The first time Alice came to the sexology clinic, she did not want to see a doctor. She asked at the reception if she could buy Viagra. The receptionist advised her to talk to the doctor but she refused and walked away. A week later she was back. This time round she agreed to see me.
“I know what am looking for,” she explained. “I have not had sex with my husband for two years because he can’t stand to the occasion. I just want Viagra to sort that out. I nodded understandingly, looking for an avenue to strike a rapport before we could go into details of Viagra and ED.
Alice was 48 years old. She was a journalist married to James, a 55-year-old high school teacher. The couple had been married for 19 years and had three children, the youngest being 12 years old. They had had a blissful marital life till James’ erections started dwindling. Because he was embarrassed, he opted to avoid sex altogether.
Alice was unhappy with his decision. She tried to get him to go for treatment but he would hear nothing of that. This is why she wanted Viagra. Unfortunately for a problem as important as ED, a complete medical evaluation has to be made. I had a long chat with Alice after which I decided to talk to her husband on phone. James was difficult to convince.
“You have actually teamed up with my wife to talk about my private life?!” he snapped. After a lot of patience and persuasion from my end, he agreed to visit the clinic.
I did not hear from the couple for another three months, until a giant of a man walked into the clinic one morning and told me that he was James. He was not just tall, but also wide. After asking me a number of questions about my clinic, James finally opened up about how his erections had faded over time and his subsequent fight with his wife. He thought it was demeaning for a man to seek care for such problems.
On examining him, I found James to be obese. His weight was 150 kg. The right weight for his height was supposed to be 70 to 85 kg. His blood pressure was high. I ordered tests to assess his hormones, cholesterol and blood sugar. We agreed to meet in three days to review the results. Meanwhile, I prescribed anti-hypertensives.
The next day I received a call from Alice. She was weeping. James was no more. He had developed chest pains in the night and was rushed to hospital, but was pronounced dead on arrival. I followed up with the medical team in the hospital to understand the cause of death; he had had a heart attack.
Two days after James died I received the results of tests I had ordered. He had high cholesterol as well as sugar. James’s case showed that ED can be a symptom of serious health problems. In his case, obesity and undiagnosed high blood pressure, high cholesterol and high blood sugar were the real problems; ED was the symptom. These abnormal changes in the body are a result of sedentary lifestyles. The changes ultimately result in cardiovascular diseases (CVDs) epitomised by heart attack and stroke.
CVDs kill close to 18 million people every year worldwide. Most of these deaths happen in developing countries. Another big number of people live with varying forms of disability from the effects of these diseases.
In sexual medicine, ED has been identified as one of the warning sign of CVDs. Anybody who suffers ED should seek medical help and should be screened to ensure that they are not at risk of sudden death.
Alice came to the clinic after James was buried. She wanted to understand more. “Do you think I stressed him so much that his heart failed?” she asked, tears welling up her eyes.
I explained that she was right to insist he seeks medical attention. However James took too long to do so and just when we were about to diagnose his problem, he passed on. Alice broke down and cried uncontrollably. Overcome by emotion, she walked out of the clinic. She was still in the early stages of mourning and I realised my explanation only caused her more pain.