Why young men are popping Viagra to give themselves a lift

The Ottawa Citizen

July 4, 2004

More and more healthy men are taking the erectile dysfunction pill to help overcome performance anxiety brought on by sexually aggressive women, Sharon Kirkey reports.

Forget Bob Dole or Guy Lafleur. The next pitchman for Viagra could be Macaulay Culkin.

Lured by the idea that fail-safe and firmer erections can be found in a pill bottle, younger and younger men are asking doctors for erectile dysfunction drugs even when their sexual "functioning" is normal.

Older teens and men in their 20s are taking Viagra or newer erection remedies routinely before dates or parties, doctors report. Other younger men are seeking impotence pills to ward off performance anxiety and cope with a new generation of sexually aggressive women who, simply put, are behaving more like men.

"Guys come in and, if they're single or dating, they say, 'I can't believe how aggressive women are now. They know exactly what they want sexually. They tell me exactly how they want me to do it -- and I'm supposed to do it,' " says Dr. Abraham Morgentaler, an associate clinical professor of urology at Harvard Medical School and author of The Viagra Myth: The Surprising Impact on Love and Relationships.

"That can lead to more anxiety and certainly performance anxiety. There are some guys who don't need the Viagra, they just feel better having it in their wallet."

Meanwhile, men in their 30s and 40s are taking the drugs -- sometimes secretly -- for improved rigidity, because, according to Dr. Morgentaler, men equate firmness with greater masculinity. Others are seeking shorter "refractory periods" -- the time it takes to get a second erection after orgasm.

Whatever the reasons, the rise in the use of erectile dysfunction medications in the young is occurring as drug ads become sexier and more hip. Dr. Morgentaler points to a recent ad for Levitra, one of two new post-Viagra erection drugs.

"There's sort of a sexy woman, a little bit younger, she looks like she's in her late 30s, and the guy looks like he's in great shape and younger too. And they're talking about (sex) like they just want to have fun."

It's an entirely different flavour from Bob Dole's 1999 commercials for Viagra, when the silver-haired former U.S. senator encouraged like-aged men to "talk to your doctor" about erectile dysfunction.

Advertising is shifting "from any notion of a medical condition or disease," said Dr. Leonore Tiefer, of the New York University School of Medicine, in a recent interview with the New York Times. "Now you take these drugs because you're less perfect than you want to be. It's like teeth whitener."

When Viagra hit the market five years ago, the only men drug manufacturers targeted -- and doctors were comfortable treating -- were those with a physical basis for their erection problems.

But there's such easy access to the drugs via the Internet that men don't even need to see a doctor face-to-face.

According to IMS Health Canada, which tracks prescription drug use, in the four-year period before Health Canada green-lighted Viagra in March 1999, just over 175,000 prescriptions were filled for older forms of erectile dysfunction treatment.

Last year, 1.3 million erectile dysfunction "scripts" were dispensed across Canada. Viagra accounted for 90 per cent of them. About 800,000 visits for ED were made to doctors in Canada in 2003, six per cent by men younger than 39.

In the U.S, the number of men diagnosed with erectile dysfunction has soared 250 per cent since Viagra hit the market.

The different drug brands work essentially the same way. In order for an erection to occur, the nerves release nitric oxide, which signals tiny blood vessels in the penis to dilate, enhancing blood flow. Nerves can be damaged by diabetes, spinal cord injury, multiple sclerosis or even simply aging. The pills work by amplifying that signalling pathway.

The quality of a man's erection begins to decline in his 20s, explains Dr. Alvaro Morales, professor of urology at Queen's University, who is also seeing much younger men in his practice for a range of sexual problems.

"Teenagers have probably the best erections a man will ever have."

ED drugs may make a healthy young man's erections slightly harder and longer lasting, but Dr. Morales doubts whether they would see a physically noticeable difference.

Still, the brain is the most important sex organ. "They feel better, because they've taken the 'wonder' drug," Dr. Morgentaler says.

For him, the safety issue surrounding recreational use of ED drugs isn't a big concern, so long as the man isn't using nitrates, a heart medication. The drugs can also be dangerous when mixed with Ecstasy and other libido-sabotaging "rave" drugs.

But as science gets better at improving erections, Dr. Morgentaler worries people will lose sight of what's most important for a solid relationship -- acceptance, honesty and perhaps love.

"I don't think rigidity of the penis fits into that."

 The Ottawa Citizen 2004