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27 February 2008
Little Blue Pill, Mighty Big Market
by Paul Aitken

What a difference a decade makes. It's been ten years now since Pfizer introduced Viagra to the market and almost as many since Bob Dole gave it his endorsement. Bob Dole has never disclosed the amount of money he was paid for his pitch but it must have been a fair chunk for it certainly marked the end of his presidential ambitions. After all, it implied that the old boy couldn't get it up and if nothing else, Americans want their prez to be potent. For every person who openly admired the guts it took to act as a "limp dick" spokesman there were a dozen that sniggered like school kids.

Nevertheless it was seen at the time as a slam-dunk marketing ploy. After all, if Viagra was an impotence drug then it seemed reasonable to assume that the primary market would be limp dicked geezers like well... Bob Dole.

But while this early campaign was successful and helped launch the Viagra brand, a brand that is still dominant in spite of recent market incursions from johnny-come-latelys such as Cialis and Levitra, the early marketing efforts are understood by many hind-sighted experts as a marketing failure. Why? Because as the last decade has demonstrated, the natural market for Viagra wasn't old geezers or even men who suffered from erectile dysfunction (ED). Rather, the fastest growing market segment is younger men from 18 to 50.

Apparently, the natural market for Viagra is every sexually mature adult male on planet earth.

But you won't find industry statistics showing this. Most such data is pulled from pharmacies and few young men are going to tell their doctors "they need to drop a little Viagra with their ecstasy for a well rounded night out." But doctors no longer keep the keys to the medicine cabinet. Anyone can log on to an online pharmacy and get a trunk load of blue pills delivered in the mail. In fact, the price structure of online pharmacies strongly encourages volume purchases. Ten pills will cost you $6 each. Buy two hundred and that price drops to $1.35. As such, a large secondary market has emerged in campus dormitories. The same guy who sells you your ecstasy and your pot will happily throw in some Viagra at $3 a pop.

I know what you're thinking; guys that young don't need Viagra. They can get it up anytime they want. Well, yes, but erectile function is variable. Erection quality can be affected by anxiety, hormones, level of intoxication etc. And it's ironic that the drugs (alcohol, pot, ecstasy, cocaine) that enhance our sexual desire actually diminish our ability to perform. But with Viagra, sexual doubts (and irony) are vanquished.

Viagra works by keeping the walls of the arteries leading to the penis relaxed. Blood flows in and for the most part it stays in. If your erection has a tendency to flag when you're thinking about Mom or putting on a condom, Viagra will take care of that. If you're pissed to the gills or floating on ecstasy and your dick is a separate unknowable entity, not to worry, Viagra will see you through. And if you're prone to ejaculate just as she's working herself to a climax, relax, thanks to Viagra you'll be ready to go in just a few minutes and this time you'll be able to go for half an hour. It turns out that Viagra's killer app isn't erectile dysfunction so much as erectile imperfection. It's a competitive world out there. Women expect more. Why not use every advantage? Come to think of it, that should be Pfizer's slogan...

It's a competitive world out there.
Women expect more. Use every advantage.

But you won't be seeing ad copy like that anytime soon. ED drug manufactures go to great lengths to distance themselves from this booming youth market. Spokespersons for both Pfizer and Eli Lilly (which makes Cialis) insist that their product is intended to treat medically confirmed erectile dysfunction and deny any role in promoting the drug for sexual enhancement. Indeed, most advertising is still directed at men in their fifties, guys that while not technically impotent, could use a leg up.

The drug companies are nervous because there is a backlash against what is being called Viagra Abuse. Some of this is being driven by doctors, who are understandably miffed at being sidelined by this emerging trend in self-medication via the Internet. It's also driven by the media, always on the lookout for juicy copy and by religious groups who are against sex and drugs in equal measure.

But is unsanctioned drug use necessarily abuse? Popping a Viagra as a back-up to ensure a successful conclusion to a third date is a rational choice. There is something to be gained and little if anything to be lost. Surely to be considered abuse, the negative effects of any drug must outweigh the positive.

So what is the potential downside of Viagra abuse? The first is the problem of self-medication. Viagra was approved by the FDA as a prescribed drug. An overdose can lead to priapism (a painful unrelenting erection). When mixed with other nitrate based medications (which lower blood pressure) Viagra can be fatal. Ditto when mixed with nitroglycerin (poppers) which also lower blood pressure. A good doctor will take the time to spell out the risks. Online pharmacies generally don't.

Then there's the problem of over-reliance. I personally doubt there are Viagra addicts but it stands to reason that any drug that is perceived to have a positive effect can be habit forming, especially if you're using it to allay performance concerns. Drug dependence of any kind is unhealthy; psychologically and physiologically. Part of the problem is that over time efficacy is reduced and more of the drug is needed to achieve the same effect. This might be OK if there were no side effects, but Viagra has several potentially deleterious effects.

One of these is sperm damage. According to a recent study conducted by David Glenn at Queen's University, Belfast, Viagra damaged sperm acrosomes (the enzymes that break down the zona pellucida surrounding the egg). Mice, force fed Viagra produced 40 percent fewer embryos. This may not be entirely a bad thing. Most guys out clubbing aren't looking to knock-up their mates. And frankly, there are too many people in the world anyway. But for couples anxious to conceive it's potentially a problem. So far it's unknown whether the effects are permanent or cumulative.

One of the main complaints about unsupervised Viagra use is from health officials concerned about renewed outbreaks of HIV/AIDS. It seems that many younger Viagra users are gay. According to a survey conducted by the San Francisco Department of Public Health, 31 percent of a group of sexually active homosexuals reported taking Viagra without medical supervision. Another study found that Viagra users are also twice as likely as non-users to be HIV positive. This is not to say that Viagra is making gay men have unsafe sex. Men who are inclined to have unsafe sex are using Viagra and it just allows them to have more unsafe sex.

When it comes to Viagra use/abuse, I tend to be a libertarian. Hell, I've used it myself (for research purposes, of course). It basically turns you into a teenager again. If guys are stupid enough to double-up their dosage then they deserve to spend their Saturday night in the emergency room with a tent pole in their pants. If Viagra allows them to drink and still have great sex, I say rock on.

My only real concern with Viagra abuse is what I would call the enhancement cycle problem. This is akin to the doping problem with athletes or genetic enhancement. It is a competitive world out there. If Viagra becomes used widely as an enhancement drug then those drug users will set a new standard of performance. Women will expect more and men will be under greater pressure to use Viagra. Pretty soon everybody will be using it.

Hmm, maybe I should invest in Pfizer...

Recreational Erectile Dysfunction Drug Use A Risk
"Erectasy" Drug Combo Worries Experts
High Level Of Erectile Medication Use In Young Men Surprises Experts
Dangerous Link Between Viagra And Nitrates
Pfizer Sued Over Viagra Ads
Increase In "Love Hormone" Levels From ED Drug

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