Should Viagra Prescriptions Require Wife's Permission?

A proposed bill in Kentucky would require men to consult their wives before obtaining a prescription drug for erectile dysfunction.

Kentucky State Representative Mary Lou Marzian recently introduced House Bill (HB) 396, which would place new restrictions on men seeking a prescription for an erectile dysfunction drug.

Of note, about 5% of 40-year-old men and 15% to 25% of 65-year-old men have erectile dysfunction.

Rep. Marzian has branded HB 396 as a means to promote men’s health and build awareness of the potentially dangerous side effects of erectile dysfunction drugs. The specific brand-name medications named in the bill are Viagra, Cialis, Levitra, and Avanafil.

“I want to protect these men from themselves,” Marzian told Kentucky’s Courier Journal.

Specifically, the text of HB 396 says a health care practitioner shall:

1. Require a man to have 2 physician office visits on 2 different calendar days before prescribing a drug for erectile dysfunction to him.

2. Prescribe a drug for erectile dysfunction only to a man who is currently married.

3. Require a man to produce a signed and dated letter from his current spouse providing consent for a prescription for erectile dysfunction.

4. Require a man to make a sworn statement with his hand on a Bible that he will only use a prescription for a drug for erectile dysfunction when having sexual relations with his current spouse.

To its credit, the bill does make several valid points about erectile dysfunction drugs that both prescribers and pharmacists should educate patients on before use.

For instance, HB 396 notes that some lifestyle factors such as diabetes, heart conditions, smoking status, being overweight, and drug and alcohol use may contribute to erectile dysfunction. Adjusting these behaviors alone may help reduce the need for pharmacological interventions.

A medication review may also help pinpoint the cause of erectile dysfunction, given that polypharmacy has been identified as a potential culprit. The drugs that are most commonly associated with erectile dysfunction are beta-blockers, selective serotonin reuptake inhibitors, tricyclic antidepressants, lithium, monoamine oxidase inhibitors, and any medications that interfere with testosterone.

Pharmacists should also be sure to counsel patients about the possible side effects of ED drug use, which HB396 says can range from mild headaches to more serious issues such as sudden vision loss in one or both eyes or a persistent erection that lasts more than 4 hours.

The bill is the latest in a series of bills related to sexual health in Kentucky.

An “informed consent” law, signed by Kentucky Governor Matt Bevin (R) last week, requires women to consult with a health provider at least 24 hours before obtaining an abortion.