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The Viagra Revolution

"But the effect of Viagra is so far beyond its pure medical indication. The effects are psychological, they're attitudinal, they're behavioral and they're societal. ... Viagra has turned out to be a window into certainly the minds of the psyche of men but also of women and what it is that sex means for us."

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April 22 ? It's not just 50-something men needing a little boost who have sought out Viagra and its newly approved cousins.

It's also 18-year-olds with performance anxiety (not to be confused with actual performance problems), 38-year-old music stars overwhelmed with opportunity and 90-year-olds who want to be virile forever. In fact, there seems to be a veritable stampede toward the magic pills.

According to a recent issue of the Harvard Health Letter, the number of men diagnosed with erectile dysfunction in the United States has increased by 250 percent since Viagra was approved in 1998. Two similar drugs, Levitra and Cialis, were approved in 2003.

But is sex being confused with sexuality?

Viagra seems to be changing not only the firmness of a man's penis; it also seems to be changing the way people think about relationships.

"Viagra is really one of the most remarkable advances in medicine in the last 50 years. It's remarkable," says Dr. Abraham Morgentaler, an associate professor of urology at Harvard Medical School and author of The Viagra Myth: The Surprising Impact on Love and Relationships.

Added Morgentaler: "But the effect of Viagra is so far beyond its pure medical indication. The effects are psychological, they're attitudinal, they're behavioral and they're societal. ? Viagra has turned out to be a window into certainly the minds of the psyche of men but also of women and what it is that sex means for us."

Viagra as 'Insurance'

There are those who really do benefit from Viagra. In his book, Morgentaler discusses the case of George, 58, and his wife, Marie (not their real names). Tests revealed that George was indeed having trouble getting firm erections. It was not all in his head. Viagra fixed that problem and gave new life to their relationship as well.

Other patients, however, want a Viagra "six pack" simply as insurance.

Even men in the traditionally virile, 18-to-25 age bracket are hooked. "The area of greatest concern is the young men entering the dating scene," Morgentaler says. "That age is characterized by a certain lack of confidence in one's ability."

According to Morgentaler, there's a fair amount of anecdotal evidence pointing to Viagra use among young men who don't have any physical problems. One younger patient asked Morgentaler for a prescription because "I feel like it gives me an edge."

"I think, for them, it raises the bar. Because my buddies are using this, do I now need to be pharmacologically enhanced in order to measure up," Morgentaler explains. "If a man feels he needs to take a pill in order to be adequate, then I think there is an opportunity lost to be loved and accepted for who he is."

This is precisely what happened to "James," a 38-year-old, ponytailed recording artist who was taking Viagra every time he had sex because it gave him "total confidence." Given his status in Los Angeles, James needed to summon up this confidence quite a bit.

After a while, though, he started feeling like he couldn't have sex without the little blue pill. And a little while after that, he fell in love with "Sara," who accidentally discovered the pills in a jacket pocket. "It's amazing she didn't find them earlier. I had Viagra pills stashed everywhere just in case," James said. Soon both James and Sara were seeking counsel from Morgentaler.

"The Viagra experience has shown us [that] men care deeply about being a good sexual partner," Morgentaler says. "They want not just to be adequate but to be admired. Viagra can play into that."

Not Always a Fix-All

But it also opens a window on how women feel about their sexual appeal.

"The other thing we've learned is how important the erect penis is for a woman's sense of her own sexual appeal," Morgentaler says. "When a woman finds out a man has been using the pill secretly, there are two main reactions. One is fury about the dishonesty aspect and the other is, 'I thought it was me that was turning you on. Why do you need a pill to have sex with me?'"

How much of the problem is physical and how much is the relationship or other emotional issues is not always clear. And Viagra may not be the solution to either, as Ed Buckner, 50, of Boston, found out. When he was in his mid-40s, Buckner noticed he was having a "performance issue."

Buckner talked to his general practitioner, who immediately wrote a prescription for Viagra. Buckner's response: "Wow, I was hoping you would say that. This is just going to fix everything."

It didn't. "As much as I wanted to be aroused, I wasn't," Buckner recalls.

After a battery of tests (including visits to a psychologist), Morgentaler diagnosed low testosterone levels. Now Buckner gets twice monthly injections and, he says, "I have my life back."

More information

For more on erectile dysfunction, visit the National Institutes of Health or the American Foundation for Urologic Disease.

Posted by thinkum at April 23, 2004 11:43 AM