Some Prescription Medications Help Counteract Impotence

Question: My husband and I have been married for 36 years. We’ve always had a very satisfying sexual relationship, but over the last several years, he’s had increasing difficulty getting and maintaining an erection.

We both find this frustrating. I have tried to encourage him all the ways I know how, but he says the problem isn’t lack of interest or stimulation.

I remember reading something in your column about a drug to counteract impotence, but it didn’t seem relevant at the time. Now I wish we knew more about medications that might be helpful. Where does a person get this type of help?

Answer: There are indeed some prescription medications that can help men with erection difficulties. First, though, your husband should see a doctor for a thorough workup that could determine whether an underlying condition such as diabetes or cardiovascular disease is to blame.

Papaverine by itself or in combination with Regitine (phentolamine) can produce an erection when it is injected into the penis. It doesn’t work for everyone, however. In addition, repeated use of the combination injection may lead to fibrous lumps in the penis. Liver function tests may also be affected.

Another injection that has been used is Prostin VR (alprostadil). Reports indicate that this drug works at least as well as papaverine and Regitine. It doesn’t seem to cause fibrosis or liver problems but it costs about twice as much as the combination, and the injection is more painful.

None of these drugs have been approved by the Food and Drug Administration for treating impotence, so your husband will have to find a doctor who is knowledgeable about this issue.

Q: When I read the letter in your column about the person who can’t handle milk sugar, I wanted to tell you about a product my husband uses. He controls his lactose intolerance with a liquid enzyme, Lactaid. I add five drops to a quart of milk, and he can enjoy it on his cereal or in a milkshake without the bloating, gas or diarrhea that would result otherwise.

A: Thanks for reminding us about Lactaid. The enzyme is also available as a pill that can be taken with dairy products such as ice cream or cheese or with lactose-containing medicines.