Twenty-five years ago, a new treatment for erectile dysfunction first appeared in Britain that went by the brand name of Viagra. Thanks to a mix of high hopes and marketing hype, Viagra was seen as a miracle pill that could transform any impotent man into a sexual superman. It gave men their manhood back and gave women their men back, for they could now enjoy sex with their once flaccid and forlorn partners.
At least that was the great Viagra dream. But has the so-called “miracle pill” lived up to its promises? It was called the pill that “changed the world” – but has anything really changed? What has been its sexual, emotional and psychological impact on British life? And is Viagra now too old to face the competition of a new generation of alternative treatments for erectile dysfunction?
Created in Britain by the pharmaceutical giant Pfizer, Viagra began life in the early 1990s as sildenafil citrate, a drug first developed as a treatment for lung and cardiovascular problems. But Pfizer’s research team accidently discovered it was more effective in promoting erections.
In 1998 Viagra – as sildenafil was now marketed – first appeared for use in Britain as a prescription-only drug and soon became one of the biggest-selling drugs of all time. It captured the popular imagination, popping up in plotlines of TV shows like Sex and The City and spawning a whole series of popular Viagra jokes. One elderly man curious about Viagra asks his friend: “Can I get it over the counter?” And his friend says: “Yes, but only if you take two.”
Back then, men who took Viagra – particularly the famous ones like Playboy king Hugh Hefner and actor Michael Douglas – were treated with a mix of envy and mockery.
Everyone had a good laugh at Viagra Man, except the older men who had suffered from erectile dysfunction. To paraphrase Wordsworth: Bliss was it in that dawn of Viagra to be alive – but to be old was very heaven! For suddenly here was this little blue diamond-shaped pill that could bring your penis back from the dead! Hallelujah!
Stories of old priapic guys dying of heart attacks while in the sack or married men leaving their lifetime partners for the first pretty face they saw became a daily feature of the tabloid press. In reality, however, Viagra was giving millions of British men relief from the shame and sadness of erectile dysfunction. Before Viagra, this condition was treated with shots of testosterone, available on the NHS.
What Viagra did was bring the whole problem of male impotence out into the open; no longer did we have to suffer in silence. This was the first step in men’s evolution from stiff-lipped stoics to being able to talk about their emotions, mental health worries, physical wellbeing and, yes, even failed erections.
How Viagra has changed our mindset
Another big change to British life brought about by Viagra happened not in the bedroom but in the mind. It changed our conception of what it meant to be an older person. Until Viagra appeared, many older men assumed – rightly or wrongly – that after 70 or 80 your sex life was pretty much over. It was time to say goodbye to wild, frenzied hot monkey sex on the ceiling and hello to a sex-free life of early nights of sweet cocoa and soft cuddles. But V(iagra)-Day had liberated older men from the limitations of our age. Sex was no longer the prerogative of youth.
But what about Viagra’s impact on women? It may have helped older men get their mojo working again, but it’s older women who have had to pay the price – or so some of them claim. That peace and serenity they could have once counted on in the bedroom after a certain age has gone: now they find sleepless nights sharing a bed with a born-again bonker.
The statistics seem to back up this story. In Britain in 2022, the over-70s received a record 282,000 prescriptions for Viagra, including 7,000 for nonagenarians. This led the journalist Petronella Wyatt to claim that Viagra has turned Britain into a “country for dirty old men”. But why is it if you’re an older man who still wants to have sex you are dismissed as a “dirty old man”? Are women who want sex after 70 “dirty old women”?
I asked a 73-year-old married woman whose Viagra-taking husband is 82. Did she consider him one of these “dirty old men”?
“That’s a very offensive idea,” she tells me. “My husband is a very loving and sensitive man. For years I had given up hope of us sharing any kind of sexual intimacy – Viagra brought sex back into our lives. And no, it’s not perfect, but compared to what it was, it’s heaven!”
