MEDICAL MATTERS:Viagra has saved men from some odd 'cures', writes MUIRIS HOUSTON
ACCORDING TO a recent European survey, 27 per cent of women who are in relationships with men aged 35 or over say their partner has experienced erectile dysfunction, defined as an inability to attain or maintain an erection sufficient for satisfactory sexual performance.
The Partners survey, sponsored by the pharmaceutical company Pfizer, looked at the sex lives of 2,500 women in five European countries. It found that the biggest turn-off for women was bad breath, followed by erectile dysfunction and flatulence. To the best of my knowledge, Pfizer doesn’t market products for either halitosis or excessive wind, but it did, of course, develop Viagra.
Viagra – or sildenafil, to give it its correct chemical name – was one of those serendipitous drug discoveries. First developed in the late 1980s as a possible treatment for angina, it didn’t do well in early clinical trials. But when the dose was changed, scientists spotted an unusual side-effect: male patients in the trial reported a marked improvement in their sex lives as sildenafil boosted blood flow to their penises. Pfizer then started large-scale trials of the drug in men suffering from impotence, and one of the biggest pharmaceutical success stories of all time took shape.
The diamond-shaped blue pill generated huge publicity. It was a major advance on previous treatments, many of which involved injecting substances into the penis. At one infamous urology conference in the US in the 1980s, a specialist lecturing on the technique said he had injected himself earlier. He then stepped out from behind the lectern and dropped his trousers, in an attempt to prove the technique’s efficacy.
A key factor in producing an erection, chemically at least, is the filling of blood within the open spaces of sinusoidal tissue in the penis. This engorgement depends on the release of nitric oxide in the penis following sexual stimulation. By blocking a particular enzyme, sildenafil magnifies the effect of nitric oxide and the penis fills with blood. Achieving this by oral medication is clearly a more palatable option than painfully injecting the male organ.
Medical history is full of unorthodox “cures” for erectile dysfunction. Julius Althaus, a Victorian surgeon, recommended electricity as a way of clearing the “blockages” thought to be responsible for impotence. By sticking an electrode up through the penis and applying another to the lower back, the aim was to run a current between the two. But the electrodes had a tendency to fuse to the inside of the penis, giving a whole new meaning to the term “hardwired for love”.
Predictably, animal testicles were the source of numerous failed treatments. In 1889 a 72-year-old doctor, Charles-Édouard Brown-Séquard, announced he felt “tremendously rejuvenated” after injecting himself with extract of guinea-pig testicles. He claimed to have gained strength in his muscles and to have cured his impotence.
Several attempts were made to transplant testicles into humans. In the 1920s a Kansas doctor claimed to cure impotence by transplanting some goat testicle into patients’ scrotums. Apparently thousands queued up at his clinic, where they had an option to choose a particular goat from the doctor’s own herd. Despite claims from some recipients that they subsequently fathered children, pressure from orthodox medicine eventually shut down his Pan-inspired enterprise.
Starting in 1918, Dr Leo Stanley, a San Quentin prison doctor, reportedly carried out testicle transplants on 500 inmates. He used testicles from executed prisoners as well as those from rams and goats. But he took an orthodox, experimental approach to his work, which was published in a reputable medical journal, avoiding the opprobrium visited on his more commercially minded Kansas colleague.
With Viagra and its fellow drugs helping to solve erectile dysfunction, the 67 per cent of European women who want more sex, according to the Partners survey, must be hoping for the serendipitous discovery of a magic bullet to deal with flatulence and bad breath.