Letter: Unfair to men

Sir: Whilst a retired doctor in my 60s I had come to accept impotence as part of normal ageing.

Soon afterwards, widowed and enjoying a new relationship, the bogey of erectile dysfunction confronted me again. After psychiatric counselling, a trial of the latest new remedy, still unlicensed in the UK, proved unhelpful.

Later, a uroandrologist established organic causation amenable to treatment. He recommended androgen replacement. Testosterone on its own failed to restore potency. Next, painful injections into the penis of another costly remedy, freely available under the NHS, proved too repugnant to tolerate.

The latest reputedly "magic" cure became available eventually to nominated specialists. Before prescribing it, my uroandrologist sought psychiatric reassurance about the relationship with my wife. Before our joint appointment, Viagra became freely available abroad.

Tablets bought over the counter in Switzerland and taken in a low dose restored normal potency immediately, after 15 years' impotence. The benefits to the remarriage of a retired doctor in his early 70s and his pre-menopausal wife do not need to be spelt out.

The uroandrologist recommended continuation of hormone replacement plus Viagra and the joint prescription was implemented by my GP. Later, having studied official advice, she felt bound to discontinue the Viagra; it seemed that the androgen could continue to be prescribed, but Viagra should be sought privately.

I sought reconsideration of her decision and, after reviewing my extensive specialist investigations, she resumed NHS prescription of testosterone with Viagra, pending the Health Minister's advice and the BMA's response.

It is anomalous that a joint NHS prescription, demonstrated as curative for a seemingly irremediable organic condition, is apparently to become impermissible once again, unless the proposed "list" is reviewed sensibly and promoted on an advisory basis. It should not deny doctors the right to exercise clinical discretion individually.

NAME AND ADDRESS SUPPLIED

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