The Viagra Myth: The Surprising Impact On Love And Relationships

\ The Viagra Myth\ \ \ \ The Surprising Impact On Love And Relationships\ \ \ \ By Abraham Morgentaler\ \ \ John Wiley & Sons\ \ \ \ Copyright © 2003\ \ Abraham Morgentaler\ All right reserved.\ \ \ ISBN: 0-7879-6801-3\ \ \ \ \ \ Introduction\ \ \ In 1998, Viagra was first introduced to the world, and it is fair to say\ that the world has not been the same since. The impact of this\ medication has been enormous, not just in the narrow area of treating\ erectile dysfunction (ED) for which it was approved, but also in\ the way we think of sex and sexuality, and even in the realm of\ relationships between men and women.\ Millions of men in the United States have tried Pfizer's wonder\ drug, sildenafil, better known as Viagra, and there are thus millions\ of women who have also seen its effects on their husbands,\ boyfriends, and lovers. Many other millions of men and women\ wonder about whether Viagra can offer a solution for their own\ sexual and emotional problems or for the problems of their partners.\ We human beings are sexual animals, after all. And unfortunately,\ our sex lives are not always the way we want them to be. So\ it's no surprise that when sex goes sour, relationships suffer in other\ ways as well.\ As a practicing urologist in Boston on the faculty of Harvard\ Medical School, I have treated many men with sexual problems\ andmany couples who have sexual issues in their relationships. I\ knew about the development of Viagra before it was introduced to\ the public and was involved in its clinical application as soon as\ the Food and Drug Administration approved the new drug. I had\ anticipated using Viagra primarily for older patients with well-established\ erectile dysfunction, but it didn't take long before I realized\ that I had completely underestimated the huge extent of\ public interest in trying this new medication. For example, shortly\ after Viagra became available, an orthopedic surgeon came up to\ me in the surgeons' lounge as I was having a cup of coffee between\ operations.\ "Tell me," he said, "what should I know about prescribing\ Viagra? I have a patient who I think should try it."\ Now I have great respect for my orthopedic colleagues, but\ I have yet to meet one who would take on the treatment of a\ problem outside his area of expertise in bones and cartilage. It was\ quite clear that this surgeon's patient was none other than himself!\ Everyone wants to know about Viagra, and many are interested\ in trying it, whether or not they think they have an erection problem.\ When I lecture to students at Harvard Medical School about\ sexuality, there are always a good number of Viagra questions, such\ as, "What happens when a young, healthy man with normal sexual\ function takes Viagra?" Or "Can a woman tell during sex that her\ partner has taken Viagra?" Or "Is it true that Viagra increases a\ man's sex drive?" No one ever falls asleep in those classes!\ Viagra quickly tapped into a set of wishful fantasies that mirrored\ our culture's hunger for certainty and the quick fix. Supported\ by stories that described elderly men restored to such sexual vitality\ by Viagra that they abandoned their wives in favor of younger\ women, a conventional wisdom arose that Viagra was a fountain of\ youth, a sure cure, the real deal. Baby boomers could now look forward\ to fabulous sex well into their nineties. Men shared Viagra\ stories with each other at cocktail parties or around the office water\ cooler.\ "All I can say is 'Wow!'" says one man, and other men listening\ in wonder how their lives might be different if they also took\ the magic blue pill.\ Women too have been targeted to confirm Viagra's ability to\ create satisfaction and serenity within a relationship where frustration\ and friction had once been the rule. One of the most successful\ early Pfizer ads showed a series of couples happily dancing\ together after Viagra apparently cured the loss of rhythm in their\ relationship.\ Former senator and presidential candidate Bob Dole appeared\ in Pfizer ads soon after Viagra's introduction and instantly turned\ into household words the terms Viagra and ED. Viagra jokes\ became a staple of comedy acts on late-night television (Have you\ heard the one about the man who swallowed Viagra, but it stuck in\ his throat? He wound up with a very stiff neck!), thus ensuring its\ place in our cultural lexicon. Viagra tapped into both our fantasies\ and our embarrassment about sexuality in a way that no other drug\ had ever done. When, for example, was the last time you heard a\ joke about a new cholesterol-lowering medication?