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The Viagra Effect: Has It Really Given Sex a Lift?


History Reads is a weekly series featuring work from Team History, a group of experts and influencers, exploring history’s most fascinating questions.

Four years of work, all for naught.

That’s what a team of Pfizer chemists working in southwest England in the early 1990s was coming to conclude about sildenafil citrate, a pharmaceutical compound they had been developing as a possible treatment for chest pain and high blood pressure. Test results for its effectiveness were not looking good. The project teetered on the brink of failure. Then, just as it appeared Pfizer was going to pull the plug, something happened that would earn the company billions of dollars, impact countless lives and upend cultural norms the world over: A few study participants reported that the drug, unexpectedly, was giving them more erections.

The project got an immediate lift.

Combining this finding with new information available from recent studies on the biochemical process of male arousal, the lab soon confirmed that while sildenafil did little for hypertension or angina, it did help the blood vessels in the penis dilate more easily, producing an erection if a man becomes sexually aroused. Some early study participants enjoyed the effect so much, they didn’t want to return unused samples of the drug when the trials ended.

Just a few years later, in March 1998, the Food and Drug Administration approved sildenafil—under the brand name Viagra—to treat erectile dysfunction. Arriving two months after the Bill Clinton–Monica Lewinsky scandal thrust oral sex and semen stains into the national conversation, the drug underscored a fundamental tension in American culture: Everyone was desperate to talk about the taboo topic of sex.

Viagra’s arrival, now 20 years ago, became a watershed moment for men. Previously, the only options for dealing with erectile dysfunction involved treatments that were either shamefully seedy or uncomfortably invasive. The drug also ignited something of a sexual revolution—albeit one with a complicated legacy. Because even as it liberated men from the stigma surrounding erectile dysfunction, it reinforced a very specific, limiting version of sexuality that persists to this day.

VIDEO: MODERN MARVELS: Viagra. A look at how the popular erectile-dysfunction drug works and why pharmaceutical companies are rushing to create alternative versions.

I remember that moment in history well. Initially, media coverage of the new wonder drug reflected America’s competing attitudes toward sexuality: feverish and prurient, scandalized and eager, obsessed and embarrassed. Within a year on the market, Viagra had generated about a billion dollars in sales and appeared on the cover of Time magazine.

Along the way, Pfizer made some canny marketing decisions. The name—a combination of “vigor” and “Niagara Falls”—had been floating around the company for a while, just waiting for the right product. And instead of saying the drug treated “impotence”—a word that connotes failure—Pfizer billed it as an aid for “erectile dysfunction,” a much more clinical term, one that implies an isolated problem instead of defining a man’s entire persona.

At first, federal regulations prevented Viagra commercials from being run before 11 p.m.—a problem, since much of the drug’s target audience had already gone to sleep. And because the ads had to talk about sexual performance without using the word sex, those first commercials were tame, featuring a wholesome couple wearing visible wedding bands. The implication? Viagra wasn’t a “sex pill,” but a couple’s aid, amenable to America’s puritanical legacy: Since sex is dirty, you should save it for the one you love.

Soon, the stigma began to evaporate—or at least to evolve. After the 74-year-old former presidential candidate and prostate-cancer survivor Bob Dole told TV host Larry King he’d participated in Viagra’s trials, he signed on to appear in an ad campaign. A year after the drug was approved, it became the subject of a Sex and the City episode. No longer shrouded in mystery and pain, erectile dysfunction became part of a broader societal discussion, from the barber shop to late-night TV monologues. The word “Viagra” even entered the cultural lexicon, signifying a catalyst to massive success—as in “That new quarterback has been like Viagra to the team.”

The timing of Viagra’s debut couldn’t have been better, of course, with the first wave of the massive Baby Boomer generation just entering their 50s. A 1999 University of Chicago study found that men between the ages of 50 and 59 were three-and-a-half times more likely to suffer from erectile dysfunction than men aged 18 to 29, and many more would experience other changes in their erections as they aged. Common medications for the over-50 set—for prostate issues, blood pressure, diabetes and depression—also contributed to male sexual performance issues. For the 1960s “youthquake” generation that in many ways, resists going gently into their dotage, the little blue pill has offered the promise that, in at least this one way, they could stay forever young.

As one of the first drugs advertised directly to the consumer, Viagra became a legend in doctors’ offices. An initial shortage created a small frenzy. Many physicians had to open weekend consultations, with 10-minute sessions, to give out samples. Some patients arrived wearing disguises and giving false names to hide the fact that they were seeking treatment for erectile dysfunction. One office referred to the drug as “Vitamin V” to help patients avoid embarrassment. A salesman recalled to Bloomberg that he felt like a “rock star.” “Never before, and probably never again,” he said, “will anybody get a standing ovation in the waiting room.”

