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EDUCATION IS KEY: Leading urologist Peter Lim with an anatomical model and a collection of sexual enhancement products. He believes teaching men about the dangers of fake sex drugs will help reduce their use. -- ST PHOTO: LAU FOOK KONG
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THE pills hold out the promise of instant virility for barely $5 each, half the price of a cinema ticket.
But since the beginning of the year, at least 30 men - ranging in age from 21 to 97 - have learnt the hard way that Power 1 Walnut and other fake sex drugs do more than turbo-charge their sexual performance.
Containing dangerously high doses of glibenclamide, a prescription drug which reduces blood-sugar levels, the pills have also sent these men to hospital reeling from an assortment of ailments.
Two died after lapsing into a coma, and several others are still critically ill.
Besides these, there are another 70 suspected cases.
Madam Joyce Chew, 67, is appalled by the episode, especially when she learnt that one of the users is 97 years old.
'What a dirty old man. So old, still thinking of sex. Is he trying to kill himself?' the housewife asks.
Several others interviewed by The Straits Times share this sentiment.
Not Professor Peter Lim though.
One of Singapore's leading urologists, he specialises in treating male sexual problems, including erectile dysfunction.
He says many men - regardless of age - prize virility and will go to great lengths to make sure they have it.
'I have patients, including retirees in their 60s and 70s, coming in to tell me, 'What's the point of living if I can't have sex?'' says the 58-
year-old who runs a practice in Gleneagles Hospital.
Are you man enough?
IT IS probably no coincidence that the term 'manhood' refers to both the state of being a man and the penis.
For many, to have a malfunctioning penis is to not be a complete man.
Erectile dysfunction (ED) or impotence, however, is a common affliction affecting many men.
According to the United States National Institutes of Health, between 15 and 30 million men (about 20 per cent of the male population) in the country are affected by ED.
In Singapore, urologist Li Man Kay from Gleneagles Hospital estimates that more than 40 per cent of men above 30 suffer from some form of the condition.
The causes range from depression to diabetes and side effects of drugs. Ageing also lowers the level of testosterone - the hormone which primarily controls men's sexual drive or libido.
Psychiatrist and sex therapist Calvin Fones, 43, says many older men still have sexual desires because the body never stops producing testosterone entirely.
'With that desire comes the desire to maintain sexual activity,' he says.
Indeed, a 1996 Swedish study on the sexual health of elderly men shows that even among 70- to 80-year-olds, an intact sexual desire and ability to have an erection and orgasm are considered important.
An ageing woman's libido, on the other hand, is harder to define because it is influenced by not only physical issues brought on by menopause but emotional and psychological ones as well.
The New England Journal Of Medicine published a study of sexuality among older adults in the US last year.
Dividing the roughly 3,000 subjects into three age groups (57 to 64, 64 to 74 and 75 to 85), it found that women were significantly less likely than men at all ages to report sexual activity.
'At the risk of generalisation, men are more coitus- and penile-centric. Women look at other more encompassing aspects, including love and commitment,' says Dr Fones.
Indeed, evolutionary theory suggests that men are by nature more polygamous than women, and more accepting of casual sex. They lust after physicality and novelty, and are biologically driven to sow their seed.
Women, on the other hand, are more sexually sedate because they want a provider, a man for whom they can bear children, one who will provide for them and their brood.
That may explain the lengths men go to to explore ways to stay virile - from imbibing potions brewed from animal penises and so-called aphrodisiac herbs to using pumps to draw blood to their sexual organs.
Some ask doctors for injections to deliver instant erections or for surgically inserted inflatable implants which enable even paraplegics to engage in sex.
Little blue wonder
AND then came Viagra - the first oral treatment for impotence.
It was discovered accidentally by scientists who found that sildenafil nitrate - a drug being tested to treat angina and other cardiovascular problems - also gave the subjects erections.
In 1998, pharmaceutical giant Pfizer launched the little blue pill, putting an end to the woes caused by ED.
Since then, an estimated 1.8 billion Viagra pills have been dispensed to 35million men in more than 120 countries around the globe.
Viagra made its debut in Singapore a year later. More than 3.5 million pills have since been sold here.
Cialis and Levitra, two other oral drugs used to treat impotence, followed five years later.
Viagra revolutionised sex for men.
Dr Gan Tek Kah, 51, from Singapore Men's Health Clinic, says: 'In the past, treatments for ED included injections, pumps and urethra suppositories which were either invasive or difficult to use.'
With Viagra, you just pop a pill.
More important, the drug also removed the stigma of ED and brought discussion of men's sexual issues out in the open.
