No rest for the old and weary

One small pill for a man, one giant hang-up for men's minds? Viagra is an inexhaustible topic. By Alix Sharkey

In the future, when they debate the last days of the 20th century, historians may well conclude this was the era when satire died. Life at the end of the millennium, they will surmise, was so absurd and hysterically caricatured as to make ridicule obsolete. To prove their theory one word will suffice: Viagra.

This diamond-shaped blue pill is already the fastest-selling and most successful legal drug ever marketed, with more than 2 million prescriptions written - or nearly 1,000 every hour since it was licensed by the US Food and Drug Administration in March. But in making the manufacturers, Pfizer, a pretty pfennig, it poses important questions about our society's attitudes to drugs, pleasure, ageing and male sexuality.

Forget the fact that Viagra was supposedly developed for use by clinically impotent men only; already the tabloids are calling it "the love drug", and the Penthouse owner Bob Guccione has heralded it as "a return to virility after years of emasculating feminism".

Whenever demand outstrips supply, a black market is inevitable, and the global hunger for this little blue pill, at once the Mother of All Uppers and Daddy's Little Helper, is currently insatiable. With legal supplies limited to the US, Brazil, Switzerland and Andorra, a new industry has sprung up (ahem) on the Internet, with some firms offering tablets for as little as $7.50 (pounds 4.70) each. Most, though, are American and Canadian advertisers offering the drug at between $44 and $52 for five tablets, with another $30 for postage and packing.

To conform with American law, these suppliers demand a faxed copy of the buyer's prescription with each order. However, those without the requisite paperwork can have an immediate diagnosis from an online doctor: simply fill in the questionnaire, tick off a list of "symptoms", sign a waiver assuming full responsibility for any "physical or psychological damage", and for another $85, a prescription will be issued. And then there are the counterfeit brands already on offer, including "Viagro", "Vaegra" and "Viagre".

In Uruguay, where the drug will not be licensed until 1999, several travel agents now offer "Viagra Tours" to neighbouring Brazil, where pharmaceutical laws are more lax. Meanwhile, a Japanese tour operator is chartering a weekly jet from Tokyo to Hawaii, a seven-hour flight. For just under pounds 800, customers get a return trip, four days' hotel accommodation, a medical consultation and a box of 30 tablets. Viagra has even penetrated the African market, where it was reportedly implicated in the sudden death of the Nigerian dictator General Sani Abacha last month. The 54-year-old tyrant took it while cavorting with two prostitutes, went into convulsions, and died shortly afterwards from a heart attack.

Though Pfizer admits that Viagra is not without its dangers, the 30-odd deaths officially attributed to it in the US have done nothing to curb demand. A New Delhi GP has reported a 400 per cent increase in men claiming to be impotent and in need of the drug; most, he believes, are simply looking for a bit of staying-power. Likewise, the secretary of the Urologists' Association of Malaysia, Dr Peter Ng, says most men asking him for Viagra just want to give it a shot. When one of the American team who developed the drug went on holiday to Turkey last month, he was greeted at Istanbul airport like an international celebrity by TV cameramen and a pack of print journalists. "The men of Turkey have absolutely no need of this pill," said the urologist with a winning smile, clearly playing to the gallery.

Nonetheless, the men of Turkey want it, and badly: when a line of text announcing its availability appeared on the national Flash TV channel, its phone lines were blocked for six hours (it turned out to be a joke by the teletext typist). The reaction is equally hysterical throughout the developed world. The fact is that men everywhere, from Bangkok to Buenos Aires, desperately crave some Pfizer lead in their pencils. So while those with the money fly to America and the nearest clinic, others join health service waiting lists. There is little doubt that many British men will do exactly this when Viagra gets its European licence in September. In fact, at a BMA conference in Cardiff earlier this month, doctors expressed concern that, at pounds 6 a tablet, Viagra could near-bankrupt the NHS if made freely available - one doctor estimated the cost at pounds 1bn a year. And that's just to treat those men already diagnosed as impotent.

Despite its jokey, cartoon-ish name (Niagara Falls, but Viagra Rises, geddit?), the drug was developed to facilitate erection in impotent men, most of whom are well into their fifties or even beyond. Thirty years ago, this age group was widely considered to be too old for sex, and few would have been bold enough to demand a drug that restored their tired, doddering members. Ageing men were expected to contemplate spiritual matters, or tend their allotments. However, that was before we abandoned all pretence to dignity and discovered Middle Youth, the lifestyle choice that means we never have to grow up, let alone - God forbid - grow old.