Talk about a turning point. Until Viagra, the possibilities for treating ED ranged from dubious to downright scary. Ancient Greeks and Romans ate snakes as well as the genitalia of goats and roosters; Romans also advised wearing “the right molar of a small crocodile” as a talisman to guarantee erections. One 13th-century monk advised men to roast a wolf’s penis, chop it into small pieces, and eat a small portion for instantaneous arousal; European astrologers during the Renaissance and the Enlightenment suggested urinating through a spouse’s wedding ring. Beginning in the 18th century, electrical belts and beds also promised help.

In the years leading up to the introduction of Viagra, men often had to turn furtively to the back pages of nudie magazines to find “miracle” creams and gels—or supplements like ginseng and (the aptly named) horny goat weed. And if they tried the medical route, intervention might have involved painful injections or silicon rods and pump-activated inflatable cylinders that were surgically implanted in the penis. Ouch.

Undoubtedly, Viagra offered a dramatic improvement on these options. And it’s always a good thing to lessen stigma around sex. Still, despite the liberating effect it had on men, the drug also reinforced several harmful stereotypes about sex and relationships. For many in our instant-gratification culture, the drug was seen as a quick fix not only for an aging appendage, but for fragile psyches and relationships as well. The little blue pill promised eternal youth, sexual prowess and extreme virility, handily regenerating lackluster marriages by making sex last forever.

But the fact is, Viagra just helps increase blood flow to a man’s nether parts; it doesn’t bestow erotic intelligence. Forget connection, pleasure, intimacy, sensuality—with Viagra, the emphasis was on getting it up, getting it in and getting it done. This magic-bullet approach to relationships limits possibilities. The message of Viagra—that a big erection equals great sex—de-emphasized the physical, emotional and erotic communication necessary to true intimacy.

Indeed, in a society where the cultural construct of manhood is linked to impossible standards of constant, on-demand performance—economic, sexual, or otherwise—the possibility of failing to deliver can spell humiliation. Viagra has offered an enticing shield against embarrassment, a promise that penetrative sex—ie. robust manhood—could always be on the table. But here’s the thing: From behind this barrier, a man doesn’t have to reckon with the very feelings of vulnerability that, ironically, might help him grow his empathy and sensitivity, and connect more honestly and intimately with his partner.

And what do intimate partners say? Certainly, men and women alike have welcomed their partner’s renewed ability to get—and keep—it up. On the same-sex side, some men call Viagra a godsend, since erections help condoms stay on, reducing the risk for disease transmission. Some women, though, have expressed mixed feelings about the drug. With its emphasis on facilitating intercourse-based sexual encounters, Viagra has contributed nothing to the understanding of the elusive female orgasm. In fact, with a recent study finding that more than 80% of women don’t climax through intercourse alone, the drug has likely widened the gulf between men’s experience of sexual pleasure and women’s. Meanwhile, some women wondered when drug companies would be offering a “little pink pill” to address their own sexual dysfunction and low libido. And others reported feeling upset that the drug had “disrupted” their sexual routines with their partners—or reintroduced activity they thought they were “done” with. In one “Saturday Night Live” skit from 2000, a series of exasperated women acidly “thanked” Viagra; one furtively poured the pills down the toilet.

About 10 years ago, I attended a panel at a urology conference where speakers were asked: Is it appropriate to prescribe Viagra to men who don’t need it? The debate was vigorous, and fascinating to me. I still don’t think there’s one right answer. Viagra itself has been an amazing contribution to the evolution of sexuality—in some ways it’s as important as contraception for women. But the erection is just one aspect of sex, and a little blue pill will never replace communication and eroticism. It alleviates performance anxiety, allowing partners to focus on everything that comes before, during, and after—on what kind of lover they want to be. For the next 20 years of Viagra’s history, it should be celebrated as the beginning of a conversation—not the end.

Psychotherapist Esther Perel is recognized as one of today’s most insightful voices on modern relationships. Fluent in nine languages, she holds a therapy practice in New York City and is a certified sex therapist. The author of bestsellers Mating in Captivity: Unlocking Erotic Intelligence and The State of Affairs: Rethinking Infidelity, Esther also hosts the podcast “Where Should We Begin?” Follow her on Twitter at @EstherPerel.


