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There's no question that for millions of men, most of whom are above age 40, the price is worth it. Viagra and other ED drugs work for approximately 70 percent of the men who try them.
According to the Massachusetts Male Aging Study conducted in 1994, age is a leading indicator for ED. The study examined men ages 40 to 70 and found that 52 percent experienced some degree of impotence, ranging from mild to severe. The severity increases with age, with just 5 percent of men in the 40-year-old bracket reporting complete impotence, compared with 15 percent of the 70-year-olds.
Viagra works by permitting smooth muscle tissue within the penis shaft to relax, increasing blood flow into the organ. This in turn crimps the veins that allow blood to flow out of the shaft, and voilà! Instant woody. Researchers discovered the effect while testing sildenafil citrate as a treatment for angina. Impotence can be caused by vascular disease, diabetes, certain cancer treatments and high-blood-pressure medications -- conditions usually experienced by men over age 50 that reduce the blood flow to the extremities.
Nevertheless, Pfizer and other pharmaceutical companies have been marketing their wares to a progressively younger and less impotent audience. Crusty septuagenarian former Senator Bob Dole was Viagra's original spokesman, 41-year-old NASCAR driver Mark Martin joined the team in 2000 and 37-year-old major league baseball star Rafael Palmeiro (accused earlier this year of illegal steroid use and lying to Congress) signed up in 2002. "More than half of all men over age 40 have difficulties getting or maintaining an erection," advertises Viagra's Web site, yet the handsome stud currently depicted in the ad could easily be in his late 20s.
I'd be lying if I said such advertising hadn't had an effect on this 40-something. Even though I don't have a problem (and wouldn't tell you even if I did), I'm sitting in my doctor's office in part because I'm a rabid NASCAR fan. Others in my age group and below have been similarly affected. According to a 1998-2002 insurance-industry study of 5 million men ages 18 and older, the 18-to-45 bracket constituted the fastest-growing segment of Viagra users. Although men over age 56 filled the majority of prescriptions, the survey also found that use of the drug for "an underlying medical reason declined in all age groups over the five years," indicating the "increased use of Viagra as an enhancement or recreational agent."
One reason Viagra has become so popular with men who do not suffer from impotence is that it can decrease the refractory period -- the amount of time it takes to get another erection after orgasm. All night long becomes a very real possibility. Still, for some, enhanced performance doesn't necessarily justify the use of Viagra by those who otherwise don't have erection problems.
Roseville marriage and family therapist David Chervick enthusiastically supports Viagra use for those who medically require it but believes that what appears to be recreational use of the drug by some patients may actually be abuse. "It's not the drug," he stresses. "It's the reason for their participation in recreational drug abuse -- and it is drug abuse. It's just like any other drug they would experiment with and abuse."
Some insurance companies are leery about filling expensive Viagra prescriptions for recreational purposes, and the practice has drawn the ire of social critics as well, including Meika Loe, an assistant professor of sociology at Colgate University and author of The Rise of Viagra: How the Little Blue Pill Changed Sex in America. Borrowing a term from sociologist George Ritzer, she suggests that Viagra and other ED drugs are contributing to the "McDonaldization" of sex.
"McDonaldization refers to this idea that the ethic that underlies fast food has pervaded our culture, and so even the realm of sexuality has become McDonaldized, meaning that we want to serve it up fast and hot, efficiently," she explained in an interview with Mother Jones last year. "So, then, the question is where is the nutritional value for our souls?"
Chervick notes that the rapid pace of modern life is increasingly stressing our sexuality. "People have no downtime anymore," he says. "We are the most exhausted country in the world. We're also the most productive and the most creative, but that doesn't mean that it doesn't have an effect on family and sexual life." Instead of dealing with the issues that underlie sexual problems, now there's a quick fix: Viagra. "It's a panacea for any sexual problem. Anybody can use it, and their problems go away."
A Big Mac is the same, whether you buy it in Sacramento or Saskatchewan. Today, that goes ditto for your dingus. Says Migliaccio: "If you're fighting about money, and your sex life declines, you say, 'We're not having sex. What does that mean?' Now, someone comes in and does the job for you, masks over the underlying problem. It's good -- but is it as fulfilling as a homemade burger?"
