UPDATE - Issue 24 - Winter 2005
Sex like it used to be . . . .
A number of Update readers suffer from erectile dysfunction as a result of Benign Prostatic Hyperplasia (BPH). Many will have tried Viagra®, the first of the PDE5 inhibitor drugs to reach the market just seven years ago.
Now there are three such drugs competing for a $2 billion world-wide market. All are available on the NHS. All are effective in stimulating erections in suitable men but they differ in the length of time for which they remain effective. Cialis™ (Tadalafil), which has been available for only two years, is the best in this regard, lasting for seventeen hours or so. This is so long that some physicians are now suggesting that it become a once a day pill with a lower dose rather than be taken when the patient feels the time is right.
'sex should be a spontaneous activity'
Recent research shows that this small change (to a daily pill rather than on patient demand) has significant psychological results and is much preferred by patients. Rather than 'Doctor, every time I take a pill it reminds me that I am impotent' consultants are now hearing 'Hey Doc, it's wonderful. I'm cured!'
This huge change in perception comes about because men are remembering how their sex lives used to be before they contracted BPH. One of the most important factors for them and for their partners was feeling that sex should be a spontaneous activity. Decoupling the activity from taking a pill can be a truly liberating experience.
Studies are now being conducted to assess the longer term effects of a daily dose. Currently there seems to be no downside. There may even be evidence that a regular small dose of a PDE5 inhibitor works to mitigate the lower urinary tract symptoms of Benign Prostatic Hyperplasia. So, not only a treatment for one of the most distressing symptoms of the disease but also treatment for the cause may be emerging.
Men who suffer from erectile dysfunction as a result of their treatment for prostate cancer do not in general respond to PDE5 inhibitor treatment. We shall publish an article dealing with the treatment of their erectile dysfunction in a future edition of Update.