Is there a more culturally potent pill than Viagra?
It’s not called the blue diamond for nothing. Since its market release in 1998, Viagra has literally changed many men’s lives. And now it’s set to change even more.
According to figures from the Health and Social Care Information Centre (HSCIC), prescriptions for erectile dysfunction drugs have increased by 25pc in the last 12 months. Specifically, 1.7m prescriptions for sildenafil (typically sold under its brand name of Viagra) were handed out last year; that’s compared to 1.4m in 2013 and just 1m in 2004.

What's behind this sudden increase?
Dr. Abraham Morgentaler, author of The Viagra Myth: The Surprising Impact on Love and Relationships and, most recently, The Truth About Sex: Intimate Secrets from the Doctor’s Office says the dramatic rise in usage can be linked to solid market thinking.
“Viagra has been a boon to men with sexual problems, and a talisman to those without,” he says. “It should be no surprise that prescription rates would increase as costs comes down.”

He is referring to the sudden fall in the price of sildenafil, which has nosedived by a whopping 85.9pc since Viagra’s European patent expired in 2013, allowing other drug companies (i.e. Actavis and Teva) to flood the market with unbranded and significantly cheaper versions of the medicine.

The impact on the consumer, however, was not only fiscal in nature. In the wake of this stiff (couldn’t resist) competition in the drugs market, the NHS relaxed restrictions. Firstly, the health authority increased the number of tablets that could be prescribed per week to more than one.

And secondly, NHS directors issued a directive for doctors to broaden the range of medical conditions for which the medicine, now under its generic name sildenafil, could be prescribed enabling them to ask a wide range of patients about the frequency of their erections in order to encourage earlier diagnosis and treatment for more serious disorders (two out of three men suffering from impotence also suffer from high blood pressure, high cholesterol, diabetes or depression). For instance, GPs are now required to ask diabetes sufferers, at least once a year, whether they are having any difficulties with erectile dysfunction; men who suffer from multiple sclerosis, Parkinson’s Disease, and prostate cancer are also monitored for ED.
Consequently, awareness has increased among men of sildenafil as a medication for a serious illness - and not just a magic blue pill that delivers a recreational rocket to the nether regions. This increased awareness has reduced the stigma around the subject of ED and ED medication.

What's more, for for those that were still shy, other legal methods to obtain the blue diamond have sprung up in recent years.

Stuart Gale, chief pharmacist from the website pharmacy Oxford Online, explains: “The growth in sales can also be attributed to the rise in awareness of legitimate online pharmacies in the UK, which are becoming a more trusted and more widely used route to accessing ED medication for those who don’t have time to visit their GP, or who prefer the convenience and discretion of using a delivery service.”
It’s a point backed up by stats. ED medication equates to around 70pc of all sales for Oxford Online and Gale says the site receives significant numbers of new ED enquiries every month via email. By comparison, the site's dedicated GP, Dr. Helen Webberley, receives an average of just two new ED enquiries in surgery every month. A surgery that has over 6000 patients.

Clearly, online availability is a huge factor for what is still for many men an embarrassing condition to deal with. Gale does, however issue a warning: men should be wary of websites selling non-prescription drugs.
“Viagra type medicine is classed as a Prescription Only Medication (POM)," he says. "The prescription requires the involvement of a GP enabling them to diagnose the condition and identify the best medication to treat the individual patient.”

“POM is only available with a prescription for a very good reason. If ED medication is being offered without a prescription the message is simple: do not buy it. It is illegal and there is a strong chance that what you are buying will be fake, which at best is a waste of your money and at worse could lead to health complications.”
Of course, not everyone is heeding Gale’s warnings. Many men are buying Viagra illegally – and they’re not the typical 45-64 silver foxes Oxford Online supplies.
Hayley Quinn is a London-based private dating coach. She encounters a lot of young professionals – both men and women – with disposable incomes and a high sexual appetite. She tells me that there are large amounts of deregulated online websites that give you access to Viagra, making “it easier to order these drugs without a clinician’s scrutiny.”

Quinn also says for a lot of young people, Viagra is taken even when the man does not have an erectile dysfunction. “I've heard of a lot of instances of Viagra being used by men and women recreationally,” she says. “This could be for added stimulation and improved sexual performance or offset the affects of alcohol and/or recreational drugs. It is certainly not uncommon for professional couples to indulge in mutual Viagra use to stimulate desire and have an extended sexual experience.”
She has “even heard of women buying Viagra to ‘drug’ their boyfriends and increase sexual desire,” she says.

What does the consumption of sexual performance enhancing drugs say about the modern sexual psyche? Should we be concerned by this upward curve of Viagra use?
Quite the contrary, says Dr. Morgentaler. He suggests we should use this moment in time to ask the key question: how does Viagra change male sexuality?
“We live in a brave new world of instantly accessible sexual information and imagery via the internet, availability of medications that enhance sexual performance, and a changing culture in which women now embrace ownership of their own sexuality,” he says. “Yet we remain as ignorant as ever of the most important aspects of sexuality.”

He says instead of seeking answers we should ask more questions: What is sexuality and what role does it/should it play in our lives? How does sex impact relationships? How does it affect the view of ourselves as men and as women? How do we reconcile sexual desire with the rules of everyday life?
He concludes, “What we need now is a heightened understanding of sexuality to match our current reality.”