Once considered exclusively a “medicine for older men,” Viagra and other erectile dysfunction medications are becoming commonplace in younger men’s lives. But why are these young men relying on that little blue pill when they clearly don’t have a physiological obstacle?
It’s been over two decades since Viagra — the little blue pill — came on the market to change the lives of millions of men. Although it was originally intended to treat angina pectoris and high blood pressure, it soon became a hit in the bedroom after showing its “magic” as an erectile dysfunction (ED) medication, particularly among older men.
In recent years, however, more and more young men have turned to this pharmaceutical solution even though they had no age-related ED problems. For some, it’s something new to try out and it’s fun. But when we look at the many personal reasons behind this trend, we can see that it is much deeper and emotionally rooted than we thought.
So, is Viagra a harmless quick fix, or are young men now relying too much on these pills, giving a wider cause for concern? And what can that tell us about the connection between men’s physical and mental health?
In the latest episode of our In Conversation podcast, Medical News Today looks for answers to these questions and more, while also addressing the stigma associated with men’s psychosexual health.
Guests include Dr. Edward Ratush, board-certified psychiatrist and co-founder of the SOHOMD telepsychiatry and psychotherapy practice in the United States, Dr. Peter Saddington, an accredited psychotherapist specializing in sexual addiction, counseling, and psychosexual therapy at Relate, and three guests who openly (but anonymously) shared their personal experiences of using Viagra.
You can listen to this episode of our podcast in full below or on your favorite platform.
Editor’s note: This podcast contains comments that mention the use of illegal drugs. Medical News Today does not condone or encourage their use.
Viagra prescription product
Originally referred to as compound UK-92,480, sildenafil (sold under the brand name Viagra) was developed to treat high blood pressure and angina pectoris, when reduced blood flow to the heart causes chest pain.
In the 1980s, biologists from Pfizer began testing the drug for its anti-angina and antihypertensive potential. However, patients soon reported other effects the drug had on their bodies. One such effect was improved blood flow to the penis, which boosted their sex life.
Dr. Ratush said that Viagra’s potential to treat erectile dysfunction was discovered by chance.
“The history of pharmacology of these products [t], which began with Viagra, was originally intended for heart patients because it was hoped that they would be able to dilate small heart vessels and deliver oxygen to the heart. [Later], they found that many of the men, regardless of whether they had a heart effect or not, reported erections they might not have had otherwise because they might have had problems with their blood flow in more than one place,” he said.
In 1998, the FDA approved the drug for first-line oral treatment for erectile dysfunction (ED). In the following years, patients would have to go to their doctor to have it prescribed.
However, in 2018, Viagra Connect came to the UK market as an over-the-counter version for consumers. According to the company, seven million pills were sold in the UK within the first year. Around two thirds of the customers were between 25 and 54 years old.
However, Viagra still requires a prescription in the USA.
Dr. Ratush said although Viagra isn’t available as an over-the-counter drug, it’s easy to get and people just need to tell their doctors the truth.
“If you have insurance or could afford to pay out of pocket to see a doctor, you can get that prescription,” he said.
3 men talk about their experiences with Viagra
Our first guest said he was 19 years old and with his first girlfriend when he tried Viagra for the first time.
“[I was] with my girlfriend for almost a year, but we haven’t had sex yet. None of us had done it before. We were both really excited [b] but every time I tried to put it in, my penis became soft. I told my doctor about it pretty quickly because it was putting a strain on our relationship,” he said.
Some sessions of sex therapy did not initially bring any improvement.
“I felt so ashamed and useless. I don’t know why my girlfriend stayed with me. It made them angry. As a result, she felt that she wasn’t attractive enough. But I knew there was something wrong with me. I was so worried about losing my virginity,” he said.
At this point, the doctor reluctantly prescribed Viagra for him.
“I got too nervous the first time I took it, so I didn’t feel energized enough to do it. But after another try, we were finally able to have sex. It felt amazing. I was so relieved. And that kind of broke a barrier,” he said.
“For me, Viagra pushed me over that mental wall I had built around sex, where nothing else seemed to work.”
— Guest 1
For our second guest, ‘R’, who is in his 50s, is healthy and regularly exercises, his first experience with Viagra was when he recently came out of a long-standing relationship.
“[L] Last year, I had some concerns about whether I could maintain an erection with some casual partners. And this was partly triggered by an experience with a particular casual partner who kind of prepared me for our meeting that he, you know, wants to make sure there won’t be a problem,” he said.
