News Sexual Health

“Viagra” Bill Introduced in Ohio To “Protect Men’s Health”

Robin Marty

Mandatory pre-erectile dysfunction counseling? Makes sense to me!

As I’m sure anyone who has experienced priapism can no doubt tell you, erectile drugs side affects are no laughing matter.  Well, unless you’re in an “American Pie” sequel.

That’s why Ohio state Senator Nita Lowry is introducing a very important bill to help regulate Viagra usage.

Via the Middletown Journal:

Before getting a prescription for Viagra or other erectile dysfunction drugs, men would have to see a sex therapist, receive a cardiac stress test and get a notarized affidavit signed by a sexual partner affirming impotency, if state Sen. Nina Turner has her way.

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At least she didn’t mandate a rectal exam.

News Sexual Health

Eight-Hour Erection Case Leads to Complaint Against Men’s Health Clinic

Martha Kempner

The complaint was filed by a local urologist who said he's seen a number of cases of priapism in patients of a Minnesota clinic who end up in the ER.

A complaint has been filed against the Minneapolis Men’s Clinic in Bloomington, Minnesota, on behalf of one of several patients who says the clinic pushed him into buying injectable erectile dysfunction drugs that caused a painful episode of priapism.

The complaint was filed with the Minnesota Attorney General’s Office and the state Board of Medicine by Karl Kemberling, a local urologist who ended up treating the patient for an erection that lasted more than eight hours. (He was unable to reach anyone at the clinic after-hours.) Kemberling says he and his partners have seen a number of cases of priapism in patients of the clinic who end up in the emergency room. He told the Star Tribune, “We … consider their lack of care medical negligence or patient abandonment.”

According to reports, the clinic appears to be pushing injectable treatments over the more widely used oral medications, which are less likely to cause this condition.

Erectile dysfunction (ED) is defined as the inability to attain and maintain an erection sufficient to permit satisfactory sexual performance. In order to be diagnosed with ED, the issue must affect a man’s physical and psychosocial health and have significant impact on his quality of life and that of his partners or family. It is estimated that 20 to 30 percent of men suffer from ED at some point, with 5 to 20 percent of men reporting moderate to severe cases. The likelihood of ED increases as men age.

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ED can have its roots in physical and/or psychological issues. Erections require increased blood flow to the penis, which means that cardiovascular problems such as heart disease, clogged blood vessels, high blood pressure, high cholesterol, diabetes, obesity, and heavy smoking can contribute to trouble getting or maintaining an erection. Other health issues such as Parkinson’s disease and multiple sclerosis can also increase the likelihood. Some prescription medications are known to limit sexual desire and functioning, as can some illicit drugs and even alcohol when used in excess. Other issues more closely associated with sexual function also increase the risk of ED, such as prostate cancer and treatments for prostate cancer, low testosterone levels, and injuries to or surgeries on the pelvic area or spinal cord. Relationship issues and other psychological issues such as depression and anxiety can also affect erectile functioning.

Although the ideal treatment for most men would address both the physical and psychological realms, since the introduction of Viagra in 1988 most doctors and patients turn first to PDE5 inhibitors. By blocking the PDE5 enzyme, the medications help the smooth muscles in the penis relax and increase blood flow to the penis. Other PDE5 inhibitors have been introduced since then, including Tadalfil (sold as Cialis) and Vardenfil (sold as Levitra). The differences between these drugs are mainly in how long they take before they begin to work and how long they last in the body before they stop working.

As with any medication, there are side effects to PDE5 inhibitors. Common side effects include headaches, flushing, indigestion, nasal congestion, and dizziness. About 2 percent of patients experience vision issues that include seeing a blue haze, temporary increased brightness, and even sudden vision loss or partial vision loss. Though all advertisements for these drugs warn of the multi-hour erection, cases of priapism are very rare.

Before 1988, doctors often relied on drugs that were injected into the penis with a fine-gauge needle. The most common of the drugs is alprostadil, which is marketed under the names Caverject Impulse or Edex. Other drugs include papaverine and phentolamine. These can be used in combination and the dose can be tinkered with for each patient. Side effects can include bleeding from the injection, formation of fibrous tissue at the injection site, and prolonged erections. These drugs are still available but are no longer considered first-line treatments.