Prof Lim says: 'Inadequate sexual performance now has a medical solution. And when a problem can be medicalised, it also becomes respectable, not one you need to hide.'
Dr Li agrees: 'It's like saying you can't play golf because you have back pain. So you just fix your back pain, and you can play again.
'And you can even see your GP about it. In the past, you would have to consult a specialist.'
Dr Gan, who has been in practice for more than 20 years, says that where he once saw just one ED case a month, he easily gets between five and 10 cases a day now.
Freer discussion of sexual dysfunction issues is a good thing, he says.
'ED is a warning sign of other health problems like diabetes, hypertension and cholesterol. With more men coming forward, it can help us pick up these conditions earlier,' he says.
Viagra has been a godsend for MrJohn Foo, 53, who had ED problems because of hypertension and excessively high cholesterol levels.
'I tried everything - from herbs brewed with tiger's penis and jamu,' says the businessman, referring to Indonesian herbal remedies.
Nothing worked and his wife began to suspect he was fooling around.
Viagra, he says, saved his marriage. His doctor prescribed it as soon as it arrived here.
'It changed my life. I've become much closer to my wife. I use it twice a week,' says the father of two children in their 20s.
'You don't know the frustration a man feels when he is unable to perform sexually.'
In some cases, Viagra more than delivered a sexual fillip to marriages; it also brought the stork.
Prof Lim says at least three of his patients had children after they were prescribed the blue pill.
On the other hand, the sex drug has also been blamed for a litany of marital woes.
A 2005 New Zealand study involving women shows it can introduce unwelcome changes to sexual practices, tension and conflict in communication between partners, fears about men's infidelity and concerns about adverse health effects from use of the pill.
Prof Lim was recently berated by a 64-year-old patient's son for prescribing Viagra to his father. His mother had discovered the pills and suspected her husband was up to no good.
Meanwhile, private investigator Dennis Lee, 38, says he handles at least two marital-infidelity cases involving Viagra each month.
He once tailed a retired teacher whose newly resurrected sexual capabilities had led him to take up with a mistress from China.
The retiree told his family he was giving tuition lessons but, when these sessions became more frequent and longer, his children called in the PI.
Mr Lee says the man is still with his mistress.
Marriage counsellor David Kan, 42, says some wives blame Viagra for their husband's infidelities.
Mr Kan, who is also co-founder of The Family Life Centre, says: 'I won't say the drug itself causes infidelity, but the user will find it easier if he wants to stray.'
'If you blame Viagra, you can also blame mobile phones as they allow people to chat or exchange SMSes with their lovers in secret.'
Doctors point out that the drug is no miracle cure for all relationship, psychological or emotional problems men may have.
Business consultant Dicky Chua, 58, can attest to this. He tried Viagra several years ago, but all it gave him were headaches and nausea.
'I was going through a divorce and I had depression and self-esteem problems. Everyone thinks Viagra will turn you into Superman. Some men will learn the hard way it doesn't work for everyone,' says Mr Chua, who is now divorced.
He says his ED problems disappeared after he took care of his psychological and emotional issues.
Indeed, the perception that drugs like Viagra and Cialis can turn ageing Lotharios into sex machines has fuelled a whole cottage industry of imitations.
Drug manufacturers from India to China capitalise on Viagra's reputation, putting out pills and potions which claim the same, if not more powerful, effects - at a fraction of the price.
Doctors say that while genuine sildenafil drugs - which cost about $20 a pill - may cause side effects like headaches, blurred vision and backaches, they are not lethal if prescribed after thorough medical evaluation.
Prof Lim, who studies the effects of fake sex drugs, says: 'There are lots of conmen who go around saying their drugs are safe because they are made of herbs. Many men - especially the less well-off and less educated - will find the proposition very attractive indeed.'
In light of the Power 1 Walnut episode, the Health Sciences Authority has warned the public that any product sold on the street claiming to improve sexual performance should be considered dangerous.
Anyone caught selling these drugs can be jailed for up to two years and/or fined up to $10,000 for each offence.
Despite this, at Desker Road last week, one peddler was openly flogging sex drugs from every continent including Viagra, Cialis and Levitra pills at $5 a pop. He insists they are real and even offers a 'double refund' as guarantee.
'We not like pharmacy, sell so expensive,' he says in Singlish.
Prof Lim believes the controls lie in education.
'We have to start educating the public, especially the young, on the dangers of such drugs,' he says.
He adds that punitive measures should be targeted at purveyors of the trade.
'Targeting users won't work. They are driven only to satisfy themselves.'
Even if it means dicing with death.
ADDITIONAL REPORTING BY TEO CHENG WEE
kimhoh@sph.com.sg
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