Of course I’m not suggesting that the rise of Viagra Man hasn’t had its downsides. A single friend in her mid-50s tells me: “You have no idea how boring it is having bad sex with a man who can now bonk for hours. In the old days it was just three minutes of tedium followed by a good night’s sleep. Not now!” But is that Viagra’s fault or her choice in men?
Not only have older men become more open about their sexual health, but so too have younger men. If it was embarrassing to be an old guy who couldn’t get erect, imagine how embarrassing it must be for younger ones. Research in 2021 by the online chemist Pharmacy Direct found that the age group that suffers most from erectile dysfunction is 25-34, more than half of whom (52 per cent) say either they or their sexual partner can’t get hard always, sometimes or occasionally. And researchers at UCL found that Gen Z were experiencing a sexual recession, with fewer of today’s teenagers having sex than millennials did when they were younger.
Viagra was approved for sale over the counter in 2017, with stock hitting shelves the following year, and doctors and sexual health workers have since noticed increasing numbers of young people using it. Some take it because of anxiety about their performance, feeling they need to be completely hard all the time and worrying they will be able to get it up but not keep it up. Others use it for recreational purposes, often in combination with illicit drugs or while drunk. It’s also been noted that the use of pornography can lead to erectile dysfunction, which young men are far more likely to avail themselves of than their older counterparts.
And in the wake of Viagra’s success, even women are trying to find ways to revitalise their flagging libidos. According to an NHS information site, more women than men experience a loss of interest in sex. There is a growing number of so-called “female Viagra” products that use “natural remedies” such as ginseng, maca root and Prelox (which has products for men and women) on the market. In the US, women are treated with Addyi and Vyleesi, neither of which have been approved in the UK yet. Some women are even taking Viagra, but there’s no evidence that it’s an effective treatment.
Whereas in the 1940s and 1950s people were prepared to put up with mediocre or miserable sex lives, today that’s not the case. It seems that everyone believes they have an inalienable right to sexual pleasure. And that somewhere there’s a pill or a potion that can deliver it.
How widespread is the problem of erectile dysfunction? Over the past 25 years it has steadily increased – or so the increasing number of prescriptions suggest. In 2021 4.1 million prescriptions were made in England and Wales for drugs such as Viagra, sildenafil and other common erectile dysfunction treatments. The continued popularity of these pills suggests that they must be doing something right for consumers.
And the benefits of Viagra aren’t just about sex – but then sex isn’t just about sex either. It’s a means of emotional intimacy and physical closeness that every couple needs. Dr David Edwards, a GP with a special interest in sexual dysfunction and a past president of the British Society of Sexual Medicine, says: “When erection difficulties do occur, emotional and physical closeness between a man and his partner can diminish, leaving him with a sense of isolation and lacking confidence in day-to-day life.”
This is what happened to Tom (not his real name), who is 80 and looks super fit. He tells me that Viagra saved not only his sex life but his marriage too. “During my mid-70s I suffered from impotence. Attempts at sex always left my wife disappointed and me depressed. Things got so bad we were drifting towards divorce. Viagra gave us a second chance.”
So what’s the actual lived Viagra experience like? Okay, I confess I have, on rare occasions, used Viagra. How many times? Oh, once or twice… or three or four or… but who’s counting? Viagra virgins think you pop a pill and – hey presto – instant hot sex for the next six hours. Alas, if only life and sex were that simple.
The thing that many men and women don’t understand about Viagra is that it’s not an aphrodisiac – it won’t make you fancy someone you don’t fancy. This is important for women to understand. Some women feel insulted by a man’s use of Viagra. Their logic goes: if you found me attractive, you wouldn’t need to take a pill.
That’s not true. Viagra only goes to work once a man feels aroused and works by inhibiting an enzyme released after ejaculation that contributes to the loss of an erection. Blood flow to the penis is increased, making it easier to get and maintain an erection. For many, it provides not desire but the confidence they need to act on that desire once the mood is underway.