Viagra FAQs: 22 Common Questions About Viagra Answered

Got a question about Viagra? We’ve got answers. From the history of the drug to information about Viagra’s onset of action, potential side effects and more, we’ve answered 22 of the most common questions about Viagra (as well as its generic counterpart, sildenafil) below.


An Erection That Won’t Quit?! 3 Viagra Myths Debunked

Along with all of the hype you hear about Viagra®, there are also a few myths that seem to follow that little blue pill around. But is what you’ve heard true?

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Maybe your doctor gave you a prescription, but you’re hesitant to try it because you’ve heard stories about unending erections or dangerous side effects.

Urologist Drogo Montague, MD, helps set the record straight on how Viagra performs — both inside and outside of the bedroom.

Myth No. 1: Viagra is bad for your heart

The facts: Taken alone, Viagra won’t hurt your heart. But don’t take it if you’re already taking nitrates for heart health, Dr. Montague says.

Viagra was originally intended to treat angina (chest pain), which it does well — just no better than other medications. Stiffer erections were a side effect.

“Here’s a drug that not only treats angina and is good for the heart, but it works on the penis when other medications don’t,” he says.

Like nitrates, it helps dilate blood vessels constricted by coronary artery disease. But it also similarly lowers blood pressure. If you take the two medications together, your blood pressure could drop too low, putting you at risk for a heart attack.

Myth No. 2: Viagra damages your eyes

The facts: No, taking Viagra to enhance your bedroom performance won’t make it harder for you to see your partner. However, once in a while it could make everything seem a little blue, especially if you take the maximum 100 mg dose.

The chemicals in the drug can temporarily change how light hits your eye, and everything takes on a short-lived blue tint.

“This side effect can happen with higher doses, but it’s uncommon,” Dr. Montague says. “There’s no bad impact on the eye, but pilots can’t take it because of the possible color tint.”

Myth No. 3: Viagra causes hours-long erections

The facts: While this may sound intriguing theoretically, this condition (known as priapism) can be harmful. Fortunately, it doesn’t really happen if you’re only taking Viagra.

“To my knowledge, Viagra has never caused a prolonged erection by itself,” Dr. Montague says. “But, it can happen if you’re also getting penile injection therapy.”

Combining the treatments has a cumulative effect — penile injection therapy makes your erections hard, and adding Viagra makes them harder and even more long-lasting. So, stay on the safe side and don’t pair them, he says.

One final fact: Viagra can prevent penis bending and scarring

It’s no secret that Viagra makes your penis harder for penetrative sex. But what you might not know is that it can save your penis from injury — if you start taking it early enough.

If you’re experiencing erectile dysfunction but wait to talk to your doctor until you can’t achieve an erection hard enough for penetrative sex, you may damage your penis. Having sex with an erection that’s barely “hard enough” can bend it and tear tissues that may scar as they heal, Dr. Montague says.

Scar tissue isn’t elastic like healthy penile tissue, so it will force your penis to bend with future erections, creating a condition known as Peyronie’s disease.

This affects 9 percent of men between the ages of 40 and 75. Many of these men have what Dr. Montague calls erectile insufficiency — erections that are not as firm as they used to be. During intercourse, bending may damage the penis. Taking Viagra could help prevent the problem and avoid an injury with lifelong consequences, he says.

No matter what your concern is, talk with your doctor. “If you’re having erectile dysfunction problems, you should feel confident going to your doctor. It’s a common issue,” Dr. Montague says. “Many men are embarrassed, but they shouldn’t be. Help is available, and it’s worth a try.”


Real Viagra Stories – Have a Story, Share With Us

1. Patience is a Virtue
The directions in the pamphlet said I should take Viagra one hour before sex. I had everything planned out, with dinner and candles and flowers. I dimmed the lights and took the pill. Well, my wife got stuck in a shareholders’ meeting, and I was stuck with osso bucco for two and a raging hard on.

2. Diet Hard
My wife and I have been together for two decades, but over the past five years or so, our sex life fizzled and I got fat. I was sitting at the pool one day like a beached whale when I noticed how hot the ball and chain looked in a bikini. She is one HOT ball and chain. I hit the gym and lost 44 pounds, but I didn’t have the sexual stamina I had before I put on the pounds. I got a Viagra prescription, and now I’m up for sex so often, the wife sometimes turns me down!

– J. Johnson, NY – 51 years old

3. Viagra Saved Our Marriage
Our marriage lost its spark somewhere between the 20th and 25th year. My husband would barely look at me anymore he seemed more interested in the television than sex. During one of our many weekly arguments, I asked him–more as an insult than as an actual question, "Can you even get it up any more?" Well, it turns out he had ED and was just too embarrassed to say anything about it. We saw a doctor, got him on Viagra, and now we’re happy as can be, although I’m often very tired in the morning.

