IS THIS the dawning of the age of the ‘Viagraborg’? That’s one term now being used to describe the 21st century male who, thanks (or not) to developments in sexuopharmacology may now choose to rise to the intimate occasion more frequently and for decades longer than his 20th century counterpart. So, is there a downside?

It’s now ten years since Viagra – the ‘blue diamond’ – dragged the spectre of erectile dysfunction kicking and screaming out of the bedroom and onto billboards, talk shows, magazine pages and (... hit delete/trash) computer screens, across the western world.

In the wake of a charge closely followed by that of fellow travellers such as Cialis and Levitra, the whole landscape of sexuality for older men has taken on a new shape.

It’s now possible for many of them to have ‘sex for life.’ The question for many users of Viagra and other pharmaceutical sexual ‘performance’ enhancers is: do they want to? Does it make life and relationships better?

The answer, it seems, is less emphatically positive than you might expect, especially when you consider that the ‘success’ rate of Viagra is up to 80%.

Most experts stress that Viagra and related drugs, when appropriately prescribed and properly used, have a definite place in the treatment of erectile dysfunction. However, they also express varying degrees of concern about their potential for misuse.

What’s the problem?

Chief among the concerns expressed are that, in offering a ‘quick fix,’ these medications may prevent men (or couples) from resolving issues that are deeper than the organic, vascular problems that the drugs typically address.

These might include difficulties within the relationship itself, anxiety, depression or general confidence issues that, arguably, may more satisfactorily be resolved in the long term through other means, including counselling and psychological therapy such as cognitive behavioural therapy.

Some also express concern that the marketing and promotion of these drugs perpetuates the idea of masculinity being linked to the ability of a man’s penis to become erect, while narrowly defining the ‘normal’ sex act as the male-centric, mechanistic, stage-by-stage process of erection, penetration, ejaculation, de-tumescence. Any deviation from this might then be seen as ‘dysfunctional,’ causing unwarranted distress and concern.

As many sex therapists and researchers point out – and most sexually active people know for themselves – sexual intimacy extends way beyond penile penetration of the vagina. They feel that this is a simplistic, limited and unrealistic view of sex, in particular in relation to older people who, in the absence of an erection, often happily find myriad other ways to enjoy sexual intimacy.

In addition, there are concerns that younger men in particular can become psychologically dependent on these drugs and find themselves unable to have sexual intercourse without them. Typically this happens when anxiety or other psychological problems have triggered some erectile problems. When resolved with the confidence boosting power of a drug, the user becomes reluctant and ultimately, unable, to have intercourse without it.

An allergy to an emotional life?

Eric Lyleson is a clinical psychologist specialising in relationship counselling. He has seen first hand a number of downsides to Viagra and related drugs.

“Up until they are around 40, men are used to their penises ‘working’ just fine regardless of where their heart is at. However, as you get older things like sex become driven not just by whether you can get an erection, but the quality of your relationships,” he says. “I’m not saying there is no place for drugs like Viagra but often problems come down to other issues.

“I think the widespread use of Viagra and similar drugs even by men who have no physical need of them speaks to a trend in society to be materialistic, externally focused and superficial – it’s almost an allergic reaction to an emotional life.

“Of course it’s understandable to want an easy fix. There are aspects of living that seem too hard. We can feel our emotions are bit of a curse, so we try to forget them, keep busy, take a pill. There is also the increasing feeling in conventional medicine that there’s a biochemical explanation and underpinning of everything including emotions. Whereas that may often be the case, it is not always the case. Sex can be like a mirror to where you are at emotionally in your life, just magnified.”

Eric Lyleson says that before taking Viagra or similar drugs, a man should be fully investigated to establish whether there is a physical cause for the problem.

He says that the option for counselling to talk through issues and gain a deeper understanding of some potential causes – and constructive ways to address them – is one that offers real potential for help and suggests that men consider this before going for the quick fix.

’Sex for life’: marketing myth or viable reality?

Annie Potts Ph.D, is a psychologist, researcher and teacher in the School of Culture, Literature and Society at the University of Canterbury in Christchurch, New Zealand. She is a leading researcher into the sociological impacts of Viagra and related drugs.

Potts is one of a number of academics to explore the concept of the ‘Viagraborg’, a notion extending from the definition of a ‘cyborg’ as a human-machine or animal-machine hybridisation – in this case, however, arising from a human-drug combination.

Potts has conducted hundreds of interviews with both men and women affected by Viagra and related drugs, and published various papers outlining her findings.

Broadly, these ‘Viagra stories’ reveal that, while many men and their partners are satisfied – or even ecstatic – about the impact of Viagra on their intimate lives, just as many others have mixed feelings or even reservations about it.

At one end of the spectrum are men who report that the ‘raging hard-on’ experienced after taking Viagra made them feel ‘invincible’ and gave them a sense of moving ‘from strength to strength.’

Women, too, described the effect of Viagra in glowing terms, including as ‘the most wonderful thing out.’

Many other women, however, also reported feeling that after taking Viagra their partners became quite ‘weird’, ‘predatory’ and exhibited what they describe as ‘unusual behaviour from long term partners’ that ‘turned them right off.’

Men, too, reported a sense of unease about having a ‘false erection’ and ‘not being the real me.’ Some wondered about the effect this feeling of being ‘artificial’ had on their partners.

Women too had concerns that the sex ‘wasn’t genuine.’

Both men and women also expressed views along the lines that, before Viagra, ‘nature’ took care of sexual desire. So as a man’s libido changed and declined, so did a woman’s – nicely in step. They were concerned that Viagra ‘has made a lot of people feel inadequate.’

Whether, when and how to pop the pill

Dr. Michael Lowy is a consultant men's health physician specialising in sexual medicine and counselling, in particular the assessment and treatment of male sexual dysfunction and relationship and sexual problems.

While stressing that Viagra and other drugs are highly effective, he also has concerns about over-prescription.

“They are simple and quick, but there is also a risk that people may use them excessively when other forms of treatment may give them help,” he says.

He also highlights that, for the drugs to enable an erection, the man must still feel sexual desire. For this reason, when there is a problem in the relationship or a man is just out for some anonymous sex, they may not work.

“You may also be able to get an erection but not find the sex act to be ultimately satisfying, so in that sense it’s not treating the underlying problem. You still need good conditions for having sex: a sense of arousal or intimacy and so on.

“One does have to be careful that they are prescribed for the right reasons, for the right person – typically this is an older man with a vascular blood flow problem.”

Like Eric Lyleson, Dr Lowy suggests that anyone worried about their sexual function should visit a physician to check for physical causes, and consider relationship or similar counselling if none is found.

If medication is recommended, he suggests:

• If you are planning to have sex with your long term partner, it’s important that you both feel comfortable about using the medication and are open about it. For one off or ‘date’ sex, this may not apply.
• Take it about an hour before you expect intimate contact to begin.
• Make sure you engage in plenty of sexual stimulation after you’ve waited for the hour.
• Don’t take it with a lot of food in your stomach.
• Avoid alcohol.
• If the tablet doesn’t work once, that’s not to say it never will – remember, conditions for sex must be right.
• Do consider counselling or therapy if you think there may be relationship or psychological issues affecting your sex life – it can help.
• NEVER take these medications if you are also taking nitrate medications; for example, to treat heart conditions like angina.

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