Yet patients at the Minneapolis Men’s Clinic say they were given the hard sell on this type of treatment, and the long erection appears to be a part of the sales tactic. The clinic’s website says its treatment is unique:

Our pharmacy custom blends your prescription medication so that after you achieve a climax your penis will stay erect for the entire requested amount of time whether it’s 45 minutes, 90 minutes, and hour or more. This allows you to achieve a second climax (the sensation is greater each time) and adequately please your partner.

One man, a 63-year-old retired surgeon, who spoke to the Star Tribune on the condition of anonymity, said that he went to the clinic in response to an ad offering a free trial of ED treatment. After he met with a clinic doctor, he was handed over to a salesman for the treatment who was pushing a one-year supply, for a total cost of $2,800. When he asked if he could start with a smaller supply, the salesman “rolled his eyes” and “acted like that would be difficult.” The first time the man gave himself an injection he ended up with an erection that would not go down. He tried cold baths and Sudafed (a decongestant that contracts blood vessels, which was given to him by the clinic for just this situation), but neither worked. He ended up in the emergency room, after he wasn’t able to get in touch with anyone at the clinic, where doctors inserted a large needle into his penis to extract the blood. He called the treatment excruciating. The retired doctor tried the self-injected ED drugs one more time in a lower dose and wound up in the ER yet again. As he told the Star Tribune, “The stuff worked, it just didn’t unwork.”

According to the Star Tribune, Thomas Lund, a regional medical director at the Bloomington clinic, said the clinic does have a 24-hour emergency hotline with medical staff. “These claims by the local urology clinic are baseless and motivated by an attempt to drive out their competition,” Lund told the newspaper in an email.

The Men’s Clinic is one of a chain of 14 clinics across the country, which was founded by Dr. Kevin Hornsby, who self-published a book on ED and says his clinics offer an alternative to Viagra and other pills. According to the Star Tribune, the Better Business Bureau has received 19 complaints against Men’s Clinics in various states.

News Politics

When it Comes to Women’s Health and Rights, South Dakota Is Still in the “Hoghouse”

Robin Marty

It will be hard for women to see any legislative gains in a state that can literally rewrite bills.

In North Dakota, activists were happily surprised when Democrat Heidi Heitkamp beat Republican Rick Berg for the state’s open senate seat. But in South Dakota, pro-choice activists didn’t even have a victory win to revel in. The state not only didn’t make any gains when it came to protecting a woman’s right to choose, they may have lost ground in the last election.

Pro-choice legislators were already a dying breed in the state, and this election made the situation even more dire. The state senate has dropped from seven pro-choice members to just three who actively identify as such. In the state house, the number has gone from 16 to just seven.

Although Roger Hunt, the state’s leading anti-choice politician, is now out of office due to term limits, there may be another legislator ready to take over his mantle. Rep. Jon Hansen touts his faith and belief that the number one role of the government is “the protection of life and civil liberty.”

“It is a sad fact that government has neglected this role and millions of innocent people have been killed as a result. We must act to protect more lives from being lost as a result of abortions in our state,” Hansen says on his website, beneath a banner reading “Saving lives of the unborn in South Dakota.”

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Hansen has already acted as a conduit for Americans United for Life model legislation to be proposed in the House, such as the 2012 bill to limit abortion coverage in the state’s implementation of the Affordable Care Act. In Hansen’s proposed bill, abortion would only be allowed to be covered by insurance exchanges in the state if it was to save the life of the pregnant woman, and an employee would have to inform an employer if he or she wanted to purchase a separate rider on his or her insurance plan in order to cover abortion.

As the 2013 legislative session looms, some wonder whether bills that were expected to be seen last year but didn’t make it into the calendar may once more pop up. The most likely contender is a state ban on abortions after 20 weeks, which was believed to be in the works in 2012 but ended up not coming to fruition because of already-ongoing legal action surrounding the 72-hour wait and mandatory crisis pregnancy center visit bill, which is still enjoined and being reviewed by the courts.

Nothing has changed since 2012, but Democratic state Senator Angie Buhl agrees that a 20 week or “fetal pain” based ban wouldn’t be a surprise if it were proposed in 2013. Despite the state voters consistently rejecting full bans when they are put on the ballot for a vote, the message that South Dakotans aren’t interested in curbing reproductive rights doesn’t sink in with the legislators who are elected.

