Not Joking Now

Tuesday, November 26, 2013

Question

Dear Patrick: I used to laugh at the commercials for Viagra, Cialis, and all those other boner pills where they say if you have an erection for more than four hours, you should seek medical treatment. A friend of mine used to joke that if his erections didn't last at least four hours, he would wonder what was wrong with him. (Yeah, right.)

            That was before I found out that I have some issues with blood pressure that are interfering with my ability to have intercourse. My doctor has offered me a prescription for the same medication I used to laugh at. I'm seriously tempted to take it because my marriage is fragile. My wife refuses to believe that I am not having sex with anybody else. She thinks I can't get it up in bed is because I am exhausted from chasing and pleasing other women. She has never been a very empathic person when it comes to other people's health issues, but aside from that, she does have a right to a husband who gives her a certain amount of intimacy. I would like to stay married at least until our children are older and can handle a separation.

            But the list of side effects really scares me. I don't want to have trouble with my vision. I certainly don't want to wind up with an erection that won't go away. My doctor seemed embarrassed when I asked him about the side effects. When I asked him what the treatment was for a persistent erection, he just waved his hands and said, “Don't worry, that never happens.” But if it never happens, why do they mention it in the commercials? I work in advertising, and I know manufacturers would rather not caution consumers about anything if they can avoid it!

            I know you'll give me the straight scoop on this, so to speak.

 

Answer

Make sure that the doctor who prescribes Viagra for you knows about your blood pressure and any other health problems or medications. It is potent stuff, and it really is important to know if you are healthy enough to use it safely. If your regular doctor can't answer your questions or won't make the time for a decent conversation, get a second opinion. This is an important decision, and you have a right to be fully informed.

            Satyriasis (the medical term for an erection that won't go away) is not a common side-effect of taking drugs that treat erectile problems. But it does happen; it isn't just a dirty joke put in the commercial to entertain viewers. In order to get hard enough for sex, the penis needs increased blood flow into spongy bodies of tissue on either side of the shaft. But if there is too much blood flow, it can sometimes get trapped in the penis. A normal orgasm opens the flood gates, so to speak, and allows all the extra fluid to be released back into the bloodstream.

            Doctors are sometimes able to give the patient drugs that will allow the blood to drain. But if that doesn't work, or if there is no time to fiddle around with drugs, they need to drain the excess fluid with a needle. The penis is numbed with anesthetics, and then a fine needle is inserted and the blood is withdrawn. It sounds pretty terrible, sorry to say, but it fixes the problem quickly, and it doesn't hurt nearly as much as it sounds like it would. I hope nobody will avoid going to the emergency room because they are afraid of the treatment. Suffering from a prolonged erection can do permanent damage to the penis. It can hurt the nerves you need to experience sexual pleasure, creating numbness, and it may also damage the internal structures needed for a firm erection.

            I empathize with your difficult marital situation as well as the need to make a decision about getting treatment. I know that it's no longer popular to give a man a psychologically-based treatment plan for erection problems. It's great to be able to take a pill, dust off your hands, and jump into bed—but sex is more than a mechanical act. It has profound emotional connotations. I often meet with clients who found that a pill did not fix their sexual problems. At the least, you may need support for remaining loyal to someone who ignores hour health issues and persecutes you for imaginary infidelities. This is an extremely stressful situation, and it could be affecting your health on many levels. So I hope you will seek out a place where it is safe to vent about what's going on. It might be possible to improve your marriage if you get some expert feedback. Since your wife is so jealous, I would recommend keeping therapy confidential, or seeking out a well-trained, male therapist.

 

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