Twenty-one years ago today, Viagra was approved by the Food and Drug Administration (FDA) to treat erectile dysfunction (ED). No ordinary drug, it became a commercial sensation and pop culture phenomenon almost overnight.

The drug wasn’t actually designed for ED. First synthesised in 1989, it was intended as a treatment for high blood pressure and angina. However, it performed badly in trials, and was almost lost to history, only for the study participants to report an interesting side effect.

“I seemed to have more erections during the night than normal,” said one man. The others smiled and said: “so did we”.

Pfizer (the pharma company) had stumbled across something completely unprecedented. While their compound didn’t do much to relax blood vessels, it did inhibit an enzyme that regulates blood flow to the penis. This makes it easier to achieve and maintain erections.

Then and now

Two months after its launch, Viagra made the cover of TIME magazine, with the headline ‘The Potency Pill’. Later that year, a former presidential candidate, Bob Dole, featured in its marketing campaign, adding a certain gravitas to a concept that had previously been the butt of bad jokes.

By the end of 1998, Viagra sold nearly 100 million pills in the US. Since then, it has made tens of billions of dollars, reaching $1.6bn globally in 2016 alone.

Today, Viagra is one of the most famous drugs in the world, and is enjoying a new lease of life since becoming available over the counter. As of March last year, men in the UK have been able to buy Viagra Connect without a prescription, causing sales to soar.

Myth and misconceptions

However, despite its popularity, the drug is still shrouded in misconceptions.

Just think of the first episode of Netflix’ Sex Education, which perpetuates the idea that Viagra = instant erections. We begin the episode by watching Adam, the school bully, fake an orgasm. Later in the episode, we find him moaning in the toilet because he’s taken “three Viagras”.

“It feels like it’s going to explode, and not in a good way,” he says, an enormous bulge visible through his pants. “I feel lightheaded, and I can taste scampi.”

Suffice it to say, tasting scampi is not a recognised effect of Viagra. But neither is getting an uncontrollable erection that won’t go away. The drug makes it easier to get hard if – and only if – you’re in the mood. You’re not likely to experience anything without sexual stimulation.

(As a side note, you can suffer a painful prolonged erection, known as priapism, if you exceed the recommended dosage. While this is pretty rare – and Netflix has certainly used some artistic license – it is important to only take the dosage you’re prescribed).

Not just for old men

Another big myth about Viagra is that it’s only for older men. Again, the media presentation hasn’t really helped its case here. (The late Hugh Hefner used to brag about taking Viagra in interviews.)

However, ED can occur at any age, and you certainly don’t need to be an ageing playboy in a bathrobe to benefit from Viagra. One study found that, in patients seeking help for ED, a quarter of them were under 40. Other research suggests that the proportion of men with ED correlates to their decade of life (30% of men in their 30s, 40% in their 40s etc).

Even if it’s not a chronic problem, many younger guys can still struggle to get hard from time to time. Performance anxiety, too much alcohol, work stress – all these factors can lead to the occasional frustrating occurrence in the bedroom.

Slowly but surely, the stigma does seem to be lifting, and there have been a number of campaigns highlighting the prevalence of ED in younger men. That said, it’s still not easy to talk about, and if you’ve been struggling in this department you’ll likely appreciate discretion.

What’s in a name?

There’s no denying the famed status that Viagra has achieved over its 21 years. But the ubiquity of the brand name can itself be a deterrent for young men seeking treatment. Viagra’s association with an older demographic, and the myths of instantaneous erections are heavily embedded within the public understanding of the drug.

Unbeknownst to many, Sildenafil is the unbranded, generic version of the famous little blue pill. It is exactly the same from a medical point of view, but is available from several manufacturers, meaning it can be more competitively priced. (Because Viagra is branded, the pills command a more premium price tag.)

Sildenafil, like all medicines sold in the UK (including Viagra), has been reviewed and authorised by the MHRA, which ensures that medicines meet applicable standards of safety, quality and efficacy.

One of Many

Since Viagra’s approval by the FDA in 1998, a number of other medications have been made available for the treatment of ED (including Tadalafil and Levitra). Despite persistent myths, the condition itself has more widely understood, and Viagra Connect has even been made available over the counter in the UK.

To find out more about ED and a few of the different medications used to treat it, there is a handy summary page here.

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