Men's Health Thursday December 8, 2011

Why some men might have to ration sex

According to recent reports in the media, guidelines have been issued to limit prescriptions for impotence treatments such as Viagra, Cialis or Levitra to just two pills a month. The reasons behind these new ‘guidelines’ are largely budgetary, because it’s classed as a ‘non-essential’ treatment, and not because these treatments are a health threat.

This should, however, come as no surprise as impotence medications are already difficult to get a hold of on the NHS, limited to those who have the condition with serious illness.

The initial restriction issued by the Department of Health specified that middle aged men shouldn’t need more than a pill a week because of the average sex drive of men in this age group, but this was later halved to a pill every two weeks.

I certainly don’t think it’s entirely fair to cap it for all men, and other critics agree, with Richard Hoey, from medical magazine Pulse, saying that: "Limiting patients to drugs like Viagra just twice a month is to treat sex like an unnecessary luxury, and completely fails to recognise the degree of anguish it can cause some men with erectile dysfunction."

Misconceptions about impotence

I am also tempted to think that prescribing guidelines such as these shows how little understanding there is for this condition, what it is and its ability to emotionally affect a man suffering from it.

Some newspapers reporting on these new recommendations even made the mistake of assuming that impotence is about a lack of sex drive, when in actual fact a man may have a perfectly normal and functional sex drive, but be unable to get an erection sufficient enough to be able to react to it, which is just one example of how easily a condition such as this can be misunderstood. Although, admittedly, a man’s sex drive can influence a man’s ability to get an erection, it’s not the only cause.

Special circumstances

Understandably not all men with impotence should consider medication as the first port of call, as there may be many other root causes that can be treated successfully with psychosexual measures, such as psychotherapy.

However, the group of men that is actually reliant on the NHS for their impotence treatments, such as those with spinal injury, Parkinson's disease, spina bifida, diabetes, prostate cancer, multiple sclerosis and polio, have primary physical causes for their impotence and rarely benefit fully from the free counselling options available to men on the NHS.

Alternative options

This doesn’t, however, mean that men who can afford it don’t have alternative options. These treatments are still available privately and men could potentially supplement their prescription from the NHS with those from private services. The South Central Priorities Committee, responsible for the decision, is also saying that doctors don’t have to vehemently stick to these guidelines and can use their discretion to provide men with a higher number of pills a week, which means that getting more than a pill a two week a week on the NHS isn’t entirely impossible.

Why ‘non-essential’?

It’s understandable that impotence treatments aren’t necessarily directly saving lives, unless they are being used off-label to treat another conditions, but how can these treatments be seen as ‘non-essential, for those men who are fundamentally unable to have any kind of sexual intercourse unless they use it?

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