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Rafael Palmeiro seems an unlikely Viagra pitchman. The Texas
Rangers slugger is only 37 and won’t admit to having erection problems, yet he
recently agreed to appear in ads promoting the drug. The deal has made people
wonder whether Palmeiro really represents men with erectile dysfunction, or
whether Pfizer, the company that makes Viagra, wants to persuade young men to
try it for fun.
It’s true that erectile dysfunction is more common in older
men, but many potential Viagra users are hardly senior citizens: About 40% of
40-year-old men in the U.S. have some degree of erectile dysfunction. Most
Viagra users today, according to Pfizer, are in their early to mid 50s. So it
makes sense that the company would want to reach more men around Palmeiro’s
age.
Urologist Myron Murdock, medical director of the Impotence
Institute of America, says these men are likely to use Viagra because sexual
performance is a high priority for them.
A younger man, Murdock says, “wants his V-12 Jaguar working
just perfectly,” whereas an elderly gent may be content with less
dependable erections. What’s more, the sexual partners of younger men “are
more demanding of their performance,” Murdock says.
Pfizer denies that it’s promoting Viagra for recreational use.
“We’ve consistently opposed that,” says spokesman Geoff Cook.
Nevertheless, Murdock says it’s fine to pop the little blue pill to
“optimize” your sexual performance.
We assume all young men have normal sexual functioning,
“but they’re really not normal,” Murdock says. Hardening of the
arteries, which restricts blood flow to the penis, can begin during the teen
years, so that by the time a man is in his 20s, his ability to get and keep an
erection has already begun to decline. Murdock says many men who seek Viagra
for recreational use actually have minor erectile dysfunction.
There’s also some evidence that Viagra can shorten the time it
takes a man to recover after sex and be ready for another round. This is called
the “refractory period.” Normally it lasts 20 minutes or longer. One
study, published in the journal Human Reproduction in January 2000,
found that Viagra shortened the refractory period by about 10 minutes in
healthy men.
What Viagra cannot do is increase your sexual appetite or make
you ejaculate if you have problems reaching orgasm. Ira Sharlip, urologist in
San Francisco, says you shouldn’t expect your erections to reach staggering new
proportions, either. “I don’t believe that Viagra can increase an erection
beyond 100% of normal,” he says.
“Viagra is a super-safe drug,” Murdock says, assuming
you have a healthy heart and don’t take nitrates.
Nitrates include — a drug that many men take for
chest pain from heart disease — and “poppers.” Poppers are little
vials of amyl or butyl nitrate. Breaking the vial releases nitrate vapor, which
gives a brief high when inhaled. It’s most often used to enhance sexual
pleasure, and mostly by gay men. Poppers are not all that safe to use on their
own, and they’re especially dangerous when you’re on Viagra.
Nitrates widen blood vessels, and Viagra increases that effect.
Mixing the two can cause your blood pressure to drop drastically. A sudden drop
in blood pressure can make you pass out, and you may die if your blood pressure
stays too low for too long.
Preservatives like sodium nitrate — found in processed food –
do not cause this problem, so you won’t die from eating a hot dog while on
Viagra. Even so, it’s best to take it on an empty stomach. That way, the drug
absorbs into your bloodstream faster. Wine may contain nitrates, but not the
kind that cause problems with Viagra. It’s fine to play some Marvin Gaye on the
stereo and sip a glass of Chardonnay, if that’s what puts you in the mood.
Although you may be tempted to order Viagra discreetly from one
of the hundreds of Web sites that sell it, don’t. “It’s bad medicine,”
Murdock says. You really must bring your doctor into your sex life if you want
to use Viagra.
When you buy from an online pharmacy, you just have to answer
some health questions before you proceed to the checkout page. If you answer
honestly — and that might be a big “if” for those determined to get
what they want — the questionnaire may catch some possible complications. But
the who fill your order don’t know your medical history, and no
questionnaire can diagnose the root cause of your problem. Erectile dysfunction
can have serious underlying causes, like diabetes, heart disease, liver
disease, or thyroid disease.
Cook says Pfizer is opposed to Internet Viagra sales. “Our
goal with any of our marketing is simply to reach men and encourage them to see
a doctor,” he says.
It seems that Viagra can make sex better for women, too. Like
the penis, the clitoris is erectile tissue — spongy tissue that becomes
engorged with blood during sexual excitement. By increasing blood flow to the
clitoris, Viagra may heighten a woman’s sensation and arousal. It also seems to
increase vaginal lubrication.
Murdock says many couples like to heat things up by splitting a
dose of Viagra. “It’s an interesting sexual situation,” he says. The
dosage for men is up to 100 milligrams per day, and that seems to
be just as safe for women. Young people may get results from a smaller dose: As
little as 25 mg may be enough.
The FDA has not approved Viagra for women, but Murdock says,
“It’s just a matter of time.” He says he and other doctors who
specialize in sexual medicine prescribe it to women, which is perfectly legal.
Doctors are allowed to use their best judgment. Drug companies, however, can’t
advertise any use that isn’t FDA-approved.
The studies being done to test Viagra’s safety and
effectiveness in women have shown good results so far. “We’re cautiously
optimistic,” Cook says.
Martin F. Downs is a health writer in New York City. He was
formerly an editor at CBS HealthWatch. He has also written for Health.com,
Salon.com, and POZ magazine and is the editor of the Alicubi
Journal (alicubi.com).
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