4. Back in the Saddle
I’m 63 and six years ago, I had back surgery. My age combined with my gammy spine put the kibosh on my sex life. My wife of 42 years suggested I get on the Viagras. Holy Cow. My only problem now is deciding which kama sutra position isn’t going to make the back give out!

5. Young Stud
Having ED at 25 is humiliating. It affected me in many ways, including my confidence. When I went on job interviews, when I’d go out with my friends, or even when I ordered a pizza, it was always in the back of my mind that I wasn’t a complete man. I finally gave in and ordered Viagra and MAN what a change, and it wasn’t just about my penis. I walk into a room and I feel like I’m large and in charge–because I am!

– Calvin T, CA – 25 years old

6. A Second Chance
At 67, I thought my sex life was over. I had a good run up through my fifties, but it was time to throw in the towel. Then I met this spritely young 59 year old at a church mixer. We hit it off, but when she started making less-than-subtle suggestions, I knew I could not disappoint her. Well, one little blue pill later and not only are we boning like teenagers, I’m sometimes going two or three times a night!

– Philip D, OH – 67 years old

7. Eat Drink and… On Second Thought, Don’t
The first time I tried Viagra, my girlfriend and I were so excited. Over a fancy Italian dinner, we talked about all the positions we’d been wanting to try. When things started getting hot and heavy, though, my little soldier remained at ease. Luckily, she was willing to give me–and Viagra–another chance. The next night, I tried eating a lot less, and the rest is history. Come to think of it, the way we were moving the earth, it was geology!

8. You CAN Go Back
At my 20th high school reunion, I was happy to discover that Sally DiFillipo, the biggest crush of my life, was still hot and newly single. I chickened out, though, and sometime during the next ten years, I developed ED. As the 30th reunion approached, I was determined to man up and ask Sally out. I ordered Viagra and when I walked into that auditorium, I was full of confidence. Sally and I married a year after the reunion and at least five nights a week, we bang like it’s prom night!

9. Touchdown
Since junior high, I was always the stud. I was told in high school that the girls’ bathroom walls were covered with legends of my sexual prowess. The world of work and family finally caught up with me, though, and at age 27, I began taking hypertension medication. I had difficulty getting it up, let alone keeping it up. I thought my life was ruined. At the advice of an old football buddy, I ordered Viagra, and while I’m a one-woman man, I’m giving her enough boning for a whole squad of cheerleaders.

10. Honey, I’m Home
My 52 year-old boyfriend has been a sweet and generous companion for four years. And while I wanted so badly for us to have an active sex life, his ED made it impossible and I figured I’d just have to settle for a life of no more nookie. Then one day, he surprised me. He came home from work, hauled me up to the bedroom, and made love to me not once, not twice, but THRICE! As I lay exhausted, he confessed that he loved me too much to let me remain unsatisfied. He had gone and gotten a prescription for Viagra.

Have a real Viagra story to share with the eDrugstore.com audience, please email: [email protected]

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The Viagra jackpot: A history of the little blue pill at 20

In the annals of the frustrating fight against impotence, men have ingested rhino horn dust, performed elaborate dances, employed vacuum hydraulics, and chanted what one historian called "protective spells" that went like this: "Get excited! Get excited! Get an erection!"

But none of those remedies were as successful - or crazy - as what one physician did at a urological conference in 1983. Before presenting his research to hundreds of doctors, Giles Brindley injected - yes, injected - his penis with a chemical that made it erect. On stage, he dropped his pants to demonstrate the results.

(Insert your own mental image here.)

"There was not a sound in the room," a urologist recalled in a scientific journal. "Everyone had stopped breathing."

It is quite possible that audience members, having "dispersed in a state of flabbergasted disarray," did not exhale for another 15 years, when federal regulators approved Viagra - the little blue pill that made it a little easier, and certainly less humiliating, for men to make everything work as God intended.

Viagra, approved 20 years ago on March 27, 1998, became a pharmaceutical and cultural phenomenon at a very odd moment - amid President Bill Clinton's sex scandal with intern Monica Lewinsky, when one of Clinton's fiercest and oldest political enemies became a TV pitchman for the drug.

Bob Dole, the conservative Republican senator from Kansas.

"Dole may have lost the presidential election," Meika Lee wrote in "The Rise of Viagra," "but this time he returned victorious," capturing the country's attention - and late night TV laugh lines - as "the one bringing respectable sexuality back to America and American politics."

And you thought things were strange now.

