Viagra (
sildenafil), a prescription medication that enhances the quality of
erection, was first introduced onto the U.S. market by
Pfizer in 1998, becoming what wags described as the first
purely recreational drug to gain approval from the
FDA. The name "Viagra" is a
portmanteau synthesized from "
Niagara" and "
vigorous", intended to carry connotations of strength and energy.
Viagra was originally marketed towards elderly and aging males as a treatment for erectile dysfunction. The FDA had in 1997 lifted its long-standing prohibition of direct-to-consumer advertising of prescription drugs, and Pfizer took advantage of the new possibilities by running an initial advertising campaign featuring the endorsement of former U.S. Senate majority leader, failed 1996 presidential candidate, and prostate cancer survivor Bob Dole. The dual taboos of open talk about erections and of sex among the elderly, combined with the role of Dole, who had by this point reinvented himself as a somewhat comic figure, made Viagra a goldmine for not particularly creative comedians, and Viagra jokes were a staple of late-night talk shows for months if not years.
While Viagra's public image may have been a common topic of jest, what could not be dismissed so lightly was Viagra's commercial success, coming at a dark time for a pharmaceutical industry facing the imminent expiration of patents on several popular medications. Viagra brought Pfizer over 1.5 billion dollars in sales annually, and competitors hurried "me-too" drugs Levitra (vardenafil, from GlaxoSmithKline and Bayer), and Cialis (tadalafil, from Eli Lilly) through testing and onto the market.
Once Pfizer had firmly established Viagra and sponsored initiatives to significantly dispel taboos and a previously common sense of embarrassment surrounding weak erections, it sought to expand its market to younger men who might not have otherwise considered their unsatisfactory erectile capabilities as a disorder for which they should seek treatment. In contrast to the septuagenarian Dole, figures in later advertising campaigns appeared to be closer to their forties and fifties, and the ads' tone became more playful.
Of course, even this cutoff point was largely arbitrary. Before the introduction of Viagra and its competitors, a trend towards decreased erectile capability and libido and increased difficulty in achieving orgasm that came with age was largely considered a natural, if regrettable, state of affairs, not a medical condition. "Erectile dysfunction" was in large part a definition created and promoted by Pfizer to create a vocabulary by which to legitimate Viagra by medicalizing unsatisfactory erectile function, and as such does not have a solid, hard and fast definition.
Elderly men previously unable to achieve the strength of erection necessary to achieve satisfactory penetration report that Viagra allows them to engage in coitus again, but at the same time 20- and 30-something men who might traditionally have been considered perfectly sexually capable have found that Viagra can lend a strength and rapidity of erection previously considered the exclusive province of 17-year-olds, the age at which male sexual function is considered to reach its peak. In both cases, users report increased pleasure during sex on behalf of both themselves and their partners, a heightened sense of virility and sexual competence, and a resultant increase in confidence and self-esteem.
There is some evidence to suggest that Viagra may also have some benefits for female users - anecdotal reports have indicated heightened sexual drive, increased pleasure during sex, and greater ease in attaining orgasm. The mechanism for these effects is yet unclear. It may stem from increased blood flow to the clitoris, labia, and other structures of the female genitals. On the other hand, it might be some entirely separate mechanism, or simply a placebo effect. With thoughts of a possible doubling or more of their potential market, pharmaceutical companies are currently studying the female use of Viagra and similar compounds closely.
Another popular unapproved use, especially among young people, is that of taking Viagra in conjunction with recreational drugs like ketamine, cocaine or methamphetamine whose circulatory or anesthetic effects inhibit erection. The combination of Viagra with Ecstasy (MDMA), a popular recreational stimulant which augments tactile and emotional sensitivity but inhibits tumescence, has been especially highly praised. The prominence of such Viagra cocktails is perhaps most pronounced in gay dance club culture, where amyl nitrite had historically been used in a similar role.
Viagra isn't a perfect wonder drug, though. Unlike previous attempts at erection-inducing medications, Viagra does not directly cause erection, but simply makes it possible - physical, mental, or other stimulation is still necessary, and Viagra will not cure psychological impediments to erection. Further, Viagra's "window" of effect is somewhat limited, and users are directed to take the pill at least thirty minutes and no more than four hours before, erm, making use of its effects. Given the degree to which sexual intercourse is considered to properly be an impulsive, passionate, unplanned activity, users may find these constraints limiting. For the horndog in a rush, Viagra can be insufflated to produce more immediate effects, but there is yet no clear way to extend its period of effect aside from repeated administration, which may aggravate unwanted or dangerous side effects. Those interested in prolonged periods of effect may want to consider Viagra's newer competitor Cialis, nicknamed "the weekender" for its 36-hour effective duration.
Though Viagra has shown benefits in a wide range of users, its legitimation within a medicalized disease/treatment framework means that the bulk of the millions of its prescriptions written yearly go to older men. However, not all users acquire Viagra in this manner. Viagra's popularity even among those who might not consider themselves recreational drug users is considered a major factor in the growth of "internet pharmacies" - online retail operations, often hosted on flag of convenience servers, selling medications with only the most perfunctory (if any) nods towards legal requirements regarding physician approval. In the face of lingering taboos regarding discussion of the genitals and a culture in which weakness of erection is often considered symbolic of low value and failure as a male, the anonymity these services offer can't hurt, either. Viagra is such a staple of internet commerce that a poorly spelled solicitation for its purchase is generally considered the spam archetype.