\ Skillful marketing contributed to our perception of Viagra as\ the pill that put the "man" in "manly." Star professional athletes-vigorous\ men such as baseball's Most Valuable Player Rafael\ Palmeiro of the Texas Rangers and NASCAR driver Mark\ Martin-endorse the medication in widely seen advertisements.\ Other kinds of athletes use Viagra as well. Hugh Hefner, the aging\ head of the Playboy empire who is known for his bevy of beautiful\ blondes, gives Viagra credit for maintaining his pleasure quotient.\ Rumor has it that he provides bowls of Viagra tablets at his famous\ parties.\ Magical Viagra. A wonder drug. Or so we have come to\ believe. But does the reality live up to the myth? Is it really that\ good? Can it truly solve erection problems? What about relationship\ issues? What does Viagra do for a man who has lost his sexual\ desire or for a man who is simply nervous about having sex with a\ new partner? What's the real story?\ \ * * *\ \ As someone who treats men with Viagra nearly every day, I can testify\ to the remarkable effects of this medication. For many men and\ their partners, Viagra has unquestionably brought about significant\ improvements in their lives, and to a degree that was not previously\ possible with other treatments. And yet there is clearly much\ more to the story of human sexuality and relationships than the\ Viagra Myth would have us believe. The Viagra Myth has less to do\ with the effectiveness of the medication than with our cultural\ propensity to look for the easy fix. This myth suggests that a pill\ that improves blood flow to the penis can solve personal relationship\ issues, no matter how complex.\ I started wondering about the disconnect between the Viagra\ Myth and reality soon after I had started prescribing the medication.\ John, a fifty-five-year-old man married for over twenty years,\ saw me three months after I had prescribed Viagra as treatment for\ his erectile dysfunction, with which he had suffered for over two\ years.\ "So, John, how's the Viagra working out for you?" I asked.\ "Well, it works, Doc. But I don't take it anymore."\ "Why not?"\ "To tell you the truth, my wife and I decided to separate. All\ this time, I'd thought that if I could have sex with her again, everything\ would work out fine. But it turns out that our problems are\ bigger than the sex thing. So we're splitting up."\ Viagra had done wonders for John's erection problem but nothing\ toward solving his relationship problem.\ Then there was Chester, who at seventy-one years old had\ initially complained that his erections were only semifirm. Sex with\ his wife had become awkward and unsatisfying, and he asked\ specifically for a prescription for Viagra. It seemed a reasonable\ request, and his physical exam revealed no health risks, so I prescribed\ the medication. When Chester returned to the office several\ months later, he reported on various other medical issues but\ never mentioned how he was doing sexually, even though that had\ been the main concern for him at his last visit.\ "Did you ever try the Viagra?" I asked.\ Chester gave me a big smile, and there was a gleam in his eye.\ "Oh, the Viagra! Well, it definitely makes me harder!" he chuckled.\ "But I don't need it. The wife and I are okay with how things\ are going without it. I don't want to spoil her, you know!"\ John and Chester are just two examples of the many men for\ whom Viagra works in a physical sense as it is supposed to, but the\ medication failed to meet their expectations in other ways. Even\ when Viagra works, men like John and Chester often do not want\ to take it, and their reasons vary. Although I saw these men in my\ practice every day and intently followed their stories, I was still surprised\ to learn that the refill rate for Viagra prescriptions is less than\ 50 percent. What happened to the old crude joke that all a man\ needs in order to be happy is a hard penis and a place to put it?\ Could our perception of Viagra and our sense of masculine sexuality\ be so out of kilter with reality?\ Surprisingly the answer is yes. The Viagra Myth, which\ promotes the notion of the hard penis as the salvation of sexual\ relationships, is so pervasive that even professionals in the field\ bought into it. After reflecting on cases like those of John and\ Chester and their partners, I began to see an enormous gulf between\ appearances and reality when sexual relationships are in question.