It may be the cure for many sexual problems, but will Viagra get to the root of sexual relationships? Jennifer Steinhauer of The New York Times and David Shapshak report
Viagra, the miracle impotence drug, may kickstart men’s libidos but it’s not the cure-all for dysfunctional relationships. While millions of men around the world have clamoured for Pfizer’s little blue “miracle” pill, urologists have warned that some impotence problems may have other origins.
For instance, a couple from Queens, New York, seemed like perfect candidates for Viagra. They have been married for 30 years, and he began having trouble achieving an erection a few years ago.
While unhappy about it, the husband (59) had learned to see some good in it. “My eye doesn’t wander anymore,” he said, “because I can’t do anything about it.”
And though the woman (53) said she “could not imagine staying in a relationship without sex”, she, too, had reconciled herself to having other kinds of intimacy and other forms of sex.
Viagra would appear to be their ticket back to a more conventional sex life. But, like many couples contemplating Viagra, the two are divided about whether or not to try it: while he is looking for a medical panacea for a physical problem that often comes with age, she has long wondered whether the problem might be better addressed on a therapist’s couch than in a doctor’s office.
In South Africa, the drug is three- quarters of the way through the Medicines Control Council (MCC) trials and is likely to be available by the end of August or mid-September. However, the cost of the pill is likely to escalate because of the decreasing value of the rand and the prescription drug will probably not be paid for by medical aid schemes.
About three to five million South African men suffer from impotence, which can also be caused by diabetes and chemotherapy.
A few months ago, Viagra was being promoted by everyone from urologists to drug company analysts as the solution to millions of couples’ sexual problems. The drug flew off pharmacy shelves in the United States and is widely available through the Internet.
But therapists and experts on sexuality are finding that Viagra and other impotence aids may actually throw into chaos relationships that have fallen into their own routine, sexual dysfunction and all.
“Erectile problems don’t happen in a vacuum, they’re always in the context of a relationship,” says Dr David Smart, a Johannesburg urologist involved in the clinical trials for Viagra’s approval by the MCC.
The most common problem, experts say, is that men hope to treat their impotence as a simple mechanical issue, while women tend to want to address the emotions related to impotence. In other cases, a man and woman are forced to confront their divergent views about what it means to have sex and how often they want to have it – issues that impotence had rendered moot.
The result is that many couples are finding that a solution to what they thought was a medical problem may uncover myriad other issues in the relationship.
“We are in a very high-tech society and people are used to having things done very quickly,” said Eileen Palace, director of the Centre for Sexual Health at Tulane University Hospital in New Orleans, US.
“We saw in the 1960s how the pill could control biology. Later, we saw how to control infertility. People want a simple, easy, fast solution. And many physicians assume that just because there is a physical problem means there is no psychological cause.”
Urologists interviewed for this article said they had been writing Viagra prescriptions by the dozens, many for patients who had never before said they were impotent. Some had not even confided in their partners. Instead, they simply avoided sex.
“The guy sees himself having trouble, and, out of embarrassment and lack of communicativity, he says, `I am going to sleep in the other room,”’ said Dr Walter Bortz, a geriatrics specialist at the Palo Alto Medical Foundation, California.
“The wife thinks he has a girlfriend. And it becomes a gulf that enters a well-cemented relationship, because egos get in the way.”
When the possibility of sex resurfaces, a couple is often at a loss. They never talked much about their problems before, and now they have no idea how to approach the change. In the meantime, all the issues that contributed to the impotence or resulted from it have been long swept under the rug.
“When someone hears about Viagra, they are expecting to get rid of their sexual problems,” said E Douglas Whitehead, director of the Association for Male Sexual Dysfunction, New York. “But there are many issues that affect desire: life stresses, the stock market, other issues. But most of the time, people don’t talk about those problems … They think Viagra will address them.”
Doctors also warn that the men most in need of Viagra are likely to suffer from some kind of heart disease which causes their impotence. If these men are already taking nitroglycerine or other nitrate drugs prescribed for heart disorders, they may put themselves at risk. At least 16 people have died, allegedly from taking Viagra in conjunction with these heart drugs.
Pfizer, the pharmaceutical giant which developed Viagra after heart patients discovered its erection-producing side- effects, is to take the unusual step of briefing doctors on the hazards of the prescription drug.
But for those who do take it, Viagra has one amusing side-effect: users tend to see the world with a blue tint – its active enzyme is similar to one used in the eye to register the colour blue.