A bigger boing!

In 1998, Pfizer introduced a little blue pill called Viagra. Now any man can achieve erection perfection. But is that a good thing?

Photo Illustration by David Jayne

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Everybody wants some. I want some, too. That’s why I’m perched on an examination room table, head bowed, shoulders slumped, feigning what I imagine to be some semblance of impotence, hoping to wheedle my doctor out of a Viagra prescription.

For millions of men who actually suffer from some sort of impotence—or erectile dysfunction (ED), as it has come to be known—Viagra and similar drugs, such as Levitra and Cialis, developed within the past decade have been a godsend, dramatically raising long dormant members.

However, for millions of other men who have no trouble “getting it up,” Viagra has become the recreational drug of choice. Such usage is challenging cultural notions of sexual intimacy, the practice of medicine and what it means to be a man.

I fall into this latter group of men, those who have no problem with erectile dysfunction. Even if I had a problem, I probably wouldn’t tell you. Such is the nature of the beast, and like many men, I’ve been curious about Viagra since it hit the market. In a culture where sexual prowess is akin to currency, who wouldn’t want to fatten their wallet—particularly when everybody else is doing it? Which is why I’m perfectly willing to lie to score some little blue pills.

Since the beginning of recorded history, man has searched for the means to a more rigid tool, an aphrodisiac if you will. “Over time, there’s always been an emphasis on male sexuality,” explains Todd Migliaccio, a sociology professor who teaches a course in masculinity at California State University, Sacramento. “How do you prove your masculinity? Through sex. If you’re not having sex, then your masculinity comes into question.”

“Everyone wants to be bigger and harder,” states Dennis Hof, proprietor of the Moonlite Bunny Ranch in Carson City and a confirmed Viagra advocate. “It’s been a boon to my business.”

The little blue pill is certainly an improvement on the remedies of the past, many of which are comprised of substances most of us wouldn’t eat on a dare: centipedes, rotten fish, rhino horn, bear bile, the crushed testes of various animals. Egyptians enjoyed rubbing crocodile semen on their genitals. Herbs such as yohimbe and horny goat weed have been used for centuries and are still available at your friendly neighborhood sex shop.

In stark contrast to such natural remedies are modern medical treatments for impotence first introduced in the late 19th century. Author David Friedman, in his probing cultural history of the penis, A Mind of Its Own, reports that such treatments included shoving a metal rod into the urethra, transplanting testicles obtained from apes into humans, and shooting an electric current through the offending appendage. Shock the monkey, indeed.

Pharmaceuticals arrived with great fanfare in 1983, when Dr. Giles Brindley, at a conference of urologists in Las Vegas, intravenously injected the drug phenoxy- benzamine into his own penis and subsequently displayed his fully engorged member to a live and somewhat startled audience. Through experiments conducted on himself, Brindley had discovered that injections of the drug promoted erections that lasted for hours.

“Never before had so many penis doctors seen another man’s erect penis,” Friedman writes. “In this singular moment, human sexuality, the healing profession and man’s relationship to his penis underwent a huge transformation, the consequences of which are still being felt today.”

Or, as Migliaccio puts it, the penis became “medicalized.” Brindley’s discovery turned out to be a blessing for impotence sufferers, and injections of the drug Papaverine (it turned out that phenoxybenzamine can cause priapism, erections that last more than four hours and can seriously damage the penis) became the preferred treatment for the next two decades. In fact, according to Hof, that’s what kept the infamous John Wayne Bobbit erect during his brief stint in porn, the 1994 film John Wayne Bobbit: Uncut.

Erection Perfection
Sticking your penis with a hypodermic needle isn’t for everyone. Fortunately, an accidental discovery by scientists at pharmaceutical giant Pfizer would render such methods obsolete practically overnight. That discovery was Viagra, sildenafil citrate, which debuted in 1998. The drug immediately sparked a frenzy as male patients suffering from varying degrees of impotency rushed to their doctors in record numbers. Up to 2 million prescriptions were filled in the first two months of its release. By 2005, 23 million men worldwide had been prescribed Viagra.