If society expresses its cultural priorities through its patterns of consumption, then Viagra's runaway success makes men look like dickheads. Really, what could be more ridiculous than a chemically maintained, lifelong erection? Where is the room for irony when the arthritic are clamouring for a drug that ensures stiffness?

Of course, the astonishing worldwide demand indicates that almost all sexually active men would welcome chemically enhanced and prolonged erections. And this is the key to Viagra's success: it focuses on the chink in the male's psychological armour. Every man harbours doubts about his potency; few can have escaped that dreadful moment of inability to "perform"; all of us would like some reassurance. We know the cock must be rampant; a flaccid member is just not up to scratch. There is even a biblical precedent: Psalm 92 clearly states: "The Lord is upright and is a rock." Stiffness, then, is clearly next to godliness.

Despite nearly a century of sexual theory, we still identify with this Old Testament image of rampant sexuality and define "successful" heterosexual intercourse as vaginal penetration. Yet, from an early age most males experience involuntary erections - often at inappropriate and embarrassing moments - which convince us that the penis is beyond all voluntary control. Still, we are conditioned to believe that real men are always ready for sex ("up for it") and never get headaches. Similarly, male sexuality is often reduced to an offshoot of physical fitness, little more than a keep-fit routine with a four-second orgasm at the end; Nature's little treat for getting through the sweaty bit. No wonder we end up falling down on the job.

As usual, Freud got it all wrong. It's not women who envy men's penises, but other men - as can be ascertained by the furtive glances in the showers or locker room at any gym or public swimming-pool. This is because men think of sex first and foremost (perhaps exclusively) in terms of an event involving the penis, and are conditioned to compete with each other.

So we celebrate virility as the key part of manhood, but are deeply anxious about its unenforceability, its tenuous, delicate, mysterious nature. Our concepts and experiences contradict each other, further undermining our relationship with our bodies, further externalising our sexual identity, and increasing our need for domination and subjugation of the disobedient flesh. Goddammit, if the penis is uncontrollable, then how are we to distinguish ourselves from women, who leave themselves so open and vulnerable!

This is the psychological problem being chemically corrected with Viagra: ours is a masculinity divorced from its own physicality, or, more precisely, from the deep and powerful link between body and mind. We seem to have forgotten that, with the possible exception of ejaculation, no male bodily function is more dependent on the psyche than erection. The mind can initiate or, equally, inhibit erection. Our flesh is willing but our spirits are weak. And so we prefer to tackle the symptoms rather than their causes.

Some men try to laugh this off, dismissing talk about psychology, sexuality and gender as so much post-feminist tosh, insisting that sex is entirely natural, a matter of common sense. But, if so, why would we need Viagra?

And we do. Its astonishing success proves beyond doubt that we just can't get it up the way we used to. Such is the inevitable consequence of a phallocentric, patriarchal emphasis on penetrative sex, the result of our neurotic insistence on Route One sexuality. Six pounds a tablet is the price we pay for our insistence that, as a hit single once put it, "The Only Way is Up, Baby".

The Viagra sales graph parodies that motion, and reinforces deep, but essentially flawed, cultural assumptions about manhood. We have developed chemicals that will force our bodies to give us pleasure on demand. But how long before we suffer the real side-effects? How long before Viagra is being sold under the counter in gyms and health clubs, the way that steroids are today? The cult of body-building is strongest in industrialised areas of high and long-term unemployment, and is clearly linked with economic emasculation. Where men once dominated through financial muscle, they now assert themselves by pumping themselves up, by making themselves physically bigger. And in a drug-dependent culture like our own, steroid abuse is seen by many body-builders as a valid short cut to body mass.

These are the same people who will want Viagra - particularly since long- term steroid abuse often leads to impotence and associated states of "roid rage". The great joke about body-builders was that they invariably had (and were perhaps compensating for) boyishly small penises. Not any more, though. Now we have a drug that can make big boys even bigger.

But when the first Viagra-fuelled rapist makes the front pages of the tabloids, as seems inevitable, will we still joke about better living through chemistry?