“They think ‘Oh, they voted against a total ban, but that doesn’t mean they wouldn’t be happy with something less than that,'” Buhl told Rewire. “They think even if they can’t pass a full ban, maybe they can if they just make it a waiting period…for nine months.”

For Buhl, one of the few pro-choice senators in the state, each session can be like walking through a minefield, trying to navigate potential anti-reproductive health bombs waiting to explode. Besides just outright hostile bills that seek to limit access to abortion or birth control, the state’s special legislative process known as “hoghousing” can turn any pro-active attempt to pass pro-woman legislation into a situation that can backfire on the authors and supporters.

Alisha Sedor, executive director of NARAL Pro-Choice South Dakota, remembered the time that Buhl and other senators proposed a bill that would force crisis pregnancy centers in the state to have better “truth in advertising” standards. The bill would open the potential where “any such pregnancy center could, under the law, be prosecuted for advertising containing any statement or omission, related to its services, that is ‘untrue or misleading’ and that the center ‘knew or should have known to be untrue or misleading’ when published.” Anti-choice activist Leslee Unruh, owner of Alpha Center pregnancy center and heavy backer of the 72 hour wait law, declared the passage of the bill could shut down every center in the state.

The law as written never made it up for a vote. Instead, a committee ‘hoghoused’ it, proposing an amendment that removed “crisis pregnancy center,” replacing it with “abortion provider.” The new bill would instead target and potentially shut down the state’s only abortion clinic.

“Not that our providers aren’t truthful in their standards,” Sedor explained. “But you never know what the legal implications of that sort of bill would be, especially with no time to prepare.”

Instead, pro-choice legislators and activists found themselves scrambling to kill off the bill that they had just introduced. “Now, here you are, on your feet, finding yourself testifying again against your own bill that is the opposite of what your brought up before.”

Hoghousing is a favorite tactic in legislation involving reproductive health, and was the means through which the infamous “shoot an abortion provider” bill in 2011 came into being. “That started as some legislation that seemed innocuous, but was just tweaking some language from a fetal homicide bill that was already in existence. Then one legislator hoghoused it and introduced it as justifiable homicide language. That was why we were so unprepared.”

As long as hoghousing is a tactic, it’s impossible to propose proactive, pro-reproductive health bills and not have it potentially twisted into anti-women legislation. “Once it is on the floor, you can’t do that sort of amending,” said Sedor.

But the only way to pursue proactive legislation is to guess what committee it will go into. And even if it gets to the floor it could be hoghoused when it gets to the other chamber. Even guessing what committee it will go into can be hard since legislators will send bills into committees where they know there will be less support for proactive measures.

Until there is more support for reproductive rights among those who are elected to Pierre, pro-choice groups and politicians will be constantly playing defense. So far, that’s a task that has been growing more daunting cycle by cycle. Ballot measures put out to voters keep failing, yet the same people who propose these measures are elected back into office year after year. “It’s a kind of disconnect between ballot initiatives not just on choice, but on progressive issues generally,” said Sedor. “The same people in the legislature who proposed it are back again. So it’s this disconnect in the electorate between the issues that they care about and the voters they support. Bridging that gap will be very important.”

Buhl agreed. “It’s the same as what you see nationally. Congress will have a nine percent approval rating, yet 80 percent of incumbents win their reelection. Voters associate the bad bills with the faceless politicians in Pierre. They don’t attach them to their own candidates. They like them.”

With their hands basically tied in the state house, and their numbers dwindling, it would seem as if those who support women’s health care and basic reproductive rights would be frustrated and discouraged. Instead, leaders like Buhl are still looking for a silver lining in an ongoing struggle to urge legislators to end their attacks. One such bright spot? Wins across the country have shown the state Democratic party that people are anxious to end the Republican party’s dominance on the so-called “social issues” and stop the GOP’s war on women and their bodies. “We’ve begun discussing how that could be approached in our state, too. We’re finally talking about it as an option, at least.”

There may be no immediate moves to win back abortion rights, but just starting the conversation shows there may be a chance in the future. “It may not be right there on the horizon,” said Buhl. “But it’s definitely something we may be able to see at some point down the road.”