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The rocky road to OTC ED medication

By Pat Kelly - 29th Mar 2021

It’s a welcome development that medication for the treatment of erectile dysfunction (ED) is now approved for OTC sale in Ireland. It is another recognition of Irish pharmacists’ healthcare knowledge and expertise and it takes a little pressure off patients who previously had to fork out for a GP consultation for such matters. But as we all know, it was not always a simple process for men to address ED, not to mention the associated stigma. Therefore, as a little light diversion, a brief stroll down ‘Healthcare Memory Lane’ might provide some context.

For example, in centuries past, impotence was in fact considered a crime and legitimate grounds for divorce; the process by which men were forced to prove their bona fides was a tortuous one, where dignity and anonymity had no place.

Indeed, divorce itself was often available only for the well-heeled, particularly in 16th and 17th Century France, Spain and England, however a man’s inability to perform in the bedroom was considered reasonable grounds. The Church was dominant in those times and it decreed that the prime objective of marriage was to procreate. The earliest records of such divorce cases stretch back to the 14th Century.

The harrowing process began with a wife making the accusation of impotence before an ecclesiastical court. According to a number of historians, the husband was then offered the chance to clear his name via an examination of his genitalia by what you might call a ‘multidisciplinary team’ of doctors, clergymen, celibate priests and midwives. The examination included scrutiny of the shape and colour of the appendage and amount of testes, as well as whatever process was employed to determine whether or not he could achieve an erection and deliver the required amount of reproductive fluid.

Natural tension and skin elasticity were also assessed. The local gutter press were most keen to report on such trials (how little some things have changed!), potentially resulting in very public humiliation. If you were a nobleman, the shame was extreme. If the husband chose to defend the accusation, a ‘Trial by Congress’ was arranged on neutral territory, whereby the couple were compelled to have sex in front of a panel of judges. A kind of ‘XXX Factor’, if you will.

The husband was given two hours to prove he could ‘perform’. If he could not do so, the marriage was dissolved. Naturally, potential underlying causes of ED were the last thing on anyone’s mind. However, in some cases, a three-year ‘window’ before annulment was granted in case the problem resolved itself. Litigant women did not escape invasive humiliation either — if a woman claimed that the marriage was never consummated, she had to prove her virginity at the Trial by Congress.

Since a woman’s reproductive and urinary system were believed to be the same, she would have been made to drink a diuretic and if she urinated immediately, it was judged that her hymen had been compromised. In some cases, a physical examination was also deemed necessary, whereby the woman was bathed and laid in front of a team of doctors and midwives. I will not assault our dear readers’ sensibilities with the details. And now, here we are. I hope this light diversion was a brief distraction from the serious issues that we all face. For today’s men, at least the ‘crime’ of ED is not one of them.

Pat Kelly, Editor
Pat Kelly, Editor

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Editor, Irish Pharmacist, GreenCross Publishing Ltd,
Top Floor, 111 Rathmines Road Lower, Dublin 6, D06K5F6.

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