The moment, in retrospect, came about from a virile accident.

Pfizer was developing a chemical compound called sildenafil citrate for high blood pressure. It was not going well.

"It was so close to failure that people weren't coming to the meetings," Pfizer chemist David Brown told Bloomberg in an oral history of the drug. "I mean, you know how people sort of smell failure and disappear? It was that close."

The scientists kept going, hoping for a breakthrough.

And then, finally, one emerged when they tested the drug on miners. But it had nothing to do with their blood pressure.

"Is there anything else you noticed you want to report?" Brown recalled asking the miners. "One of the men put up his hand and said, 'Well, I seemed to have more erections during the night than normal,' and all the others kind of smiled and said, 'So did we.'"

The side effect wasn't really a side effect: It was the jackpot.

Prizer switched gears, studying the compound for impotence. Men were given the drug in lab settings and instructed to watch dirty movies.

"They were fitted with what was called a Rigiscan-you can imagine what that does," Brown told Bloomberg.

(Insert your own mental image here.)

"At the end of the week," Brown continued, "we had to get the drugs back from them, anything that was unused. Some of them would not give the drug back."

The drug wound its way through the approval process. The jokes began almost immediately. "You must have heard them," Lee wrote. "In nursing homes, Viagra keeps male patients from rolling out of bed. Did you hear about the first death from an overdose of Viagra? A man took 12 pills and his wife died. Viagra is now being compared to Disneyland - a one-hour wait for a two-minute ride."

But Viagra really worked wonders. It became such a hot commodity around the world that - we are not making up the next part of this sentence - that the CIA used it in Afghanistan to influence tribal elders in need of a little lift. The Post's Joby Warrick reported:

"Such was the case with the 60-year-old chieftain who received the four pills from a U.S. operative. According to the retired operative who was there, the man was a clan leader in southern Afghanistan who had been wary of Americans - neither supportive nor actively opposed. The man had extensive knowledge of the region and his village controlled key passages through the area. U.S. forces needed his cooperation and worked hard to win it, the retired operative said.

"After a long conversation through an interpreter, the retired operator began to probe for ways to win the man's loyalty. A discussion of the man's family and many wives provided inspiration. Once it was established that the man was in good health, the pills were offered and accepted.

"Four days later, when the Americans returned, the gift had worked its magic, the operative recalled.

"'He came up to us beaming," the official said. "He said, 'You are a great man.'

"'And after that we could do whatever we wanted in his area.'"

But the little blue pill, now 20 years old, was more than just a punchline, or CIA inducement, or a vehicle for Bob Dole to get his groove back.

The scientists who worked on the drug, along with historians and cultural scholars, say Viagra changed the way America talks about sex - more open, less Puritanical.

The bar for sex talk has been lowered so low that this past election cycle a presidential candidate named Donald Trump felt OK referencing the size of his penis and, apparently, the fact that he didn't need a prescription to make it even larger.

"I guarantee you there's no problem," he said during a debate. "I guarantee."


RELATED ARTICLES

The binding prevents breakdown from occurring. A greater amount of cGMP is available in the blood vessels which lets blood flow to the penis.

The average response time to by Viagra is 27 minutes.

But researchers say to remember that it's just an average and that individual response depends on any number of personal physiological traits.

This period is when Viagra has reached its 'maximum erection' potential.

The medication reaches its highest blood concentration, which is why it's recommended to take the pill between one-half to one hour before you want to have sex.

In one study, men reported being able to achieve erections lasting an average of 33 minutes an hour after taking Viagra,

For every four hours that the drug stays in your body, the effects reduce by 50 percent.

But the researchers say that this doesn't mean you're incapable of having sex.

This is likely because users get confused with the warning of 'if you have an erection lasting more than four hours' referring to a continuous, uninterrupted erection.

Even after 10 hours, scientists found men could still get an erection - and at the same rate as they did two hours before taking the drug.

According to the previous study, men can have erections for an average of 23 minutes at 10 hours, and, after 12 hours, the mean duration of erections was reported to be 16 minutes.

FAST FACTS ABOUT VIAGRA

Viagra, medically known as sildenafil, is used to treat male sexual function problems (impotence or erectile dysfunction-ED).

In combination with sexual stimulation, sildenafil works by increasing blood flow to the penis to help a man get and keep an erection.

CGMP - a nucleotide - causes the walls of blood vessels to relax and dilates them so blood can flow easily.

Viagra works by inhibiting an enzyme called PDE5 to prevent cGMP from breaking down, which controls blood flow in the penis.