Hof was among the first men to sample the drug. Penthouse magazine invited the procurer to Amsterdam in 1998 for an expense-paid tour of the local brothels. “I’m done,” Hof said after a couple of trysts. Then the reporter turned him on to some Viagra. “I ended up partying with six different girls that night.”

Pfizer, previously known as a manufacturer of cardiovascular medications, had truly struck the mother lode. With more than 100 million men worldwide estimated to suffer from varying degrees of impotence, shares in the company’s stock quickly doubled in price. The blue, diamond-shaped pills retail for $10 a pop and account for billions of dollars in annual income.

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.

Posing with a very manly machete, RN&R columnist Bruce Van Dyke finds the little blue pill can transport men back to their younger, more virile selves. “It’s one of the truly great wonder drugs of the last 10 years,” he says.

Photo By David Robert

According to the Massachusetts Male Aging Study conducted in 1994, age is a leading indicator for ED. The study examined men aged 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 to 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 voila! 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 Sen. Bob Dole was Viagra’s original spokesman; 41-year old NASCAR driver Mark Martin joined the team in 2000; 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 didn’t have an effect on this 40-something. Even though I don’t have a problem (and again, I wouldn’t tell you 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 five million men aged 18 years and older, the 18 to 45 bracket comprised 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 don’t 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. 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. Borrowing a term from sociologist George Ritzer, she suggests that Viagra and other EDs 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 magazine last year. “So then the question is, where is the nutritional value for our souls?”

A Big Mac is the same, whether you buy it in Reno or Reykjavik. 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?”

In Loe’s view, the efficiency of Viagra replaces genuine intimacy, reducing a man to his “erectile potential.” Men have literally become dicks, which will cause some to quip, “What else is new?” The throbbing, Viagra-enhanced penis is the new normal, leading to increased anxiety in those men who don’t measure up. In fact, researchers in Australia have found that the ubiquity of Viagra commercials down under has created sexual anxiety in men who previously suffered no such malady.

For its part, Pfizer claims that it has never marketed Viagra for recreational purposes, maintaining that the drug works only on the physical aspects of impotence and does not alter brain chemistry. Nevetheless, scoring Viagra can be as simple as popping into your primary care physician and picking up a “six-pack” sampler.

Not that a prescription is necessary to score vitamin V. A booming black market for the drug sprang into existence almost immediately upon its release. Viagra and other ED drugs of dubious purity can be purchased on innumerous Web sites, often without a prescription, for prices as high as $100 per pill. The 23 million Viagra users cited earlier are men who have obtained the drug through prescriptions. Various studies indicate that the portion of men obtaining Viagra without a prescription ranges from 57 percent to 83 percent. Therefore, no one really knows for sure how many men are using it.

Incredibly, it’s estimated that 25 percent of all “spam” consists of unsolicited Viagra pitches. I’ve been receiving a daily Viagra e-mail from one online pharmacy for the past two years; despite my best efforts, I haven’t been able to stop it. I’ve grudgingly come to appreciate the random subject lines of each missive, designed to combat e-mail filters: “Re: You speak by jerkin,” “that bring the sole” and my all-time favorite, “Jesus: Time to know.”

“The black market for Viagra is a huge, huge industry,” Hof says. “The young guys wanna be studs, they want to be heroes. If you see some young guy partying with seven or eight girls a night, you know he’s popping Viagra like Tic-Tacs.”

Penile Servitude
By now, it should be abundantly clear that men are, as Vancouver, B.C., punk rock legends The Subhumans suggested in the late 1970s, slaves to their dicks. However, the prison of the penis can be somewhat paradoxical. Spend any time in the company of men and the conversation inevitably turns to heightened tales of sexual prowess and all manner of buggery. But suggest that this prowess is somehow inflated, by, say, Viagra, and be prepared for vigorous denial or outright silence.

