The truth about Viagra: It's a miracle - or is it? Men can't get enough, but there are questions over its safety ...and what it says about men

WE DIDN'T wait for Bob Dole to say Viagra had put new life into his erection campaign. As soon as we heard American men were queuing to fill their Viagra prescriptions, the effect in this country was instantaneous. Computer pros scoured the Internet. Harley Street was besieged. The Impotence Association recorded a 600 per cent increase in calls to the Helpline in the first week of May alone, and the association's director, Ann Craig, asked its trustees to fund additional phonelines.

This virility frenzy had a single purpose. To secure a supply of a new drug which probably won't receive a UK product licence or be available on the NHS before September.

Why has sildenafil citrate (Viagra) touched such a universal nerve among men? It's not as if the world has been starved of effective impotence remedies. Products like Caverject and Erecnos have been providing us with hands-free erections for years. Just recently, MUSE came out - or rather was put in - as men started inserting little potency pellets into their penile ends.

In fact, doctors and drug companies have had impotence under control for a decade. They now know that 75 per cent of all impotence among the estimated 2.3 million UK sufferers has an organic basis.

Viagra, it turns out, delivers less instantaneous results than some rival products; Caverject will give you an erection whether you like it or not, while Viagra still requires you to get turned on. Not only that, you have to premeditate your usage, which can make timing a little tricky.

So, unless we're looking at the greatest marketing con in history, the Niagara of inquiries has been stimulated by Viagra's one undisputed difference - its oral delivery system. As Dr Alan J Riley, Chairman of the Impotence Association, says: "Because it's easy to take, men will take it".

But my own experience with impotent patients would suggest that something slightly more complex is happening. What, for instance, is so wrong - or unmanly - about the alternatives? Caverject comes with its own neat, disposable syringes. I discussed this with one chap who said that if I thought he was the sort of casualty who had to stick a needle in his prick (or vice versa) then I was the one who needed help. I got the same pointed reply about MUSE.

Or, perhaps, it's easy for men to pretend there's nothing really the matter if a little pill cures the problem.

The enthusiasm for Viagra is almost too revealing. Not only does it show that we havea very large impotence problem in the UK, it also seems to indicate a pent-up desire among men to regain their sexual confidence - perhaps battered by the endless media emphasis on performance.

Viagra for anxiety then? While interviewing last month for an article on male sexual insecurity for Woman's Journal I met an investment manager who talked of laying in a supply of Viagra even though his marriage is free of sexual difficulties: "As a bloke", he said, "it's always good to know you've got back-up".

But there's no pleasing everyone: "Having heard nothing all week except about the wondrous powers of Viagra, I am for the first time in my life almost off sex. What the hell is the use of trying for a good performance now that everyone and their uncle has become Don Giovanni?" (Taki, the Spectator). The author is a fellow of the British Association for Counselling and a trustee of the Impotence Association