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ERECTILE DYSFUNCTION
Fuelling the BLACK MARKET for ED drugs
It is a well-known fact that South Africans are, globally, amongst the biggest consumers of male sexual enhancement pills. These counterfeit ED drugs are causing many to put their lives at risk.
It’ s estimated that one in five South African men suffer from erectile dysfunction and only a fraction seek medical help. The globalisation of drug manufacturing and the anonymity and ubiquity of the internet are fuelling the traffic in male enhancement pills, and generating a market for the more questionable manufacturers.
A study, published in JAMA Internal Medicine, by Pieter Cohen, Assistant Professor of Medicine at Harvard Medical School and a colleague collected some of the lesser known facts about an industry that produces millions of pills- and likely generates tens of millions, if not billions in profits.
Male sexual enhancement pills are considered to be one of the most counterfeited drugs in the world, and South Africans are among the biggest consumers of black market ED drugs.
‘ Rock Hard’ and similar so-called‘ natural’ supplements for men often contain potentially dangerous drugs- some of which have never been tested on animals, let alone humans.
Fatal drug interactions
When used in conjunction with nitrate containing medications, PDE5 inhibitors can cause excessive vasodilation and hypotension, which can result in death. The use of nitrate containing medication is a definite contraindication to prescribing PDE5 inhibitors. Nitrate-containing drugs are commonly used to treat diabetes, heart conditions, hypertension and hypercholesterolaemia.
The conditions these medications are used to treat are often widespread in men who have ED, suggesting that a significant proportion of men using counterfeit male sexual enhancement drugs, are putting their lives at risk. It is advised that clinicians emphasis and explain the dangers of black market drugs to patients and underline the critical aspects of proper treatment.
Background epidemiology of ED
ED is defined as the inability to have or sustain an erection adequate for satisfactory sexual activity. It is one of the most common chronic medical disorders in men over the age of 40.
A global study of sexual attitudes and behaviours, targeting an adult population aged 40-80 years across 29 countries, identified early ejaculation and difficulty in achieving and maintaining an erection as the problems most commonly reported by men, affecting 24 % and 17 %, respectively.
The prevalence and severity of the disorder increases with age; men in their 50s are three times more likely to experience ED than men in their twenties. It is estimated that moderate to complete ED affects 45 % of men in their mid- 60s, with a further increasing prevalence in older age groups.
Pathophysiology
Two-thirds of cases of ED are organic in origin and comorbid conditions should therefore be actively evaluated. Heart and vascular diseases( especially those associated with hyperlipidemia, diabetes, and hypertension) are associated with ED.
The combination of these conditions and aging increases ED risk in older men. Other hormonal and metabolic problems including primary and secondary hypogonadism, hypothyroidism,
Here’ s what they found:
• A product sold as‘ Rock Hard for Men’ in 2012 turned out to contain not only counterfeit Cialis( tadalafil)- but also a diabetes drug that can be deadly if used incorrectly. A similar combination killed more than a dozen men in Asia in 2009.
• One Utah company alone produced more than a million pharmaceutically-tainted pills monthly, earning $ 2 million between 2007 and 2010, according to an indictment issued in one of the few cases brought against such manufacturers.
• More than three-quarters of male enhancement supplements tested in one study in Singapore contained pharmaceuticals that were not disclosed- and half of them were present in higher doses than recommended.
• Over 45 different versions of drugs in the same class of Viagra have now been found in male sexual supplements. A Dutch study found that 75 % of the products sold in the Netherlands contained at least one analogue, or chemical variant that has the same effect as Viagra.
• A product called‘ Mojo Nights’ recently analysed by the Food and Drug Administration( FDA) included not just counterfeit Viagra, but also three different analogue drugs.
• The FDA identified three tainted supplements:‘ Vicerex’ and‘ Bullet Proof,’ which contain counterfeit Cialis and‘ Lightning ROD,’ which includes an analogue of Viagra.
28 | May 2017
The Specialist Forum | Vol. 17 No. 4