This drug does not protect against sexually transmitted diseases such as HIV, hepatitis B, gonorrhea or syphilis.

Viagra pills are blue and diamond-shaped. The drug is meant to be taken between 30 minutes and one hour before having sex, but it can be taken up to four hours early.

  • Headaches
  • Hearing loss
  • Impaired vision
  • Increased intraocular pressure (fluid pressure inside the eye)
  • Indigestion
  • Numbness
  • Tingling in chest, neck, jaw, or arms

For years, companies have been trying (and failing) to make a 'female Viagra' because it is estimated that one in 10 women suffer from low sexual desire.

In 2015, the FDA approved the use of a drug called Addyi, despite lingering questions about its safety and effectiveness.

In 2016, sales showed to be meager and both the pill and its manufacturer, Valeant Pharmaceuticals, rated poorly on several measures according to a report card released by an advocacy group, the National Women’s Health Network.

Valeant Pharmaceuticals International Inc said this week that it plans a US relaunch of Addyi.

Some critics said Addyi's sales suffered because Valeant didn't market the drug aggressively enough.

Additional criticism was pointed to the fact that it must be taken every day, but those on it aren't supposed to drink.


The Viagra jackpot: A history of the little blue pill at 20

In the annals of the frustrating fight against impotence, men have ingested rhino horn dust, performed elaborate dances, employed vacuum hydraulics and chanted what one historian called “protective spells” that went like this: “Get excited! Get excited! Get an erection!”

But none of those remedies was as successful — or crazy — as what one physician did at a urological conference in 1983. Before presenting his research to hundreds of doctors, Giles Brindley injected — yes, injected — his penis with a chemical that made it erect. On stage, he dropped his pants to demonstrate the results.

(Insert your own mental image here.)

“There was not a sound in the room,” a urologist recalled in a scientific journal. “Everyone had stopped breathing.”

It is quite possible that audience members, having “dispersed in a state of flabbergasted disarray,” did not exhale for another 15 years, when federal regulators approved Viagra — the little blue pill that made it a little easier, and certainly less humiliating, for men to make everything work as God intended.

Viagra, approved 20 years ago, on March 27, 1998, became a pharmaceutical and cultural phenomenon at a very odd moment — amid President Bill Clinton’s sex scandal with intern Monica Lewinsky, when one of Clinton’s fiercest and oldest political enemies became a TV pitchman for the drug.

Bob Dole, the conservative Republican senator from Kansas.

“Dole may have lost the presidential election,” Meika Loe wrote in “The Rise of Viagra,” “but this time he returned victorious,” capturing the country’s attention — and late-night-TV laugh lines — as “the one bringing respectable sexuality back to America and American politics.”

And you thought things were strange now.

The moment, in retrospect, came about from a virile accident.

Pfizer was developing a chemical compound called sildenafil citrate for high blood pressure. It was not going well.

“It was so close to failure that people weren’t coming to the meetings,” Pfizer chemist David Brown told Bloomberg News in an oral history of the drug. “I mean, you know how people sort of smell failure and disappear? It was that close.”

The scientists kept going, hoping for a breakthrough.

And then, finally, one emerged when they tested the drug on miners. But it had nothing to do with their blood pressure.

“Is there anything else you noticed you want to report?” Brown recalled asking the miners. “One of the men put up his hand and said, ‘Well, I seemed to have more erections during the night than normal,’ and all the others kind of smiled and said, ‘So did we.’ “

The side effect wasn’t really a side effect: It was the jackpot.

Pfizer switched gears, studying the compound as a way to treat impotence. Men were given the drug in lab settings and instructed to watch dirty movies.

“They were fitted with what was called a RigiScan — you can imagine what that does,” Brown told Bloomberg News.

(Insert your own mental image here.)

“At the end of the week,” Brown continued, “we had to get the drugs back from them, anything that was unused. Some of them would not give the drug back.”

The drug wound its way through the approval process. The jokes began almost immediately. “You must have heard them,” Loe wrote. “In nursing homes, Viagra keeps male patients from rolling out of bed. Did you hear about the first death from an overdose of Viagra? A man took 12 pills and his wife died. Viagra is now being compared to Disneyland — a one-hour wait for a two-minute ride.”

But Viagra really worked wonders. It became such a hot commodity around the world that — we are not making up the next part of this sentence — the CIA used it in Afghanistan to influence tribal elders in need of a little lift. The Post’s Joby Warrick reported:


Tip: Viagra Is Great for Bodybuilders

In 1986, scientists discovered that nitric oxide (NO) was a potent vasodilator and could improve circulation, heart health, and anything else that relied on optimal blood flow.

