That medicine could be the cause of your bedroom troubles

“The lion is dead, completely dead!” came the distressed voice. It was a woman’s voice. I checked the time; it was 2 am. My mind was still foggy and coming to terms with what was going on. But when one talks of death in the dead of the night it is not to be taken lightly. I shook off sleep, sat up and tried to figure out what all this was about. I hoped a relative had not died; or maybe it was one of those patients I had been attending to with quite severe diseases. I could not however remember one going by that name.

“Who has died please? And whom am I talking to?” I asked anxiously.

“My name is Jane, have you forgotten me?” She continued, “It is my husband, he has a problem, we have visited your clinic with him severally when I had problems.”

Oh yeah, I remembered that voice. I had known Jane for over ten years. She had been seen in the clinic severally for pain during sex which made her keep off intimacy. That also meant that she could not conceive. After a prolonged treatment for over three years, she finally was able to have sex and conceived. Her husband, a high school teacher, was one of a kind, and supported her unreservedly during her time of difficulty. He never missed a single clinic appointment whenever his wife sought help.

“Oh no, I hope nothing bad has happened to your husband?” I said.

“Well, I don’t know what to say,” Jane explained, “it is just that he can no longer rise to the occasion, I mean, his lion is dead!” I have learnt over the years not to jump into conclusions when patients use figurative language. I was therefore careful not to misquote Jane and asked her to explain more what she meant.

Chronic headaches

So the story was that the man had been having chronic headaches for some time. He visited a doctor who diagnosed him with high blood pressure. Because the pressure was too high, he was admitted to hospital for three days. He underwent a thorough medical check-up but they could not find a cause for the hypertension, He was put on treatment to lower the pressure. Within a week of treatment the blood pressure normalized and the headaches subsided.

The couple then resumed sexual activity. Then the shock of their lives happened: there was no erection.

“I tried what I could to stimulate him but the thing just lay there idle and lifeless,” Jane lamented, “it is so frustrating and that is why I have called you in the dead of the night.”

We agreed to meet in the clinic the next morning. Jane came early accompanied by her husband.

“He has been supportive whenever I faced challenges,” Jane said, “It is my turn to reciprocate and escort him to the clinic this time round.”

I took a detailed history, examined the man and did preliminary laboratory tests. I could not put a finger on any cause of the erection failure except for one of the medicines he had been given to control the high blood pressure.

“But I read somewhere that high pressure can also be a cause of ED,” the man interjected as I explained my diagnosis, “it is all very confusing because I do not know whether it is the medicine or the disease.”

Damage to blood vessels

He was right. Left untreated, high blood pressure can cause ED. The situation is dire when one also has diabetes and high cholesterol. The damage to blood vessels caused by the combined effect of these diseases can totally destroy sexual function and lead to erection failure. Be that as it may, the treatment given must be effective to normalise the pressure and take care of other comorbidities while at the same time remembering that the choice of medicine does matter because some medicines equally have damaging effects on erection.

“So how do we revive my husband’s organ doctor?” Jane asked her voice shaky, she was getting emotional of the whole situation, “I do not imagine that this could be the end of our sex lives given that hypertension is a long term disease.”

“No at all,” I answered emphatically.

There is a wide variety of anti-hypertensive drugs that one can use and which do not have any effects on sexual function. I simply stopped what had been prescribed and gave an equally effective treatment with no effect on sexual function.

The couple was in the clinic two weeks later. They had been monitoring the blood pressure at home and charting it. I reviewed the records and the pressures were quite well controlled.

“And you know what,” Jane said, “the lion is awake and roaring louder than ever before.”