Our third guest Scott, who was the only one who felt comfortable enough to use his first name, said he tried Viagra for the first time out of curiosity.
“[The] first time I used Viagra would have been when I was maybe 19 or 20 years old, seven or eight years ago. [It] was one evening, so I had actually met a girl. We had [gone] to the club and I had drunk a lot,” he said.
When a friend of the few in his wallet offered him a Viagra pill, Scott said he had decided to try taking one before they returned to the hotel.
One advantage he noticed from taking Viagra was the reduced waiting time between erections or sexual intercourse.
“[W] With Viagra, you don’t need any breaks in between, you can finish immediately and start again. So in a sense, that’s what it brings to the table. So if you’re ever trying to impress a woman or on a weekend trip, Viagra allows you to go again and again,” Scott said.
The side effects of Viagra
The side effects that people most commonly report with Viagra include heartburn, skin redness, blurred vision, and upset stomach.
“I’d describe it as pretty unpleasant. Maybe 30 minutes after taking the pill, I had a headache and turned red—my face was red, my heart was racing. It was uncomfortable and not a feeling I would associate with sex. “said R about his experience.
Most of these effects subside within about five hours, as the drug has a metabolic half-life of around 4 hours.
“Most of the time, it’s very effective and [people] don’t have side effects, but side effects that they can notice because it works all over the system, [are] heart palpitations, pretty extreme headaches, that feeling of really feeling pressured. That’s why some people will stop taking them because the side effects are counterproductive,” explained Dr. Saddington.
“If you feel like you’re having a heart attack, or if you have a raging headache, you’re not exactly going to feel sexual or aroused,” he added.
Scott also shared his caution when it comes to mixing different medications.
“[Most of the time I used [Viagra], I was kind of under the influence of alcohol. [I] had a side effect when I was taking other narcotics [and] had really bad heart palpitations. Apart from that, whenever I was half sober or just had a few drinks, I had no side effects at all.”
Questions and answers: Dealing with common misunderstandings
There are a lot of misconceptions people have about erections, Viagra, similar products like Cialis and Levitra, and their effects on the body. Here are a few of the most popular ones:
How do medications like Viagra work?
The active ingredient of Viagra is sildenafil citrate. This chemical helps nitric oxide, which helps dilate blood vessels, to bind to receptors that relax the helicin arteries in the penis. This results in increased blood flow to soft tissue, which results in an erection when the person is sexually excited.
Will Viagra give me a severe attack out of nowhere?
Despite the widespread opinion that Viagra can trigger erections such as aphrodisiacs or increase sex drive, the drug only works when someone is already excited. Without sexual arousal, the drug will therefore not be effective, so the individual has a certain degree of control over it.
Can you become addicted to Viagra?
Pharmaceutically speaking, there is nothing that could make someone physically addicted to it and cause withdrawal symptoms. However, the safety that exists, combined with increased consumption and higher doses, can be psychologically addictive for some people.
How long should an erection last with and without Viagra?
Ask any man in your life, and most of the time, most will believe that an erection should last longer than average. Data show that the average duration of an erection in men aged 18 to 30 years is about 6.5 minutes and in men over 51 years old, 4.3 minutes.
Viagra not only extends this time, but it can also make it easier to get consecutive erections.
According to data, the duration of an erection can extend to about 33 minutes on average one hour after taking Viagra. Eight hours after taking the medicine, this time frame drops to around 23 minutes and 12 hours after taking the medicine for the first time to 16 minutes.
However, the effects may vary for many people and may wear off around 4 hours after ingestion.
Why do young men use Viagra?
Both our experts and our guests said that taking Viagra by younger men was not a physical condition, but was seen more as a “help” for performance anxiety and a psychological boost.
“Even in men who had a successful pharmacological effect, i.e. they were able to achieve and maintain an erection as a result of this activity, more than half of them stop using the product within a few months. And that clearly shows that there was a psychological component that was never addressed,” explained Dr. Ratush.
Dr. Saddington agreed.
He said young men “use Viagra to calm down. They may get erections at other times, but they’re afraid, particularly in new situations, new relationships, or when they casually go out, that they’re really using Viagra as a backup because they’re worried that something might go wrong.”
It
However, relying on Viagra to calm down can be problematic, said Dr. Ratush.
