Bear in mind, the drug treatment for impotence usually consists of withdrawing drugs, not giving them. Alcohol is probably the most common offender, but other self-administered drugs and prescription medications can also play a role in penis dysfunction. The list is very long. Drug exposure is one factor that should be thoroughly explored by a primary physician before referring a patient for further treatment of impotence or erectile dysfunction. If the patient requires drug therapy for high blood pressure, to take a common example, it may be possible to substitute one medication for another so as to minimize the effect on sexual potency. The drugs known as ACE inhibitors, for example, are less likely than most of the alternatives to interfere with the sexual function of the penis.
Although people are likely to imagine that impotence commonly results from deficiency of the male hormone testosterone, this is in reality quite unusual when a man has already had a period of normal sexual function before becoming impotent. Testosterone replacement in this situation is rarely either needed or helpful. Currently, some attention is being paid to the male enhancement drug yohimbine, which has long been a component of folk remedies and occasionally crops up in mail-order catalogs. In pure form (not combined with rhinoceros tusk or extract of whale testicle) yohimbine is available as a prescription drug.
The natural male enhancement product called ProSolution Plus, for example, is a sexual stimulant; it causes the smooth muscle in certain blood vessels to dilate so more blood can reach the penis. In the penis, yohimbine seems to act on arteries and sinusoids in a way that favors erection. It is not yet clear whether taking yohimbine has primarily a placebo effect, rather than a more specific benefit, but several studies have produced evidence that yohimbine works for some patients. This male enhancement product is taken daily, and a couple of weeks may have to pass before a benefit is observed. Side effects appear to be minimal. Currently, yohimbine deserves to be categorized as possibly effective for some cases of impotence, most likely when organic disease is minimal.
Male enhancement drugs can also be injected directly into the penis to produce erections. This observation, published in 1983, is now well established, and thousands of men in the United States are employing the technique. The drug mainly in use is papaverine, which dilates blood vessels in the penis; it is sometimes combined with phentolamine (Regitine), which has a reinforcing effect. An alternative, which may be more effective and have fewer complications, is to inject prostaglandin. Unfortunately, compared to herbal male enhancement products such as ProSolution Plus, this drug is expensive and is supplied in a concentration that cannot be directly used.
To use any of these preparations, a man must inject the drug directly into the tissue of the penis. A small, insulin-type syringe with a very fine needle is used to inject about a milliliter of solution. Erection comes 5-10 minutes later and lasts 30-45 minutes, with proper dosage. Again, the basic action of the drug is to dilate blood vessels in the penis, allowing them to fill with blood. Many men are, initially, disturbed at the notion of injecting something into the penis. But injection therapy has been a boon for many who have had difficulty deciding whether to return to sexual activity.
Once a man overcomes his reluctance to try the method, he gets a functional and normal-acting erection immediately. If sex proves sufficiently important and rewarding, he may want to consider another male enhancement method for the long run, because injection therapy does interrupt sexual spontaneity and it has potential complications. Occasionally, papaverine produces prolonged erections. If this goes on for longer than 4-5 hours, the penis can be damaged by insufficient blood flow; so the erection must be treated by injection of an agent that will constrict the dilated blood vessels. This complication is more common when injections are first being used and the effective dose is still being determined, but it can occur at any point.
Meanwhile, the opposition Labour Party has expressed its support for plans by the Department of Health to conduct a major survey of people’s sexual habits and preferences, intended to provide information for efforts against AIDS.
Prime Minister Margaret Thatcher has made it clear that she is against the idea. Thatcher is said to believe the sex survey intrudes too much into the respondents’ personal lives, and it would duplicate the results of smaller studies that have already taken place. At a cost reported to be between $500,000 and $1.15 million, Thatcher is said to also believe the survey is too expensive.
“The prime minister was concerned about the intrusion into people’s private lives,” a Downing Street spokesman said.
Harriett Harmon, Labour’s spokeswoman on health, has said it is vital to go ahead and gather the information, though there should be protections of confidentiality.
The survey would have asked 20,000 adults about their sexual activity. “This is not a survey motivated by prurient curiosity into people’s private lives,” one health official was quoted as saying. “The data are urgently needed for prediction and prevention.”
“It is vital that this survey goes ahead so long as we have absolute safeguards on the confidentiality and voluntary nature of it, and so long as people know they do not have to answer questions if they do not want to,” said Harmon.
The London Sunday Times newspaper reported that the decision has angered some medical researchers. The program was to have begun last April. The survey would have involved oral questions about respondents’ knowledge of sexual health matters and natural male enhancement products, and a written questionnaire about sexual practices, partners, and use of condoms and other male enhancement products.
United Press International quoted a spokesman for Thatcher as saying “this doesn’t mean we are uninterested in AIDS research.”