Blue Valentine

  • Ask Dr G
  • Sunday, 16 Feb 2014

The blue pills and the class of medications called PDE5-I are quite effective in treating men with Erectile Dysfunction (ED). 

“Love is a canvas furnished by Nature and embroidered by imagination”  - a quote from Voltaire that can make your Valentine glee with a rosy blush.

This year is a very special 14th February. Valentine’s Day coincides with Chap Goh Meh (15th day of the Chinese New Year) observed by the Chinese community to be the equivalent. Such auspicious alignment of the twin celebrations of passions apparently only materialises every 19 years.

Truthfully, I could not find any evidence of such historical documentation of the “Chinese Day of Love”. Is this another excuse for us to celebrate love? I am not complaining! 

Well, the origin of the Western Valentine’s day is often challenged as well. Apparently, the first recorded association of Valentine’s Day with romantic love is by Geoffrey Chaucer in 1382. “For this was on seynt Volantynyns day, when euery bryd comyth there to chese his make”. It is difficult to speculate whether birds do mate in February back in 1400. Many also dispute such celebration in the 14th century. 

In modern times, the first mass produced valentines of embossed paper lace were printed and sold by Esther Howland in 1847. I guess the rest is history.

The US Greeting Card Association estimates approximately 190 millions valentines are sent each year in the United States. In the digital age, billions more message of love are conveyed digitally.

It is obvious, Valentine’s Day has become a commercially driven entity. The gift of love has become synonymous with gifts such as roses, chocolates and even diamonds.    

I cannot help thinking of an entity that should really be associated with this celebration of love. Yes! We are talking about the “blue diamonds” that help couples to celebrate intimacy between the sheets. 

I recently had a patient who visited the clinic after many years of observation for his prostate issues. Encik Aziz is 56 years old and has been having trouble with an enlarged prostate.

The treatment of this ageing problem was initially medication. The efficacy of the tablets dwindled after a year and he opted for the operation (Trans Urethral Resection of Prostate, TURP). Although the surgery had served Aziz well, he was left with the unavoidable complication of mild Erectile Dysfunction (ED).

On many occasions, I had attempted to propose appropriate treatment for the ED, but he was simply too embarrassed to take up the offer, and would usually brush off the suggestion. After a year of follow up, Aziz finally built up the courage to ask me for the blue pills at the end of the consultation.

Typically, a man who ask for the ED treatment will have the usual questions such as: “Are they addictive? Can you built up tolerance? Can I go blind? Will this be the last pill, I will ever take in my life?” And of course, Aziz was no exception. Interestingly, Aziz asked the right question: “Will it work on me?”

The blue pills and the class of medications are called PDE5-I (Phosphodiesterase 5 Inhibitor). Currently, there are a few in the market including Sildenafil, Tadalafil, Verdenafil and Udenafil.

Most of these drugs have been around in the market for more than 15 years and are supposedly the most scrutinised class of medications.

The mechanism of action of the medication is very simple; the active ingredient has the capacity to prevent the degradation of neurotransmitters that help to dilate the blood vessels in the penis. Hence such action will prolong blood flow and enhance erection. 

Of course, with such plain process of action, the side effects of addiction and tolerance are non-existence. With the appropriate assessment by the doctor, the risk of sudden death is negligible. On the other hand, the effectiveness of the treatment can be as high as 80%.

The interesting observation I’ve made for men who had been given the blue pills is that they would not take them immediately. Many tend to conceal the medication from their partners for weeks before they decide to have a go.

On this occasion, Aziz’s partner “exposed” the “secret medication” and confronted him. The wife was upset and suspicious as the issues and treatment were never discussed between them. Obviously, she demanded to confront the prescriber, me! 

In the clinic, the couple had more open discussions on Aziz’s self-esteem, libido and duty as a husband. They both felt that there had been a distance and “cracks” in the relationship since the operation. 

At first, both husband and wife felt awkward about discussing their bedroom matters with each other despite 40 years of marriage, but the couple were happy because the blue pills had delivered the “promised” with minimal side effects. 

Dr G was relieved that the meeting was uneventful despite the initial hostility. I guess, when there is a breakdown in communication, there is often a lack of trust.    

The sad fact is, despite 16 years of serving impotent men, the blue pills are still the most “misunderstood” and “criminalised” treatment modality for sexual dysfunction. 

I guess if Valentine’s Day is evolving, the treatment of ED is equally changing in a fast pace. Perhaps, the next time when the Eastern and Western days of love are aligned on the same day, we will be seeing phrases such as “Roses are Red and Tablets are Blue” and the blue pills perhaps will be considered more as the “gift of love” rather than “the source of all evil”. 

> The views expressed are entirely the writer’s own. 



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Dr George Lee

Dr George Lee

Dr George Lee is a consultant Urologist and Clinical Associate Professor whose professional interest is in men’s health. The column “Ask Dr G” is a forum to help men debunk the myths and taboos on men’s issues that may be too “hard” to mention. You can send him questions at


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