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More Young Men Are Turning to 'Mr. Blue'
January 09, 2004
Hundreds of patients asking Dr. Scott Parry
for Viagra at his Virginia-Highland clinic are
young, healthy and virile.
They don't suffer from diabetes, hypertension
or any other medical cause of impotence.
Some complain about performance anxiety. Others
say their marriage is in need of a spark. Partygoers
are looking for something to offset the effects
of alcohol.
They're part of a new wave of men in their
20s, 30s and 40s who look nothing like Viagra's
first spokesman five years ago: former presidential
candidate Bob Dole, who famously used the term
''erectile
dysfunction,'' or ED. Instead, they mirror
the drug manufacturer's new spokesman, home
run slugger Rafael Palmeiro, who has used Viagra
but reportedly has said he didn't need it. Or
Jeff Dauler, 30, a healthy, married producer
of "The Bert Show" on Atlanta's Q-100
radio, who told listeners he tried the pill
on a lark.
"Mr. Blue" --- a slang term for the
drug --- has exploded into a multibillion-dollar
industry, with nine Viagra tablets dispensed
every second around the globe.
Men with ED aren't the only ones fueling the
business. Curious men and others looking for
that edge in the bedroom can buy the pills from
a doctor, off the Internet or around Atlanta
nightclubs, sealed in tiny zip-top bags.
"Some young men will come in for a cold
or pain in the leg and say, 'By the way, I was
wondering about this Viagra, and my wife and
I have been having some problems,' or 'I could
use something to build my confidence,' "
said Dr. Shangbo Guan, an internal medicine
specialist in Sandy Springs, who is seeing an
uptick in the number of younger men asking for
the drug.
Experts say that some of these men suffer from
unrealistic expectations about performance or
are masking more deep-rooted problems, such
as relationship conflict, poor self-image or
drug addiction.
"There seems to be growing interest in
having a 24/7 erection and performing sexually
without looking at the context or meaning,"
said Dr. Gail Wyatt, a sex therapist, professor
of psychiatry at UCLA and author of the book
"No More Clueless Sex."
At other times it's even more superficial:
Men simply want to be impressed with how they
function.
"Everybody has insecurity, and here's
this one thing they take and they can feel they
have this power and they look good," said
Atlanta sex therapist Virginia Erhardt.
Viagra manufacturer Pfizer and other companies
selling impotence drugs vehemently deny targeting
healthy men and say the drugs are intended only
for men with ED.
With as many as 30 million American men suffering
from at least partial ED, according to the National
Institutes of Health, there's no need to go
outside that pool of potential customers, the
drug makers say. They estimate that only one
in every 10 men with ED seeks treatment.
The incidence of ED increases with age, and
it's unclear how many men under 40 have it.
Government and private sector estimates of the
number of 40-year-old men suffering from ED
range from 5 percent to 39 percent. Word of
mouth
Men 40 and younger account for at least 8 percent
of the prescriptions for Viagra, according to
Pfizer. No age breakdown is available for Levitra
or Cialis, a newcomer to the market already
dubbed "the weekender," because it
can stay in the bloodstream for 36 hours. Unregulated
Internet sales are not tracked.
But all three drug companies say that young,
healthy users represent a small slice of the
business --- even "peripheral," according
to Pfizer spokesman Daniel Watts.
Doctors and people on the party circuit argue
that they're seeing anecdotal evidence to the
contrary. While most who use the drugs need
them, there's clearly interest among growing
numbers to see if they can find thrill in a
pill.
Guan said that only about 10 percent of the
men asking him for ED medication appear not
to need it, but the buzz about the pills is
getting around, and he's seeing it in his office.
There's a reason the impotence drugs are intended
only for men who clearly need them. While considered
relatively safe, the trio of impotence drugs
can lead to serious complications when taken
with nitrates, often used to control chest pain,
and other medications. Possible side effects
include flushing, muscle aches and even bluish
vision. Urologists warn that some men who don't
need the medication might develop a psychological
dependency. And the long-term effects are still
unknown.
Use of the drugs by men without ED also seems
completely unnecessary. The drugs work by increasing
blood flow to the penis, allowing for an erection
if stimulated. It is not a hormone or an aphrodisiac.
"You should never take any medication
that's not necessary," said Dr. Deena Davis,
a urologist at St. Joseph's Hospital in Atlanta.
"Men think they will have this great erection,
but if you are fine without it, there is no
reason to take it. . . . I think some men look
at it like a miracle pill, and then there's
word of mouth about this buddy who lasted 20
days."
With impotence pills easily available through
the Internet, Parry, a primary care physician,
typically grants requests for them so he can
supervise their use and educate his patients
about the risks. He is also afraid some men
may not use a condom if denied a prescription
for Viagra.
"In an era of safe sex, the condom takes
away some of the sensation, and if you want
to encourage safe sex, Viagra can help that,"
Parry explained.
Some doctors also worry that the new Cialis
may be particularly attractive to young party
revelers because it stays in the bloodstream
for so long. "You take it at lunch on Friday
and you are good all weekend," said Dr.
Bruce Stein, an Atlanta urologist.
A Cialis spokeswoman, however, explained that
the long-acting drug is meant to let couples
"take advantage of the romantic moment
as it happens and have less time pressure."
Some doctors also say that mixing impotence
drugs with mind-altering drugs, such as Ecstasy
or crystal methamphetamine, is on the rise ---
and a potentially deadly combination. Wyatt,
the UCLA sex therapist, said Viagra has become
a staple at popular ''rave'' parties in the
gay community, known as ''circuit parties.''
"If you are in party mode and if everything
is sped up, you may not take time to talk about
sexually transmitted diseases," Wyatt said.
In fact, a study of 844 men at a San Francisco
STD clinic found that Viagra users had had an
average of 5.4 sexual partners during the past
two months, compared with 3.5 partners for non-Viagra
users. The study also found that more than half
the men using Viagra had obtained it through
a friend, not a doctor.
Pfizer spokesman Watts said Viagra is not to
blame.
"This is not about Viagra,'' he said.
''It is about individuals taking responsibility
for their actions --- practicing safe sex and
taking appropriate actions."
Many experts blame highly sexualized images
in magazines, pornography and TV shows such
as "Sex and the City" for giving young
men the impression that women desire marathon
sex.
"Sex is everywhere," said Davis,
the St. Joseph's Hospital urologist. "Men
see sex and sexual performance as part of the
definition of what a great catch a guy is. .
. . I think this is fed to them by the outside
world for the most part. Not their partners."
Relationship gurus say that many of the roots
of impotence are psychological and need not
medication but counseling, or at least a different
mind-set. They recommend drug-free solutions:
tenderness, love and communication.
"Women don't want a minute and a half,
but they sure don't want four hours,'' said
Erhardt, the Atlanta sex therapist. ''Most women
would like four hours of lovemaking that includes
hugging and kissing and cuddling --- but four
hours of intercourse? Give me a break."
Wyatt said many men are developing a warped
--- and casual --- view of sex.
"Viagra is not the way to a good sex life,"
she said. "The way to a good sex life is
to make a friend of the person you're with .
. . and look at sex as an added ingredient."
Copyright 2004 The Atlanta Journal-Constitution
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