reported the death of a 52-year-old Cameroonian man from a Viagra overdose. He had visited the country using a tourist visa from Cameroon in the company of a 25year old fellow Cameroonian woman. Post mortem examinations revealed no injuries but there was an overdose of Viagra found on toxicology analysis of his tissues.
In the United Kingdom( UK), The Sun( March 2024) cited NHS data indicating 22 million prescriptions for sexual enhancers between 2019 and 2023. Of those, 16,000 side effects were reported, including 205 deaths- most among men in their 60s. Even though the report failed to attribute the deaths directly to the drugs, there was an observed link to its use.
Experts emphasize that the drugs themselves are not inherently dangerous but must be used under medical supervision, especially by individuals with underlying illness, especially heart conditions.
How These Drugs Work
Sildenafil and its counterparts function as vasodilators( this is the widening of blood vessels). This is done by inhibiting an enzyme called Phosphodiesterase 5( PDE5). They are hence at times referred to as PDE5 inhibitors. In the penis, by relaxing the muscles and widening the blood vessels, more blood flows into the area, resulting in an erection. However, these effects are not isolated to the genital area- other blood vessels are also affected. This same mechanism is why sildenafil is sometimes prescribed for pulmonary hypertension( high blood pressure in lung arteries) and even altitude sickness and to manage jet lag. For individuals with narrowed coronary arteries or weakened hearts, the sudden changes in blood pressure and vascular load can be fatal.
Are These Medications a Death Sentence?
Not at all. When prescribed after thorough medical assessment, these medications are safe and effective.
In a study by Prof. George Magoha, published in the East African Medical Journal( Feb 2000), 219 men aged between 33 and 80 with erectile dysfunction were treated with sildenafil. Results showed a 91.3 % improvement in sexual function, including better erections and overall satisfaction. Only 3.2 % reported mild side effects such as headaches, nausea, or indigestion. No deaths were reported.
Similarly, a meta-analysis published in the Journal of Urology( Sept 2002) found that sildenafil significantly improved erectile function across all age groups, races, and causes, severity and duration of ED when compared to placebo. These findings have been consistent across various global studies.
Misuse and Associated Risks
The real danger arises when these medications are misused in scenarios including use without medical prescription, use in combination with alcohol or other drugs and use by individuals with heart disease, diabetes, or high blood pressure.
A 2021 study published in the Legal Journal of Medicine( Tokyo) reviewed six fatal cases associated with the nonprescription use of ED drugs:
• Four deaths were due to sudden cardiac arrest, all involving individuals with known cardiovascular disease. In one of these cases, more that one class of PDE5 inhibitor was found in the tissues on toxicology analysis.
• One case involved aspiration during vomiting with sildenafil found in his tissues on toxicology analysis. Other finding was narrowing of the left anterior descending coronary artery( an artery supplying the left side of the heart with blood, a major contraindication to the use of the drug).
• One involved a road traffic accident, with postmortem results showing a combination of sildenafil and alcohol upon toxicology analysis of his tissues.
These examples underscore the importance of medical evaluation before using such medications.
Conclusion: A Call for Responsible Use
Sexual health is a key component of overall well-being and is recognized under our laws and other international instruments. It also brings dignity to an individual. Erectile dysfunction can be emotionally and psychologically challenging, but there is no shame in seeking help.
It is critical that individuals consult medical professionals before using any sexual enhancement medication. ED is often a symptom of a deeper health issue, such as diabetes or heart disease. Using performance drugs without identifying and treating the underlying cause can lead to tragic outcomes.
Dr. Johansen Oduor, MBChB( UoN), MMed Path( UoN), LLB Hons( UoN), Dip for Med( College of Medicine South Africa), is a Forensic Pathologist / Medicolegal Specialist and President Emeritus, African Society Forensic Medicine. You can commune with him via mail at: Johansenoduor @ gmail. com.