Researchers at Pfizer, with big, hand-rubbing plans, began experimenting with drugs called PDE-5 inhibitors that enhance and perpetuate NO’s blood-vessel dilating effects. Their goal, at the time, was to find a treatment for angina. First up was a drug called sildenafil citrate, but drug trials showed that it was only modestly effective in treating the condition.

However, some of the researchers refused to say die and started looking at the notes detailing the drug’s side effects. Holy moly, there it was: A lot of the test subjects confessed to being visited by the erection fairy a lot more often after taking the drug.

This observation caused Pfizer scientists to no doubt feel a little stirring in their own pants as they contemplated the financial prospects of such a drug. They rapidly switched gears and began pilot studies of sildenafil citrate’s effects on erectile dysfunction.

It was, of course, a success and in 1996 they submitted a patent for the new drug, which they named Viagra. A couple of years later, Viagra was approved by the FDA.

Few drugs have had such a social impact on society. Old men, or even not-so-old men, could suddenly indulge in a part of life they thought was lost to them. But perhaps unexpectedly, much younger men also glommed onto the drug, as they also did with its chemical cousins Cialis and Levitra, which would arrive later.

They covet the drugs because they serve as a hedge against performance anxiety and reduce downtime between sexual episodes, but it turns out there are other reasons men, both young and old, might use these drugs and they’re not only health related, but bodybuilding related, too.

In fact, there may be sufficient evidence to support the idea of taking these drugs every day, like vitamins or any other health-promoting supplement.

What Erectile Dysfunction Drugs Do For Bodybuilders

PDE-5 Inhibitors Increase the “Pump”

The most elemental and basic effect of Viagra and its cousins is increased blood flow, not only to the heart and penis, but to all body parts, including muscles. More blood flow means a better pump from resistance exercise and subsequently, increased nutrient flow to muscles, which is a good thing.

PDE-5 Inhibitors Decrease Estrogen Levels

A 2005 study found that 10 mg. and 20 mg. doses of Cialis, taken an average of 10 times a month, significantly reduced estradiol levels, but only in men who didn’t have too much body fat (those with a BMI of less than 27) (1). Men with more body fat have higher levels of aromatase and convert testosterone to estradiol with impunity, regardless of how much Cialis they pop.

PDE-5 Inhibitors Increase Testosterone Levels

A study of Viagra’s effects on 140 low-testosterone men between the ages of 40 and 70 found that the drug boosted testosterone levels by about 100 clicks (2). While some of this rise in male hormone might be, as the study cited above implied, because some testosterone resisted being converted into estrogen, some of it was also apparently from increased testosterone production by the testes.

PDE-5 Inhibitors Increase Insulin Sensitivity

Viagra was shown to reduce diabetes-induced oxidative stress and improve insulin sensitivity. This experiment, unlike the others, was conducted on rats, but there’s a decent chance it would work similarly in humans.

What Erectile Dysfunction Drugs Do For General Health

  • Cialis has been shown to quash symptoms of benign prostatic hypertrophy, like frequent urination. There’s also some evidence that PDE-5 drugs improve prostate health in general.
  • Viagra has been shown to treat abnormally high blood pressure in the pulmonary arteries (known as pulmonary hypertension).
  • Despite early studies that didn’t show much of an effect, Viagra and the other PDE-5 drugs have lately been shown to be beneficial in the treatment of angina, along with high blood pressure and other cardiovascular conditions.

How To Use This Info

Sporadic use of these drugs (less than 8 to 10 times a month) might not confer any long-lasting health effects. However, Cialis is currently approved for once-daily use, and it’s reasonable to think that patients, young or old, who have such a prescription and are using it every day, are reaping some, if not all, of the above benefits.

However, if further research supports or adds to the list of positive research on these drugs, we might eventually get to the point where docs almost universally recommend the daily use of the drugs, just as they do with baby aspirin.


Before taking this medicine

You should not use Viagra if you are allergic to sildenafil, or:

if you take other medicines to treat pulmonary arterial hypertension, such as riociguat (Adempas).

Do not take Viagra if you are also using a nitrate drug for chest pain or heart problems. This includes nitroglycerin, isosorbide dinitrate, and isosorbide mononitrate. Nitrates are also found in some recreational drugs such as amyl nitrate or nitrite ("poppers"). Taking sildenafil with a nitrate medicine can cause a sudden and serious decrease in blood pressure.

