Should men be limited to two erections a month?

The NHS is becoming increasingly reluctant to prescribe treatments for erection problems.

Already drugs such as Viagra, Levitra and Cialis (the so called PDE-5 inhibitors) are only available on prescription to certain groups of patients. Now doctors in Milton Keynes, Oxfordshire, Berkshire East, Berkshire West and Buckinghamshire (MOBBB) are being advised to limit prescriptions to just two tablets a month.

The decision of the south central priorities committee which deals with PCTs in the MOBBB areas is a recommendation not an edict. But at least one PCT - Berkshire East - has been reported by the GP’s magazine Pulse as following it for their new patients (existing patients get four tablets).

Sex not a luxury

Pulse editor Richard Hoey was critical of the decision. ‘Ask most doctors and they will say that being able to live a satisfactory sex life is a key part of health and wellbeing, but the NHS has never recognised that in its policy on treatment for erectile dysfunction. Limiting patients to drugs like Viagra just twice a month is to treat sex like an unnecessary luxury, and completely fails to recognise the degree of anguish it can cause some men with erectile dysfunction.’

MHF president Dr Ian Banks said: 'Given the well-established medical causes, restrictions and confusion over a GPs ability to prescribe medicines for ED are probably contributing to the delay in definitive diagnosis of diabetes and hypertension. Even on this basis alone, it makes sense to allow greater access to anti-ED medications if men are to avoid dangerous purchases from the internet. Abuse of the drugs for ‘recreational sex’ invites the question, ‘what other type of sex is there’?'

All NHS doctors can prescribe PDE-5 inhibitors but patients usually have to pay the full cost (about £17-£30 for four tablets).

NHS prescriptions for PDE-5 inhibitors are only available for men with diabetes, multiple sclerosis, Parkinson’s disease, polio, prostate cancer, a severe pelvic or spinal injury, spina bifida and certain genetic conditions, such as Huntington's disease. They may also be available after pelvic surgery, surgical removal of the prostate gland, dialysis for kidney failure or a kidney transplant. Under the MOBBB guidelines, these men would be restricted to two tablets a month.

'Severe distress'

Currently, the only way men not in any of the above categories can get PDE-5 inhibitors on the NHS is if they can show that their erection problems are causing them ‘severe distress’. This will need to be assessed by a specialist rather than your GP.

• More information from NHS Choices