Brazilian army allegedly purchased over 35,000 Viagra pills, raising questions

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Next October, Brazil will hold a presidential election. It’s an election with an “l” and not an “r”. Thus, critics of the current Brazilian President, Jair Bolsonaro, wonder why the Brazilian army has bought 35,320 Viagra pills since 2020, according to a report by Universo Online (UOL). You can imagine how such a large purchase would raise questions and more. For example, UOL quoted Brazilian lawmaker Elias Vaz as saying, “We need to understand why the Bolsonaro government is spending public money to buy Viagra, and for such a high amount. The armed forces receive thousands of Viagra pills. The company deserves an explanation. The Brazilian military is said to have purchased sildenafil, which is the generic name for Viagra, in 25mg and 50mg doses through eight procurement processes since 2020.

Why do people stand up and question such a purchase? Well, sildenafil is best known as an erectile dysfunction (ED) drug. If you were to ask “what is erectile dysfunction” and claim that you have never heard of or seen such a thing, this is what erectile dysfunction is. This is when a penis struggles to achieve and maintain an erection. The Mayo Clinic website states that the recommended dose of sildenafil for the treatment of erectile dysfunction is 50 mg for adults under 65 and 25 mg for those 65 and over. Typically, you want to take the pill an hour before your planned intercourse, although you can stretch it out, so to speak, from 30 minutes to 4 hours before you do the deed. Before you take a pill, make sure that sex is really going to take place. Sildenafil is not the kind of thing you should be taking without a real plan in place, just because today might just be the day.

That being said, it’s hard to understand why the military would need so many doses of sildenafil. According to UOL, the Brazilian Navy and Army justified the purchases by saying that the drug can be used to treat pulmonary arterial hypertension (PAH). HAP is certainly a difficult problem in a different way. This is when there is a rise in pressure in the arteries that bring blood from the heart to the lungs. Over time, this condition can “cause stiffness, swelling, and thickening of the walls of the arteries,” in the words of the Mayo Clinic website. As a result. the right side of your heart has to work harder to pump blood through these arteries and eventually malfunctions. Chronic PAH is a very serious condition and can very easily lead to premature death. There are a number of possible causes of PAH, ranging from high altitude, congenital heart defects, exposure to drugs or toxins, connective tissue disorders, HIV infections or schistosomiasis.

Doctors have indeed used sildenafil in some cases to treat PAH. This is because sildenafil can inhibit phosphodiesterase enzymes in the walls of blood vessels, causing blood vessels to relax and widen, as I described last week for Forbes. This can cause more blood to flow through your penis and into your pulmonary arteries, two parts of your body that you probably don’t tend to mention together. Here is a video from the Mayo Clinic covering the use of these erectile dysfunction drugs to treat PAH:

Studies have suggested that sildenafil may also help alleviate high altitude induced PAHs.

Before you start taking Viagra to keep your pulmonary arteries from becoming “stiff, swollen, and thick,” keep in mind that “PAH is a rare disease found in 15 to 50 people per million in the United States. United States and Europe”. the words of Deborah Jo Levine, MD, FCCP writing for the American Journal of Managed Care (AJMC). Therefore, there are probably not a large number of Brazilian servicemen suffering from chronic PAH. Even if you argue that sildenafil should help alleviate temporary high altitude induced PAHs, it’s not as if most sildenafil is intended for military personnel likely to operate at high altitudes. According to the UOL article, 28,320 pills went to the Navy, meaning a large portion of the sildenafil may have gone to sailors. Presumably, many members of the Navy work at sea level. And sea level tends to be, you know, sea level and not mountain tops. By comparison, the Army and Air Force seem to get the shortest portion of purchases, each only getting around two thousand pills.

Also, the 25mg and 50mg doses purchased by the Brazilian military seem a bit, shall we say, large for PAHs. Take a look at what the Mayo Clinic has recommended for treating adults with PAH: 5mg or 20mg of sildenafil three times a day for adults, with each dose about four to six hours apart. Something that is 5 or 20 is not 25 or 50, no matter what angle you look at it or in any lighting.

It remains to be seen what other explanations for Sildenafil purchases will emerge. Will the Bolsonaro administration be able to provide an important reason rather than an impotent one? Will there be sufficient justification for this to be a standing order? Or will this be considered a case of erection fraud?

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