“It’s so tempting to use a drug as a crutch when it’s as effective as it is and has only limited downsides — hot flashes, low blood pressure, and maybe a bit of a frantic heart rate,” he told MNT.
Dr. Ratush and Dr.
Saddington stated
that they’ve run into men taking Viagra, particularly when they’re taking alcohol and other drugs, either to increase the sexual experience or out of fear that an erection will be less likely.
Dr. Saddington said this is referred to as “chem sex”:
“[Q] Very often, it is associated with cocaine or ketamine, [w] here they feel that taking [Viagra] improves their sexual experience. So the sexual experience they’re looking for is also associated with drug use. It is therefore becoming a very accepted pattern that they fall into.”
He said he’ll often see or hear men taking a lot of these medications for a weekend and being sexual with either the same person or many people.
Casual sex and Viagra
Dr. Saddington said it was more common for young men to take Viagra for casual sexual encounters rather than long-term committed relationships.
“It’s often associated with the idea that in a relationship where they have a commitment and feel more confident, they don’t worry as much about performance, the erection becomes much more lasting,” he said.
R said he thinks it is precisely this “nature of being more casual with people” that makes it difficult to maintain an erection.
“[Because it was casual] if I had a problem, I couldn’t negotiate [or] say, ‘Well, today isn’t the day, let’s do something else. ‘ These options and opportunities didn’t feel like they were open to me,” he said, highlighting the lack of communication and openness in this relationship dynamic.
“[It’s] a natural thing to get and maintain an erection when [they] are trying to have more casual relationships or start a relationship. Performance anxiety creeps in — the urgency, the feeling they’re being judged or blamed when they don’t get an erection.”
Communication can solve many problems
.
Dr. Ratush compared Viagra to exercise supplements and said that men are generally open to trying things like this. However, such a pharmaceutical solution has led people to push the causes under the carpet.
“The unpleasant part is that people have moved away from actual ‘talk therapy’ to address their sexual problems,” he said.
“[i] If there was communication with [their] partner, the fear of performance anxiety might not be there. So before they [take] a medication like this, therapists worked with men and their partners to create a way to communicate with each other so they could feel as comfortable as possible while making love.”
— Dr. Edward Ratush
Dr. Ratush said that not speaking and being transparent with a partner can have greater negative effects on psychosexual well-being and increase addiction to medications such as Viagra.
“In a way, over time, we’re creating an ever wider gap between men and their partners in terms of communication associated with this dynamic,” he said.
R agreed. He said taking Viagra wasn’t a cure for his fear of maintaining an erection.
“[I] got into a long-term relationship with someone earlier this year. And being in that relationship allows me to actually negotiate. If I don’t feel like today is going to be Performance Day, we have other options available that will ensure we’re still having a good time,” he said.
“[A lot of people] have trouble sharing what they’re really experiencing or talking about when they have issues with how to resolve them sexually. I think it’s taboo to talk about sex and explain how to satisfy your needs or how to talk about things when they go wrong. That’s why therapy can be so effective, because it gives them a chance to talk about it.”
— Dr. Peter Saddington
Men’s erections and self-perception
The pressure to perform and the lack of communication can lead to major relationship problems.
“What tells me the most is that there is a huge gap between heterosexual couples, between men and women in what they understand about each other. [B] Because, of course, men can still learn a lot about themselves sexually and about how they function and how they can optimize their own physiology and functionality,” said Dr. Ratush.
“[The] idea that I don’t just have to understand myself but then transfer it to someone who doesn’t have similar parts and no similar experiences is a really daunting task, in my opinion,” he said, adding that some men don’t even want to be seen by their partners when they’re limp.
“[They don’t like to enter the arena until they’re completely ready to perform, so to speak,” he said.
“[For men], it’s a lot easier to simply perform well than to be able to explain why something that happens is contributing to your anxiety. Because one of the things that Viagra and Cialis do beyond erectile function is that they also affect things like early ejaculation problems. So there is more to it than just the erections.”
— Dr. Edward Ratush
According to our experts, younger adults who want to take Viagra could also be influenced by social media and porn. However, it all boils down to sex education.
‘[I] would certainly say that for many young men, their sex education comes from porn. So if it’s based on seeing men [who] act in a very masculine way, [who] seem to be able to have sex whenever they want, in any position [f] or over an extended period of time, [and] if they judge themselves accordingly, they won’t be able to behave or act sexually in the same way sexually. So there’s going to be a lot of fear about it,” said Dr. Saddington.