To make sure Viagra is safe for you, tell your doctor if you have ever had:

heart disease or heart rhythm problems, coronary artery disease

a heart attack, stroke, or congestive heart failure

high or low blood pressure

a blood cell disorder such as sickle cell anemia, multiple myeloma, or leukemia

a bleeding disorder such as hemophilia

retinitis pigmentosa (an inherited condition of the eye)

a physical deformity of the penis (such as Peyronie's disease) or

if you have been told you should not have sexual intercourse for health reasons.

Viagra can decrease blood flow to the optic nerve of the eye, causing sudden vision loss. This has occurred in a small number of people taking sildenafil, most of whom also had heart disease, diabetes, high blood pressure, high cholesterol, or certain pre-existing eye problems, and in those who smoked or were over 50 years old. It is not clear whether sildenafil is the actual cause of vision loss.

Viagra is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether sildenafil passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Do not give this medicine to anyone under 18 years old without medical advice.


Viagra: The little blue pill at 20

In the annals of the frustrating fight against impotence, men have ingested rhino horn dust, performed elaborate dances, employed vacuum hydraulics, and chanted what one historian called "protective spells" that went like this: "Get excited! Get excited! Get an erection!"

But none of those remedies were as successful – or crazy – as what one physician did at a urological conference in 1983. Before presenting his research to hundreds of doctors, Giles Brindley injected – yes, injected – his penis with a chemical that made it erect. On stage, he dropped his pants to demonstrate the results.

Lowering the tone of conversation: Donald Trump gave a 'guarantee' about his penis during the presidential debates. Credit: SUSAN WALSH

(Insert your own mental image here.)

"There was not a sound in the room," a urologist recalled in a scientific journal. "Everyone had stopped breathing."

It is quite possible that audience members, having "dispersed in a state of flabbergasted disarray," did not exhale for another 15 years, when federal regulators in the US approved Viagra – the little blue pill that made it a little easier, and certainly less humiliating, for men to make everything work as God intended.

Viagra, approved on March 27, 1998, became a pharmaceutical and cultural phenomenon at a very odd moment – amid then-US president Bill Clinton's sex scandal with intern Monica Lewinsky, when one of Clinton's fiercest and oldest political enemies became a TV pitchman for the drug.

Bob Dole, the conservative Republican senator from Kansas.

"Dole may have lost the presidential election," Meika Lee wrote in The Rise of Viagra, "but this time he returned victorious," capturing the country's attention – and late night TV laugh lines – as "the one bringing respectable sexuality back to America and American politics."

And you thought things were strange now.

The moment, in retrospect, came about from a virile accident.

Pfizer was developing a chemical compound called sildenafil citrate for high blood pressure. It was not going well.

"It was so close to failure that people weren't coming to the meetings," Pfizer chemist David Brown told Bloomberg in an oral history of the drug. "I mean, you know how people sort of smell failure and disappear? It was that close."

The scientists kept going, hoping for a breakthrough.

And then, finally, one emerged when they tested the drug on miners. But it had nothing to do with their blood pressure.

"Is there anything else you noticed you want to report?" Brown recalled asking the miners. "One of the men put up his hand and said, 'Well, I seemed to have more erections during the night than normal,' and all the others kind of smiled and said, 'So did we.'"

The side effect wasn't really a side effect: it was the jackpot.

Prizer switched gears, studying the compound for impotence. Men were given the drug in lab settings and instructed to watch dirty movies.

"They were fitted with what was called a Rigiscan-you can imagine what that does," Brown told Bloomberg.

(Insert your own mental image here.)

"At the end of the week," Brown continued, "we had to get the drugs back from them, anything that was unused. Some of them would not give the drug back."

The drug wound its way through the approval process. The jokes began almost immediately.

"You must have heard them," Lee wrote. "In nursing homes, Viagra keeps male patients from rolling out of bed. Did you hear about the first death from an overdose of Viagra? A man took 12 pills and his wife died. Viagra is now being compared to Disneyland – a one-hour wait for a two-minute ride."

But Viagra really worked wonders. It became such a hot commodity around the world that – we are not making up the next part of this sentence – that the CIA used it in Afghanistan to influence tribal elders in need of a little lift.

But the little blue pill, now 20 years old, was more than just a punchline, or CIA inducement, or a vehicle for Bob Dole to get his groove back.

The scientists who worked on the drug, along with historians and cultural scholars, say Viagra changed the way we talk about sex – more open, less Puritanical.

The bar for sex talk has been lowered so low that this past election cycle a presidential candidate named Donald Trump felt OK referencing the size of his penis and, apparently, the fact that he didn't need a prescription to make it even larger.

"I guarantee you there's no problem," he said during a debate. "I guarantee."