Holly Fletcher

USA TODAY NETWORK – Tennessee

In 2013 Medicare covered 1,591 prescriptions for erectile dysfunction treatment in Tennessee.

High blood pressure and depression can cause erectile dysfunction.

Lawmakers want men to get cardiac stress tests before and during treatment for erectile dysfunction.

Tennessee men seeking medication to help their sexual performance could face new legal and medical hurdles, under legislation penned by a pair of state lawmakers.

The bill, introduced by Rep. Sherry Jones, D-Nashville, and Sen. Sara Kyle, D-Memphis, would require men to undergo a cardiac stress test and provide confirmation from a sexual partner that the treatment is needed before a doctor prescribes oral medication, such as Viagra and Cialis. The physician would also have to wait two days after receiving the affidavit and provide a written list of the potential side effects of the drugs under SB2292 and HB1927.

A similar bill introduced in Kentucky would require a note from a spouse in addition to a sworn statement on a Bible that the treatment would be used within the bounds of marriage.That bill, introduced by a Democratic lawmaker earlier this month, was reportedly in response to a Republican measure in that state requiring women to consult a doctor before getting an abortion.

But the authors of the Tennessee bill insist their legislation is a genuine effort to protect the health of men.

Jones said protocol should be in place to ensure men are aware of their heart conditions and the potential side effects of the treatments. "One of the patient's sexual partners" would need to affirm via a notarized affidavit that the man experienced symptoms of erectile dysfunction within the previous 90 days, under the bill's language.

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"It is obvious to me that that is not what men are thinking about (their heart and side effects) when they get the prescription," Jones said. "This is a way to have them give a little thought to what they are doing and to protect them since they obviously are not thinking about protecting themselves."

The bill — which would also remove erectile dysfunction medications from the state employee insurance plan — will go before the House health subcommittee on Feb. 23. Kyle is sponsoring the companion Senate bill.

Physicians in Tennessee wrote 1,591 prescriptions for erectile dysfunction drugs in 2013, totaling $387,244, according to Medicare data. This number does not include men too young to qualify for Medicare, or men ages 65 or older on commercial plans.

Erectile dysfunction could impact more than 30 percent of men ages 40-70, according to a 2011 study from the American Heart Association. ED, as it's sometimes referred, may be caused by several problems, including depression, high blood pressure or as a side effect from other medications, according to the AHA.

Men who go to a doctor for erectile dysfunction sometimes find high blood pressure or diabetes is their underlying cause, according to the AHA. Tennessee ranked 45th for high blood pressure and 48th for diabetes in 2015, according to UnitedHealth Foundation data.

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The medications can cause a range of side effects, ranging from headache and dizziness to hearing loss, as well as long-lasting erections, called priapism.

Men who take treatment for erectile dysfunction as extended treatment would be required to see a physician for each refill, get a cardiac stress test every 90 days and have three sessions of counseling to talk about the side effects of the drug and discuss other choices, such as celibacy.

Reach Holly Fletcher at 615-259-8287 or on Twitter @hollyfletcher.