\ Many of my male patients, together with many of their partners,\ came to realize that finally achieving a great erection did not\ solve their relationship problems. In fact, it frequently made them\ worse. As with John and his wife, sometimes when the erection\ issue is solved, couples are forced to deal with more profound troubles\ in the relationship.\ As I listened to my patients, I came to see that our culture had\ taken Viagra and created a legend out of it that went far beyond its\ actual pharmacological properties. People had come to expect that\ taking a little blue pill could solve their personal and relationship\ problems, no matter how complex those difficulties were. I heard\ variations on this theme almost daily. Men or their partners\ requested prescriptions for Viagra for all sorts of problems, sometimes\ with the barest of sexual symptoms: a lack of desire, struggles\ in existing relationships, fear of intimacy, or a desire to be a sexual\ superstud, for example. The range of issues for which men could\ envision successful treatment only with Viagra was astounding to\ me. This aura surrounding a medication that enhances blood flow\ to the penis is clearly a reflection of who we are and our desire for\ the easy, quick fix. I have called this exaggerated sense of Viagra as\ a wonder drug for various complex issues the Viagra Myth.\ Yes, the drug is enormously powerful, and it can be a lifesaver\ for many men, but it has also turned a bright spotlight on previously\ hidden areas of sexuality and relationships. In particular, it\ forces couples to decide what is real in their relationships and what\ is not. I have come to see Viagra as providing a window into the\ psyche of men, and perhaps indirectly into the psyche of women as\ well, since women are not immune from unduly high expectations\ regarding the benefits of Viagra and its potential to provide sexual\ healing.\ The lessons I have learned by listening to my patients and their\ partners form the basis of this book, and in the pages that follow I\ share the stories of those who have taught me so much about sex and\ sexuality and, by extension, about personal growth and humanity.\ The lessons to be learned are startling, profound, and often\ inspiring. What does it mean for a man to lose his sense of masculinity\ and self-esteem? How does this loss manifest itself in the\ relationship between him and his partner? How do couples survive\ when a man loses the ability to function sexually? What is it like\ when his sexual powers return? What is it like for a woman to have\ her partner restored to his "youthful vigor" after a prolonged period\ of inactivity?\ \ * * *\ \ This is a book about real people. The men and women who pass\ through my office share intimate details of their lives that would\ otherwise never see the light of day were it not for this book. Naturally,\ names and details have been changed in order to preserve\ privacy, and in many stories I have combined features from two or\ more patients. Each story is unique, yet there are themes familiar\ to every reader because of the commonality of human experience.\ Men want to feel powerful and capable and accepted, to be able to\ relate to their partners in a way that affirms these qualities. Women\ want to feel attractive to their partners and emotionally connected.\ When sex goes awry, particularly because of erection problems, not\ only do relationships come crashing down, but men and women\ lose their grip on these most fundamental human needs: secure\ identity and intimate connection.\ To be sure, the power of Viagra lies in its ability to correct a\ man's erection problems. Whether this fix rights the ship depends\ on the individuals involved and what they bring of themselves on\ board. So often, as the stories that follow show, men and women\ are at cross-purposes within their relationships and lack a shared\ language for understanding each other. As we are continually\ reminded by advertisements and testimonials in the media, Viagra\ can help correct the erection problem. But if a man is worried only\ about his lost machismo while his partner is concerned about a lack\ of emotional intimacy, then the reappearance of a firm penis is not\ likely to provide them with a happily-ever-after. Both will fall victim\ to the Viagra Myth.\ \ To dispel this myth and help readers distinguish between fact\ and fiction, this book seeks to answer some of the questions most\ frequently raised by my patients and their partners, such as the\ following:\ When is Viagra the "perfect" cure?\ When is Viagra not a cure but an obstacle to a relationship?\ How does a man determine whether his partner loves him or\ Viagra?\ What does a woman experience when she's with a man who\ can function sexually only with Viagra?