sri Lanka.
However, the deaths could probably be related to sexual overactivity,
which is not good for the heart. I feel that is very rare.
Viagra should be only taken once a week or twice a week, a
maximum of thrice a week, especially in the case of the elderly,"
says Dr. Perera.
Viagra,
manufactured by the Pfizer Company in America, was discovered
in 1994 and launched in 1998. Discovered by chance when Pfizer
was conducting research on medication for heart patients,
some call it a major breakthrough in medical history such
as the discovery of penicillin or the first antibiotic. The
cardiology patients enrolled in the study had come back with
the "by-product of erections".
Till Viagra,
taken orally, hit the market, through Astron Ltd. in Sri Lanka,
only a painful injection with the side-effect of a persistent
erection had been available for impotence. "About 100
to 200 people use it per month," sources said.
Many people
in Sri Lanka had heard about it through e-mail and the media
long before Viagra, a prescription drug, was launched here.
Pocket meetings had been held on medical platforms, with both
doctors and chemists in major towns such as Colombo, Kandy
and Galle before the launch. Then Viagra had been introduced
to a limited number of pharmacies and chemists given stock
cards to maintain the sale information.
"This
is a convenient, block-buster drug," is the opinion of
some men who declined to be identified.
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