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05. Cover Story: Sexual Health
The last taboo
Despite its wide prevalence, qualifying for treatment for erectile dysfunction on the NHS is a lottery, writes Sandra Gidley MP

When i had a proper job i worked as a pharmacist. I had never, ever been asked to obtain drugs illegally until Viagra came along. What shocked me was that it wasn't just the once. Respected members of the community were sidling up to me over canapés and lukewarm wine to ask whether I could get hold of the latest wonder medicine.

I treated each and every one of them as if the enquiry hadn't been serious but it was noticeable that few of these enquiries were made when others were within earshot.

When the prescriptions started to come in it was just routine until one day a middle aged woman came up and gave me a big hug. "He's a different man!" she explained. The Viagra had worked but bigger stuff was going on here. Within weeks her husband was off the antidepressants and had been transformed from a Victor Meldrew type character to a normal, cheery human being.

A sample of one does not, by any stretch of the imagination, provide sufficient material for a scientific survey. I watched and learned and realised that there was something more fundamental at work. It wasn't just a case of sorting out the mechanics of a troublesome bit of plumbing. There was something more fundamental and it related to the way men felt about themselves.

There are other treatments for erectile dysfunction besides Viagra. Prior to the introduction of the little blue pills men were faced with the option of injections or small pellets which were inserted into the penis using a special applicator. Neither appeared to be very attractive preparations and the instruction leaflets brought tears to the eyes but men were still prepared to subject themselves to the ordeal of using these products because they offered the only hope of an active sex life.

The government made an attempt to clarify the whole area of prescribing for erectile dysfunction and devised a list of "approved" conditions. If a patient suffered from one of these conditions then he was a winner in the Viagra lottery. One of these conditions was diabetes and in some cases the impotence was the first sign of an underlying problem. In many cases the cause of the problem could be related to the use of prescription drugs or coronary heart disease. In these cases there is simply no treatment available on the NHS. A real lottery if ever there was one.

Then came a bizarre little episode. Lord Hunt decided that he would consult as to whether the list of approved conditions should be widened. The result of this bizarre exercise was to announce that there would be no change. There had been an overwhelming response in favour of extending prescribing to treat erectile dysfunction. Yet the government decided that they would leave things as they were because there wasn't enough money to widen the availability. When you finish banging your head against the nearest brick wall you have to wonder why they wasted good money on going through such a pointless exercise at all as presumably they knew in the first place that they only had enough money to fund the status quo?

Then there was the Sexual Health strategy. There is hardly a mention of sexual dysfunction. In fact, the whole strategy is disappointing, as it appears to consist of little more than a HIV/AIDS strategy with a teenage pregnancy strategy bolted on for good measure.

So why is the whole problem ignored and shrouded in mystery? It can't be because it affects just a few people. Estimates suggest that one in 10 men will suffer from the condition at some time in their lives. Nearly a fifth of men over 50 will experience problems with achieving or sustaining an erection. This has a consequent effect on their partners who are likely to suffer from depression and low self esteem. Any other condition, affecting any other part of the body, affecting so many people would attract a lot more money and care and attention.

The general public are woefully ignorant of help that may be available and research by the Impotence Association has shown that over 80 per cent of men with erectile dysfunction suffer needlessly. Eighty five per cent of them wait for at least six months before they seek medical attention. Even more worrying is the fact that nearly half of them will wait for around two years before they pluck up the courage to ask for help. Yet in over three quarters of cases there is an underlying physical condition which will probably need treatment.

Many now argue that sex is no longer a taboo. To a certain extent they are right but the real taboo in our society is admitting to having problems with sex. It's something no one ever admits to.

The Health Select Committee are about to begin an enquiry into sexual health. I hope that we tackle this subject and manage to do it sensibly and without recourse to innuendo and schoolboy sniggering. We owe it to all of those who suffer, either directly or indirectly, to let people know that the problem is widespread but there is help available. Hopefully there will be more help and more openness in the future.


Sandra Gidley is the Lib Dem MP for Romsey and a member of the Health Select Committee
 
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