Safety jitters fuel Kenyan men’s 'blue pill’ dilemma

There is a growing concern over the abuse of sexual performance drugs among Kenyan men and whether they cause stroke or death. FILE PHOTO | SHUTTERSTOCK

There is a growing concern over the abuse of sexual performance drugs among Kenyan men and whether they cause stroke or death.

Reports show men are increasingly using performance-enhancing drugs in the market, Viagra or Cialis, in managing erectile dysfunction.

Dr Ahmed Yousef, a consultant urologist at Aga Khan University Hospital in Nairobi, says doctors prescribe the pills only after a clinical examination of the patient’s general health to ascertain their ability to handle the drugs.

However, men buy the drugs over the counter in pharmacies and online stores without being diagnosed with erectile dysfunction, also known as impotence.

Some use them to “last longer” during intercourse or show off their prowess.

“Normally, the power of erections decreases as one ages. However, men who suffer from weak erections may not know this or have refused to come to terms with this fact and still want an erection similar to what they had in their 20s and 30s,” says Dr Yousef.

The easy access, thanks to online stores where someone can order the drugs and have them delivered to the doorstep, has also contributed to their misuse.

A quick online search shows more than 100 pharmacies sell Viagra and Cialis in Kenya, indicating easy access. In some pharmacies, where the cost ranges between Sh100 and Sh2,500, they run out of stock due to high demand.

Dr Yousef says most men experiencing weak erections panic and rush for quick fixes.

“They start seeking easy solutions, most of which end in pharmacies hoping to regain their strong erection,” he says.

Dr Kassim Adbdalla, another urologist based in Mombasa, says the erectile dysfunction drugs help to achieve and maintain an erection, but there is more to it.

“You don’t just take Viagra and expect to get an erection. It doesn’t work that way. The only time you will get a good erection is when you have a stimulation,” he says.

Dr Yousef adds that the use of pills is a step-by-step process. First, you have to lose excess weight by exercising, eating healthy foods, and practising Kegel exercises, which help strengthen the pelvic floor muscles that affect sexual function.

“Once your weight is managed, you will have to undergo a cardiovascular risk assessment (if needed). If your heart condition is good, we’ll then start you on the pills, which you will use as you get reviewed by your doctor. For most men who have trouble keeping an erection firm enough for sexual intercourse, these medications work well and cause few side effects,” he says.

If the oral pills do not respond, he says, a further examination is done using a procedure that involves injecting a drug to induce erection.

“If there is a response, you will continue with this line of treatment. If you don’t respond to the injection, we’ll perform a penile prosthesis. This is an operation done on the penis to insert a prosthesis inside the penis,” he adds.

The US Food and Drug Administration also authorised an over-the-counter gel, the first topical erectile dysfunction treatment available without the need for a prescription.

Dr Yousef says not all patients with erectile problems should use the pills.

“This is because erectile dysfunction could be a symptom of chronic disease, mostly cardiovascular disease, diabetes, kidney disease, neurological disease, or stress. If you suffer from these conditions, you could have experienced erectile dysfunction at some point. To qualify for the use of pills, you must fulfil a clinical criterion,” he says.

Dr Yousef adds that a patient’s suitability to use pills depends on one’s cardiac risk.

“First, you should not have an underlying health condition that could be worsened by the drugs. Second, you have to be evaluated by a heart specialist for good heart health and ascertain if he has any cardiac or hypertensive problems, and of course, you should not have a history of heart disease,” he says.

“After your evaluation by a heart specialist, they send the evaluation results to a urologist who will analyse the results and determine if you qualify to use pills or not – and which type is suitable.”

The famous blue pill, Viagra, was approved 25 years ago and of late, its users appear to be getting younger, some misusing it to manage weak erections caused by performance anxiety.

There are medical risks that arise if one abuses the drugs. “Men who don’t have erectile dysfunction but use the medication may become psychologically dependent on the drug to the point of needing it to get an erection. This may eventually lead to erectile dysfunction,” says Dr Kassim.

Others take an overdose of the sexual performance enhancement drugs with alcohol or other recreational drugs or take it yet they have high blood pressure, which causes serious harm.

Two years ago, the Pharmaceutical Society of Kenya warned men against using sexual enhancement drugs, Sildenafil (sold under the brand name Viagra), Tadalafil (Cialis), Vardenafil and Avanafil drugs without the advice of a qualified medical practitioner and a valid prescription. But some Kenyans are still buying them indiscriminately.

“The use of these medicines without prior medical evaluation makes one more prone to their harmful effects,” it said.

Misusing these drugs could also lead to nose bleeding, insomnia, vision loss and heart problems. Some people may get dizzy spells, headaches, prolonged erection, and compromised breathing.

However, the doctors say the pills continue to be safe for patients when correctly prescribed.

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