\ If a man can function only with Viagra, does he continue to\ think of himself as impotent or does he feel inauthentic?\ Does Viagra make a man more virile, more attractive, and a\ better lover?\ What happens when a man doesn't tell his partner he's taking\ Viagra? Will she know? Is it the same as lying?\ What's the relationship between an erection and desire?\ Can Viagra work after prostate cancer surgery?\ If Viagra doesn't work for a man, will he ever be able to have\ sex again?\ Can a couple have sex without an erection?\ Does Viagra make sex less spontaneous and more predictable?\ \ I have written this book in the hope of provoking a more\ thoughtful and frank discussion about sexuality than currently\ exists. On a practical level, I hope that men and women can use\ these stories as starting points to improve the dialogue they have\ with each other in their relationships and ultimately to create a\ more fully satisfying life for themselves. I also hope this book will\ lead to the more realistic application of Viagra and other sexual\ therapies for the benefit of all men, women, and their relationships.\ (Continues...)\ \ \ \ \ \ \ \ \ Excerpted from The Viagra Myth\ by Abraham Morgentaler\ Copyright © 2003 by Abraham Morgentaler.\ Excerpted by permission.\ All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.\ Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.\ \

Dedication. Acknowledgments. Introduction. Chapter 1: Viagra And The Perfect Cure. Chapter 2: The Viagra Edge: Is Harder Better? Chapter 3: Performance Anxiety and Viagra. Chapter 4: Viagra And Desire. Chapter 5: Viagra And Premature Ejaculation. Chapter 6: When Viagra Doesn't Work. Chapter 7: The Viagra Myth In Gay Relationships. Chapter 8: Viagra and Prostate Cancer. Frequently Asked Questions About Viagra. Epilogue: The Future Of The Viagra Myth.

\ Publishers WeeklyMorgentaler, a practicing urologist and a professor at Harvard Medical School who has done research on erectile dysfunction, wants to explode the "notion of Viagra as an automatic solution, as the quick fix to all sexual problems." He has no problems with the millions of prescriptions of Viagra that doctors have made since the drug was introduced in 1998. But he is effective at presenting facts that are not so well known, such as that the drug works in 80% of men with performance anxiety but only two-thirds of men with other types of erectile dysfunction. What he does best, however, is to demonstrate how "a firm erection cannot solve deeper problems." Each chapter describes a situation in which a patient who thought that Viagra was the answer to his problems finds that there are other explanations. In one, a man learns that his performance problems have to do with the lack of trust he and his partner share; in another, a man who thinks that Viagra will make his sexual performance last the right time learns that "studies have shown that humans average only a minute and a half for their sexual encounters." Short bullet-point summaries of important information at the end of each chapter and an excellent section on "Frequently Asked Questions About Viagra" help make this book an important resource for both physicians and patients who are contemplating prescribing or using the drug, but who may be doing so for all the wrong reasons. (Oct.) Copyright 2003 Reed Business Information.\ \ \ \ \ Library JournalViagra can help many men, asserts urologist Morgentaler (Harvard Medical Sch.; The Male Body). But its cure-all-penises reputation is only a myth. It is most effective for erectile dysfunction caused by performance anxiety, less so for premature ejaculation and for medically caused problems. Viagra cannot supply desire, guarantee partner satisfaction, or rescue a relationship aground on different issues. Moreover, secret use of the drug can raise issues of trust and honesty with a partner. Yet there are effective treatments for when Viagra fails-injections, implants, vacuum devices, and couple therapy. Morgentaler's needed corrective is readable and well organized, with case histories and summaries-plus a chapter on gay relationships. Unfortunately, it lacks a resource section, guidelines for finding a doctor/therapist, and illustrations. A good general work on sexual dysfunction is Lawrence Hakim's The Couple's Disease, and Robert Butler and Myrna Lewis's The New Love and Sex After 60 is also highly recommended. Morgentaler's books is a valuable if imperfect addition to collections where Viagra books circulate frequently. (Index not seen.)-Martha Cornog, Philadelphia Copyright 2003 Reed Business Information.\ \