sex work

My paternal Grandfather died of Alzheimer’s disease before it had that name. He was 82 and the last five years of his life were among the most horrible I’ve witnessed. Last year, my Uncle Joe also died of complications from Alzheimer’s. He was 89 and had been much healthier than Granddaddy, but the last few years of his life weren’t any walk in the park, either. Poppa was 72 when cancer took him, so we don’t know if there were signs of Alzheimer’s in his future or not; there were other medical priorities. Still, it seems obvious that Alzheimer’s runs in the family. Therefore, it makes sense to take reasonable precautions against it.

A Washington Post article from February of this year came across my feed this week with an interesting premise: Viagra may reduce the frequency of Alzheimer’s disease in men over the age of 50. Researchers at University College London studied 270,000 men over the age of 40 between 2000 and 2017. All had been diagnosed with erectile dysfunction. During the study, 1,119 of the men were diagnosed with Alzheimer’s disease. A pattern was noticed: The men who were prescribed Viagra or a similar drug had an 18 percent lower risk of developing Alzheimer’s disease, compared with men who weren’t given the medication.

But wait, there’s more: “The researchers also found an even larger difference in men who appeared to use Viagra more often. Among the highest users, based on total prescriptions, the risk of being diagnosed with Alzheimer’s was 44 percent lower.”

So, to be perfectly clear, the study appears to indicate that, if you have erectile dysfunction and take Viagra, and have sex regularly, you may reduce the chance of getting Alzheimer’s by as much as 44 percent.

Maybe. The study shows an association between Alzheimer’s and Viagra use; it does not show cause and effect. Men who have erectile dysfunction and are prescribed Viagra are told that a) if you take the pill, you need to have sex, and b) don’t take more than one pill a day. To have sex with the level of frequency that might result in a significantly lower risk factor for Alzheimer’s requires a pretty decent amount of physical activity. Physical activity has a higher association with lowering the risks for Alzheimer’s. Therefore, it may be that running around the block each morning helps just as much as having sex, though, I would argue, that one is definitely more fun than the other.

How is this possible? Not surprisingly, this was never the anticipated outcome. Sildenafil, the generic name for Viagra, was developed by Pfizer as a heart medication. During clinical trials for the drug, some men reported that taking the pill resulted in getting an erection. There was no way in hell that Pfizer was going to pass up that marketing opportunity.

For both heart and ED issues, Sildenafil works by increasing blood flow throughout the body. It is also used to treat pulmonary arterial hypertension in both men and women. We’ve known for a long time that there’s a link between erectile dysfunction and coronary artery disease. We also know for certain that there is a link between increased blood flow and certain kinds of dementia, including Alzheimer’s. This study shows a significant association as to warrant additional, focused study as to whether there is a direct cause and effect of the medication.

However, the study also raises a lot of questions. The one bugging me most relates to men as they age. For a 40- or even 50-year-old man to have sex on a regular basis doesn’t seem like that much of a stretch. Men of that age are more likely to be in a relationship (for the third or fourth time) and it makes sense that they would be sexually active.

Once we get over 60, though, the entire environment begins to break down. Other diseases, like cancer, interfere with one’s ability to be active. Partners die and finding new ones becomes increasingly difficult. Body parts, such as knees and hips, begin to give out, and replacing them seldom results in a full range of motion.

There are also questions on the sex side of the equation. Is jerking off enough, or do you need to involve your body in the act fully? Does it matter who’s on top or how many positions are used? Who wakes up for the 3:00 AM feeding of one of those little swimmers gets through?

If a direct correlation between Viagra and treating Alzheimer’s disease can be established, can a sex worker then be prescribed as a medical necessity? Would Medicare/Medicaid pay for it?

I agree that a great deal of study needs to happen, and I would hope that it began a couple of weeks ago. In the meantime, I would like to volunteer myself for additional personalized study. Who wants to help?