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In early 2005, the FDA announced that 50 men who had used Viagra had become blind due to a decrease in the blood supply to the eyes, a condition known as non-arteritic ischemic optic neuropathy. However, these men also suffered from diabetes or heart disease, which can cause both impotence and blindness. Despite the seriousness of the matter, dark jokes circulated claiming that what your mama always told you about sex had turned out to be true.
By far the most frightening side effect that can be caused by Viagra and other ED drugs -- particularly in individuals who up the dose beyond doctor-recommended levels -- is priapism, an erection lasting four hours or longer. What at first sounds like a benefit can actually lead to permanent penile damage and a frightening series of emergency medical procedures. First, a drug such as pseudoephedrine is administered to decrease the flow of blood to the swollen member. If that doesn't work, the blood is drawn directly out of the shaft using a large needle. If that fails, a shunt is installed. The final option is man's greatest fear this side of death: potential removal of the damaged organ.
Fortunately, such extreme cases appear to be rare. By and large, the physical benefits of Viagra far outweigh the side effects for most users. Psychologically, however, the impact of Viagra has been more mixed.
On the plus side, impotence is no longer the taboo topic it once was. "It's an OK thing to talk about, and that's good," said Migliaccio. "It's OK for men to have a problem. It's not an un-masculine thing." As some ED drug commercials point out, "Even your co-workers will still like you."
While Migliaccio believes that many feminists appreciate the fact that talking about male sexuality in public has become more acceptable, the downside is that Viagra reinforces the attitude that sex is a biological issue and not a social or psychological issue. "It perpetuates this myth that there is only one kind of sex: male penetration," he said.
As marriage and family counselor Chervick points out, the sexual desires of both men and women go beyond the mere mechanics of the act. Many people lack romantic skills. True intimacy, which he defines as "deep emotional love," often must be learned. Yet, since the advent of Viagra and other ED drugs, Chervick says he and his colleagues have seen a decline in couples seeking help for such issues. The belief is that a pill can solve all sexual problems. That's not necessarily true.
"As the baby boomers age, these medicines are being used and becoming more useful," Chervick said. For those suffering from impotence caused by real physical problems, such drugs are indispensable. But those using Viagra recreationally have an option. "Some patients fear that we're all going to be on medication when we're old. I say that to point out we don't have to jump aboard when we're young."
There are signs that the public is beginning to heed such messages. The New York Times recently reported that this year, sales of impotence drugs have declined for the first time since Viagra was introduced in 1998, despite the $400 million or so that pharmaceutical companies spent on advertising. The Times speculated that disenchantment with side effects and high prices may account for the decline, but perhaps there's another explanation. Maybe people are beginning to realize there's no such thing as a magic bullet.
Not that any of this information has dissuaded me from seeking ammo for my own love gun. Waiting on the examination-room table, I squirm a little, slightly excited about the enhanced sexuality I'll soon be experiencing. A little too excited, actually, considering the lie I'm about to tell. Hopefully he won't look. I'm not exactly keen about showing my kit to strangers.
He enters the room, staid, doctor-like, dressed in the traditional white smock with a stethoscope hanging around his neck. We exchange perfunctory greetings. My appointment isn't for Viagra; I have other issues, 45-year-old issues. A pain in my hip. A funny mole. He refers me to X-ray for the hip and says the mole isn't cancerous. The table is cold under my butt as I attempt to formulate my phony request.
"Doc, I was wondering if you had any of those Viagra samples."
"Oh really," he says doubtfully, eyebrows jutting up. Damn. He's on to me already. "Why is that?"
"Well, it just doesn't get as hard as it used to," I fib. "Not that it doesn't get hard. It gets hard, just not as hard as it used to." I'd decided against claiming total impotence, in part because I don't want to be referred to a urologist for a bunch of humiliating tests but also because I just couldn't admit to a serious deficiency with my manhood, even a made-up deficiency. Immediately, I realize that hedging was a mistake.
