The downside of the pill that's billed as an up

On top of a new problem
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The Independent Online
A GREAT deal of nonsense has been talked about Viagra, the cure for male impotence launched in the US this week. Billed variously as the answer to men's prayers, the answer to women's prayers (a hard man is good to find, as Mae West observed) and the fastest selling drug in history, it is a victim of self-generated hype, born aloft on the hopes and fears of millions of people obsessed by the notion that they may be missing out in our sex-crazed world.

Viagra certainly appears to have a vroom,vroom effect, boosting manly vigour and self-image. It has even achieved the ultimate American accolade - top billing on the cover of Time magazine. It is clearly the answer to Pfizer's prayers, the pharmaceutical company fortunate to have stumbled across it. Early studies in students in 1991 of its potential as a heart drug revealed it had a pleasing side effect. The share price has since responded like the target organ.

But the prospects for this diamond-shaped magic bullet are not all good. In the exuberance that has surrounded its launch, the downside of a world in which every man, from 18 to 80, can feel like an Arnold Schwarznegger has been missed. Below are ten reasons why, when the drug authorities in Britain consider giving Viagra a licence, as they are expected to do in the autumn, they should pause.

1. The market for Ferrari Testarossas will be destroyed at a stroke. Which man will bother to trump up pounds 350,000 when for pounds 5.50 he can obtain the same boost to his image?

2. Marriage guidance counsellors will be in disarray. Why go through all that tearful inquiry and tricky conciliation when a glass of water and a quick swallow can guarantee repeated bliss?

3. Viagra is said to aid performance by blocking an enzyme that causes erections to subside, thus strengthening and prolonging them. Expect, therefore, a new urban scare: predatory women spiking men's drinks. It could give a new meaning to the term "lager'd up".

4. Improved performance will lead to more sex and more demand for sex. Is this what the world needs? This is a delicate matter and no one wishes to be branded a killjoy. But consider: we have an epidemic of sexually transmitted diseases, abortions are at record levels and the world faces a population explosion. Bromide, maybe; Viagra, no.

5. A black market for the pill is already in full swing in the United States. Internet sites and telephone lines have been established for those desperate for a fix. A stronger and better erection has an appeal far beyond the one-in-twenty men estimated to be impotent. Barbers may once again begin inquiring awkwardly whether sir would be needing something for the weekend.

6. Evidence is emerging of abuse. Some students are reported to have increased the dose from the recommended one tablet taken an hour before sex to two or three. One researcher suggested people without sexual dysfunction would be using it five or six times a night. "They will take it too frequently and at too high a dose and get into big trouble," he said, leaving it annoyingly unclear what "big trouble" meant.

7. The pill has side effects. The first man in Britain to take it, the director of a Harley Street clinic that is offering the drug on a private basis to selected patients, described how it made his head swell up instead of the other part of his anatomy. Other men have reported headaches, indigestion and a blue tinge to their vision. But there is a still more serious problem - its effect on the already swollen male ego. A pill that leads to exaggerated displays of male potency will not make the world a better place.

8. Impotence increases with age. While Viagra may bring increased enjoyment to the younger generation, its target market is older men. Once men of 80 perform as if they were 18 again, what of the impact on relations between the sexes? And on the divorce rate? More sex at greater ages will have a destabilising effect on the social fabric .

9. An estimated six-out-of-ten men with impotence do not seek treatment because they do not believe there is anything that can be done. As news about the wonder drug spreads, family doctors will find their surgeries bulging with men elbowing out the ante-natal classes and the vaccination clinics.

10. This is a pill that improves the mechanics of sex. It will rightly be viewed with suspicion by women who think men's chief failing is that they regard sex as a mechanical process. Men who have difficulty with sex are aiming for the wrong thing if they treat it as a mechanical failure.

Ten reasons add up to a poor prospect for a drug on which such hopes are built. And despite being misleadingly labelled the "good love pill", Viagra is not an aphrodisiac. It boosts the male erection - but only when the spirit is willing. In this respect it differs from existing drugs, injected or inserted into the end of the penis, which automatically trigger erections and can cause embarrassment on the bus home from the sexologist's clinic.

Pfizer's pill, the chemical name of which is sildenafil, is said to improve performance without stimulating desire. The distinction will, however, be lost on most people. It may save the rhino - although as a non-aphrodisiac it should offer no competition to powdered horn - but it will not save the planet. There is, however, one situation in which it may prove valuable - beyond the planet.

As Nasa gears up in the US for a new era of space exploration, there is concern among space technologists about our capacity to reproduce among the stars. Apparently, weightlessness could play havoc with the mechanics of sex.

Public interest in taking a trip into space is growing and the possibility of stratospheric sex is a part of the attraction. There is a Space Tourism Society in Los Angeles, another in Virginia and packages said to be on offer include a $12,000 trip to the edge of space in a Russian MiG. For future space explorers, Viagra may be a necessary part of the kit - guaranteeing that they do not forget how the earth moves as they tour the solar system.