There is still this silly belief that Viagra will make a man better in bed – his penis will be bigger, it will last longer, he will last longer and his partner will be howling with ecstasy. This fantasy can be found in the title of a 2023 paperback by Dr Albert Henry, which claims to be a guide to Viagra usage for “Long Lasting Erection for Her Mind Blowing Screaming Climax”.
Obviously men taking Viagra are more likely to have more and better sex than men with erectile dysfunction who do nothing for their condition. But overcoming erectile dysfunction doesn’t always lead to a better sex life. A study published in 2015 by Manchester University on men aged 50 and over found that Viagra and other drugs developed to improve erectile dysfunction improved sexual function and activity in 80 per cent of users but this did not necessarily translate into satisfaction with sex and relationships.
Why? Because the quality of sex is not determined by the stiffness of a penis – there are a whole set of emotional and psychological factors that have nothing to do with the mechanics of intercourse. Viagra is simply an effective cure for erectile dysfunction, but not a cure for being bad in bed or for being a selfish or insensitive lover. It can revive a penis but not a relationship.
Here we are, 25 years after the first wave of Viagra pills first appeared, along with the jokes, the books, the articles, the dinner-party conversations and late-night confessions. And there’s still a stigma and embarrassment around the subject of erectile dysfunction and the use of Viagra.
It takes a brave man to admit to friends and lovers that he uses Viagra, and it takes an even braver man to go into their local chemist and ask for it, despite the fact they’ve been doing it since 2018 when you could buy it at Boots and even Tesco without a prescription.
I know this because I’m one of those men. Why are we so embarrassed to purchase Viagra over the counter? After all, we buy condoms and lubricants without blushing. So what’s the big deal with Viagra? Because when you purchase Viagra, you’re not just buying a product. You’re making a confession about yourself to the shop assistant and every customer nearby. No matter how you phrase it – with boldness or embarrassment – you are in effect saying: “I’m a sad old bloke who can’t get it up any more!”
At least that’s how I and many men feel. That’s why, on those very rare occasions I have bought it over the counter, I tend to slip my Viagra purchase in with a whole series of items, usually things I don’t even need, in the hope no one will notice the V-word. My last Viagra purchase went like this...
Female shop assistant: Hello, how can I help you?
Me: Yes, I’d like a bottle of Night Nurse, some Euthymol toothpaste, mint-flavoured dental floss, one bottle of Listerine, one large bottle of Gaviscon, a pack of Viagra, the Jimmy Choo scent for men, a tube of Germaloids hemorrhoid cream, some Garnier hair conditioner and some Cremo face scrub for men.
Female shop assistant: Sorry, did you say Viagra?
Me: Me? No! Um. Yes.
Female shop assistant: We might be out of stock. Let me go and check.
She goes to the back of the pharmacy to consult with a colleague who shouts across the shop, “We’re out of Viagra at the moment. I can get you some by tomorrow afternoon. Are you in a hurry? Do you want a Viagra pack of four or eight or 16?”
I notice there’s a queue of people – young and old – waiting to be served and they’re all watching me. I panic and make a bolt for the door.
Now, a quarter of a century after Viagra entered the British bloodstream, there are signs that we’re falling out of love with it, especially as the alleged side effects become more visible. There are the tabloid scare stories – the penis that allegedly went “wonky” and the man who allegedly went blind – but also accounts of Viagra supposedly causing heart attacks and strokes, though these are rare and there is currently no scientific evidence that they were linked to use of the drug.
And since Pfizer’s patent on Viagra came to an end in 2020, there have been a whole slew of generic brands and alternatives on offer and available on the internet, such as Aronix, Nipatra and Revatio. There’s also Vardenafil, which is said to be as effective as Viagra but requires a lower dose. And where once men automatically reached for that little blue pill, they now try these products or search for healthy alternatives like exercise and changes in diet.
Viagra has become one of those pills like the contraceptive pill of the Sixties and Prozac in the Nineties that are as much a product of their time as a hit pop song. But time and trends in pills are always changing. It has not solved all our sexual problems, but think back to the days before Viagra and it’s hard to escape the conclusion that the British bedroom is now a happier place.