In Korea, age-old problem for men gets modern help

The joke among middle-aged men these days is that when they hear the shower running at night a feeling of terror begins to overtake them. The sound signifies that their wives are getting ready for bed. What used to inflame passion now inspires fear in men who find as they age that satisfying their wives in bed becomes more difficult.
“I break out in a cold sweat just hearing the sound of the shower because I know I have to please her. I dread it because these days, I can’t seem to perform as well as I used to,” says one man, who prefers not to be identified. “I hate disappointing my wife, but there you have it.”
No other Asian nation, except for perhaps China, is more obsessed with male health and stamina than Korea, a land of exotic health aids and antidotes for lost sexual prowess. In years gone by, Korean men, to boost their vigor, bought potions made of bear’s gall, black sheep, crow meat, snake, eel, powdered deer horn and raw frog eggs.
These once-sought after remedies have never been proven medically and doctors view them skeptically. “They definitely have more of a placebo effect than as real treatments,” says Lee Joong-shik, a urologist at the Samsung Cheil Hospital in Jung-gu.
But now with a variety of modern drugs on the market to treat erectile dysfunction, or ED as it is called, Korean men are beginning to spurn the traditional medicine and seek professional help.
“I cannot discredit the effects of Chinese medicine because people have testified to the effects of sansuyu or root barks of certain shrubs,” says Park Nam-cheol, 37, a urologist with the Pusan University Medical School. “But now that there are more oral ED treatments out there, these age-old remedies will lose ground.”
According to the Korea Institute of Sexology, an average of 15 percent of Korean men from ages 40 to 80 suffer from a severe form of erectile dysfunction, with the percentage increasing as age increase.
It’s a problem that men avoid talking about, but after the sex drug Viagra went on the market in the United States, there has been greater openness about ED. Celebrities such as politician Bob Dole and major league baseball player Rafael Palmeiro were hired to extol the virtues of the blue oval pill in ads and to tell male consumers they weren’t alone in suffering from erectile dysfunction.
No big-name politicians or athletes are promoting ED drugs in Korea, but Viagra has gained momentum since it was introduced to the country four years ago. Lee Youn-soo, president of the sexology institute, says, “Before oral medical prescription showed up, men tended to shun going to clinics to get treatment because they felt ashamed. But now, the perception is slowly changing, and people are embracing the once-taboo issue of sexual difficulties.” Dr. Park does not believe Korean men have more ED problems compared with other countries. “It’s a matter of responding to the problem,” he says. “In Korea, the proportion of men conscious of the problem is smaller than in other countries. In other words, the percentage of those receiving medical treatment for erectile dysfunction is relatively less than in other places.” This could be interpreted as Korean men being in denial or refusing to receive treatment for their problems. But times are changing, as seen in the increase of sales in ED drugs.
Erectile dysfunction can be divided into two types: organic and psychogenic. The former refers to ED patients whose cause is physical, such as diabetes, and the latter refers to those whose condition results from stress or mental pressure. Dr. Park says that 40 percent of his cases stem from organic causes and 40 percent have psychogenic causes, with the other 20 percent a mixture of the two.
The key benefit of ED treatment is that the drugs have been shown to work for men with various other medical conditions such as hypertension, diabetes, heart disease and spinal cord injuries. However, ED patients have reported headaches, and dyspepsia after taking the drugs. Viagra should not be taken by people who use nitrates in any form at any time.
Even with the possible side effects, the drugs hold much more appeal than earlier medical remedies. Before ED oral medication became widely prescribed, treatment included the direct injection of drugs into the penis, urethral suppositories, surgery or the use of a vacuum device to cause the penis to fill with blood. “Clinical studies worldwide report more than 80 percent of patients who use Viagra are said to have seen improvement,” says Jung Jihee, public relations officer for Pfizer Korea.
And ED drugs’ popularity continues to grow. Besides Pfizer’s Viagra (sildenafil citrate), other pharmaceutical giants have come up with rival products this year, such as GlaxoSmithKline’s Levitra (vardenafil) and Eli Lilly’s Cialis (tadalafil). The European Society of Sexual Medicine Congress, held last month in Istanbul, became a forum for heated debate among the three firms arguing the efficacy of their products, the results of which are hard to say at the moment.
Counterfeit ED products have also shown up, such as Nuegra and Chikchikee, which are manufactured domestically.
Doctors say the drugs’ effectiveness varies in each case, depending on what the patient wants. “It is too early to say which is the best,” says Dr. Lee of Samsung Cheil Hospital. “Each person has his own preference, whether one is into longevity, in which case it would be Cialis, or whether one is into a fast erection, it would be Levitra. Currently, Viagra holds about 95 percent of the market share in Korea. The latest trend is to try new products other than Viagra, out of curiosity. Which pill is more effective is completely subjective,” says Dr. Lee.
Dr. Park agrees that the drugs can be effective, but says that “in most cases, these sex drugs have a sort of a placebo effect, about 30 to 40 percent of the time.”
One Korean man who has found success with the ED drugs is Hwang Hoe-dong. The 55-year-old was first treated for erectile dysfunction in 1997. He was prescribed Viagra, but red spots appeared on his face so he tried Muse, a type of urethral insertion but it was no longer sold. He tried clinical injections into his penis, but the pain from the needle was unbearable.
When he heard about newer drugs, Mr. Hwang tried Cialis and found that not only did it result in no erection, but it also caused red spots to appear on his face. He then tried Levitra, which made his nightlife much more satisfactory. “Even though I have slightly high blood pressure, I have no side effects from taking Levitra. An erection lasts two to three hours and what’s more, my partner is very happy.”
Dr. Lee predicts that the increase in ED drugs will be a long-term trend. “With a growing elderly population across the world, the number of patients asking for ED treatment drugs will become larger. The market will no doubt grow as well.”
However, putting aside the benefits of drugs and alternative remedies, medical experts concur that those suffering from impotence should find relief in a few simple rules: There is nothing better than exercising, quitting smoking and drinking, and getting plenty of rest.

by Choi Jie-ho