Impotence may be a thing of the past with the advent of Viagra, but the drug does not have the power to re- invent a loving relationship, writes John Illman
Viagra could be a marriage wrecker, according to a leading psychosexual expert whose warning about the impotence pill has major implications for hundreds of thousands of South African couples.
Dr Alan Riley was speaking at an international impotence symposium, highlighting new concern which extends far beyond the “Viagra divorces” already reported in the United States. It is not the drug itself which is the problem so much as the fact that about a third of men with so-called “psychogenic” or psychological impotence have partners with significant sexual problems of their own.
These range from lack of desire to the “Virgin Bride Syndrome” or vaginismus, which causes muscular spasm that can make intercourse impossible. Many sufferers long for intimacy but are afraid to seek help.
“These problems can be the cause of male impotence or a complicating factor,” said Riley of St George’s Hospital, London.
But the initial blame for a woman’s sexual problems may often lie with men, it seems. Insensitive lovemaking and poor sexual technique expose women to pain, resulting in fear, loss of confidence – and, finally, disabling sex problems. No one knows how many couples suffer from this vicious circle, but about three to five million South African men suffer from impotence or “erectile dysfunction” (ED).
It is easy enough, albeit expensive, to prescribe Viagra to a man so he can have an erection. But this will not re-ignite a loving relationship if his partner has no sexual desire.
Riley said: “Women have told me, `I was delighted when he became impotent’. This is why I feel that whenever we’re treating impotence we should take account of the partner’s wishes. I’ve seen several men whose marriages have come to an end after they’ve had treatment for erectile problems without their wives knowing.”
In one case a couple had not had sex for 10 years. The husband decided to have an erection-inducing injection as a “romantic surprise” for his wife’s birthday. She was horrified by the result and for the next four months they slept in separate beds.
This is not an isolated case. Research suggests 30% to 50% of men seeking injection therapy do not inform their partners. This may reflect a medical culture in which traditionally male and female sexual problems have been regarded as separate entities.
While impotence has always been taken seriously, female complaints such as lack of desire and arousal have been dismissed as “psychological”. But the meeting of the International Society for Impotence Research in Amsterdam underlined a fundamental shift – including numerous lectures on “female sexual dysfunction”.
Professor Ray Rosen, of the Robert Wood Johnson Medical School in New Jersey, said: “This is one of the by- products of the Viagra revolution. It is helping to bring female sexual problems to the forefront.”
Research by his department shows that, contrary to popular opinion, younger women are more prone to sexual problems than older ones. “We think this is associated with lack of experience and lack of partner sensitivity,” Rosen said.
“I think that one of the things which happens as women get older is that they learn to overcome the discomfort and pain of early intercourse. They get rid of their partners or they use lubricants or other techniques.”
But many fail to make the transition to sexual fulfilment; they get caught up in a spiral which can destroy their desire and leave their husband impotent.
An acclaimed lecture on female sexual dysfunction by Dr Ellen Laan, one of the new international stars of sexology, ended with a simple message. Laan, of the University of Amsterdam, said: “We need more general sex education. In the case of women, we need to teach them how their bodies work, and how they can become aroused and lubricated.”
This could not only help women. It might prevent impotence in men – and save marriages.
l Viagra was due to be released in South Africa this week