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Ramona came in for a pelvic exam complaining of pain in her vagina that was made worse by urination. She was examined by Gregory House, who found vaginal tearing. Ramona admitted that her husband Myron had recently started using Viagra and his overeagerness probably led to the tearing. Dr. House prescribed hormone replacement to increase vaginal lubrication. However, Ramona complained that she wished Myron wanted sex less and perhaps he could be prescribed something less potent. Dr. House suggested she just say no once in a while, but Ramona insisted that the old age facility she lived in was "worse than high school" and that if she didn't have sex with Myron, he would just find someone else.
Later on, Myron came to Dr. House, telling him Ramona told him to see him about filling his Viagra prescription. Dr. House wanted to avoid the issue, but he found Myron complaining that he felt too much pressure to perform and needed the drugs. When he told him to talk to Ramona about it, Myron insisted that Ramona would take that as an indication he wasn't interested any more. Dr. House realized that the couple was putting too much pressure on each other, so he went to Marco the Pharmacist and asked him about what drug might look like Viagra, but would be harmless in normal doses. Marco suggested some blue colored acetaminophen and House wrote Myron a prescription for that.
Later, both Myron and Ramona came to confront House that the pills weren't working any more. He told them both that the other had complained about having sex too often. At first, both denied it, but eventually they admitted to each other that they just wanted to spend time together. At that point, House noticed that their wedding rings were not only different styles, they were made of different metals. He suddenly realized they weren't husband and wife, although they were both married to other people - they were having an affair. Once again, they denied it at first, but they had to admit Dr. House was right.