Ten years ago, when I turned forty-eight, I went to see a urologist in order to get a prescription for Viagra. I had just started dating a woman, the second one after my divorce in 2000, and I realized that sex had changed, and maybe I needed a little help. So I looked on line and found a doctor close to where I lived, called, and made an appointment.

I went to see him on the appointed day, a small neat little Filipino man with slicked back black hair and nicely shined pointy black shoes on his neat little feet. He wore round rimless glasses and a starched white doctor’s coat. We shook hands and I sat down and he asked what the problem was.

“Well, doctor, it seems I’m having a little trouble maintaining an erection.”

“Do you have erections when you wake up in the morning?”

“Well, yeah…”

“Then you don’t have E.D.” E.D. is medical terminology for erectile dysfunction.

“But doctor, I’m forty-eight years old and I’m telling you, it’s kind of embarrassing to start something I can’t finish.”

The little doctor leaned forward at hearing this, and unclasping his hands from in front of his chest placed them palms down on the desk top in front of him.

“Listen, you don’t have E.D., what you must do is concentrate very, very, hard during the sex act, and I guarantee you it will be OK.” He’d made a fist with one hand and shook it in the air when saying this for emphasis. He was very passionate about it.

“See doctor, I was diagnosed with diabetes about twelve years ago, and I believe it’s led to nerve damage and other things that might affect my performance. I’d read up on this, I wasn’t going to walk out of the office without a prescription and I had all sorts of justifications for getting the Viagra.

He sighed, I think he knew that I wasn’t leaving without a prescription too, and reached for his pad.

“How’s your flow?”

“My what?”

“Your flow, when you urinate, is it a normal flow?” It wasn’t something I’d ever thought about.

“It’s OK, I guess. Th esame as always.”

“Good. Any burning sensations? Do you go in the middle of the night?”

“No, everything’s fine. Except for…”

“Yes, yes, I know.”

He wrote the prescription and told me to come back in six months for another. So I went home happy, and made my girl friend happy, until she became unhappy for other reasons and we both moved on.The relationship lasted for six months, as long as the first post-divorce relationship. I wondered if I would ever meet someone I would stay with for the rest of my life, or if this was the best I could hope for- short term relationships that end  when the least bit of discomfort shows up.

I went about my business as usual, and after our second meeting and second prescription (the relationship might have been over but I had high hopes and wanted to be prepared) I found that I was getting the urge to urinate more frequently than normal, and I began to worry.

I’d experienced polyuria before, when I had first been diagnosed with diabetes, and thought it was happening again. But my blood sugar was normal, I had effectively conquered adult onset diabetes. I also noticed that it took a long time to start- slow in “getting out of the gate”, as I’d heard in some movie, and that when I did get out of the gate the stream was weak, just as they say in the TV commercials. I was going to have a talk about this with the doctor the next time I went to see him.

He’d examined my prostate before, when I’d seen him that first time, but he didn’t find anything remarkable and pronounced it healthy. But things change, you can count on that.

“So, how are things?” He asked through his steepled fingers as we sat down for our third meeting.

“Well, doctor, I seem to be going to the bathroom more, and the stream seems to be weaker that normal.” At hearing this he sat up straighter, his eyes lit up and his hands went flat on the desk once more.

“Poor flow?”

“Ah, yes, I guess. Poor flow.” He suddenly jumped up out of his chair, and said “let’s have a look. come.” He walked out of the office and I followed him into an examination room.

“Please urinate into that” he said, indicating what looked to be a giant glass beaker that extended from the floor to just below my groin. It had white gradations with numbers painted on it going all the way up, and there were wires and tubes attached to it, leading to a computer. I wondered if anyone ever filled it, I knew I couldn’t ever hope to. The doctor walked out of the room and I unzipped my pants and started to make a noble attempt at fulfilling the doctor’s request. I dribbled as much as I could into the beaker, watching as numbers came up on the computer. I finished and zipped back up. The doctor walked back in holding a long strip of paper, like the old stock marked ticker-tape.

“This is very bad” he pronounced.

“Here, lie on this table and pull your pants down.’

I did as he instructed. He turned on a machine with a screen, and started spreading some kind of gel on my lower midsection.

“This is a sonogram. I’m going to examine your bladder.”

The gel was cold, the probe was even colder. I lay still and watched out of the corner of my eye as the doctor peered at the screen while running the probe all over my stomach.

Suddenly he made a sucking sound with his teeth, “tsk, tsk, tsk.”

“Oh, nooo, you are not emptying your bladder!” I felt like a naughty child that was refusing to eat my peas. He stopped probing and handed me a paper towel.

“Wipe yourself, and let’s have a lok at your prostate.” I did as I was told and assumed the position.

“Oh, your prostate is defiantly enlarged.” We went back to the office where he wrote a prescription for flomax, which I my insurance does not cover. The on line pharmacy gave me a generic.

A couple of years later he recommended Propecia in addition to the Hytrin (flowmax) I was taking. We had a conversation on how it would diminish my sex drive, diminish my semen production, etc. At my age I could care less about my semen production, but I wasn’t happy about the diminished sex drive. I went home with my new prescription and did some on line reading.

There were dozens of men who’d claimed their penises and testicles had shrunken, and how they had developed permanent E.D., or total loss of libido. Scary stuff to someone who had just remarried.

My new wife and I had actually been introduced by that first post-divorce woman, a mutual friend named Beth. I discussed my fears with Danusia, and she said it was my decision, but not to believe everything I read on the internet. I figured I would try it, and at the first sign of shrinkage I would stop taking it. Beside, I found out that Propecia is also sold as Rogaine, and as a man in his fifties’ starting to lose his hair that may not be a bad side effect.

I have been on it for about five years now, and I have to say not much has changed. Sure, my libido isn’t what it used to be, but isn’t that a part of the aging process? My body parts are still the same size, including the prostate, and my PSA is good. I’m also happy to report that the last time I saw my brother, who is five years my junior, I marveled at how much less hair he has than I.

So, if you are a guy who just heard from his doctor the about the dreaded Proscar, take heart. I used to have a therapist who once told me, “if you read the warning label on a medication, it will say: May or may not cause the following side effects.” Just focus on the may not part and you will be OK. I’m glad I could at least concentrate on that.