“Any kind of medical condition for men has always been a private issue,” Migliaccio elaborates. “It’s a breakdown of the body, and so much about being a man is, ‘What can I do?’ It’s an even greater issue when your penis breaks down.”

Many of the men I approached for this story were reticent to comment on such a delicate subject. One who wasn’t was Reno News & Review columnist Bruce Van Dyke, who’s fairly ecstatic about Viagra.

Dennis Hof, proprietor of the Moonlight Bunny Ranch in Carson City has seen a distinct rise in business and his own sex life thanks to Viagra. He says he’ll pop one “if I’m tired or if I’m partying with more than two girls in one day.”

Photo By David Robert

“It’s one of the truly great wonder drugs of the last 10 years,” he proclaims. “It’s not just good stuff. It’s fun stuff! It’s fun in the sense that it’s like taking a time capsule. Here’s a little pill that transforms you and certain physical systems back to when you were 24 years old. You’re wheeling and dealing.”

That’s especially true for the Bunny Ranch’s older clients, according to Hof.

“The old guys are back,” he says. “It’s great to see the old guys out having fun.” He says the girls first noticed the effects of Viagra when “the guys who used to come in here with their (penis) pumps no longer had their pumps.” Instead, they now crack Viagra jokes. It’s like Disneyland—a one-hour wait for a three-minute ride. Makes you harder than Chinese arithmetic.

“They’re cute,” laughs Hof, who pops a little blue pill himself, “once in a while, if I’m tired or if I’m partying with more than two girls in one day.”

Can 23 million Viagra users be wrong? Probably not, but that’s not to say that some haven’t suffered adverse side effects from taking Viagra. Two of the most common side effects are headache and blue vision shift. Hof has experienced the blue shift a couple of times and didn’t find it bothersome. Van Dyke has experienced no side effects.

After Viagra hit the market in 1998, there were widespread reports that the drug induced fatal heart attacks. However, since heart disease is a leading cause of impotence, these reports turned out to be unfounded. Rather, Viagra indirectly caused heart attacks by permitting men in questionable health to engage in the physical activity of sex.

“If you’re using this recreationally, make sure you’re not taking any blood thinner,” Hof cautions.

Earlier this year, 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 ischaemic 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 momma 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, including amputation of the damaged organ.

Fortunately, such extreme cases appear to be rare. By and large, the physical and psychological benefits of Viagra far outweigh the side effects for most users. 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 unmasculine thing.” As some ED drug commercials point out, “even your co-workers will still like you.”

Moderation is the key for Van Dyke. He’s taken Viagra 30 to 40 times since it was released, which means most of the time, he doesn’t use it. “I don’t want to get strung out on it,” he says. “You want to know that you can cut the mustard without a boost from the Pfizer corporation. I can get by, but it’s fun to be turbo-charged every once in a while. It’s fun to be a nasty force to be reckoned with.”

A nasty force to be reckoned with—sounds like fun to me. 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, considered the lie I’m about to tell.

The physician enters the room, staid, doctor-like, dressed in the traditional white smock with 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 onto 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.

“I don’t know,” he says. “I’ve got 22-year-olds coming in here asking for the stuff. You’re a pretty healthy guy. It doesn’t sound like you have too much of a problem. I’m hesitant to prescribe it to anyone who’s marginal.” He suggests I’ve been victimized by Pfizer’s multi-million dollar ad campaign before finally turning my request down. “It’s for the best.”

“It’s for the best,” I agree forlornly.

So that’s it. Later, I tell Van Dyke about my failure to score Viagra. “Man, you’ve got to find a cooler doctor!” he replies. But I’m not so sure. Perhaps it’s good to have a physician who hasn’t jumped on the pharmaceutical bandwagon. Maybe he’s ahead of the times. Besides, I don’t need it anyway. Not that I’d tell you if I did.