New pills won’t leave men fulfilled

Historians looking back on the 20th century may well see it as the Era of Wonder Drugs, when medicine supplied an endless array of chemical compounds that made life better.
Pills solve everything, it seems. Pills make you happy. Pills calm you down. Pills make you fertile. Pills abort your fetuses. Taken properly, pills prolong your life. Taken improperly, pills hasten your death.
Take your pick. In the Era of Wonder Drugs, pretty much any problem can be solved, for better or worse, with an easy-to-swallow tablet.
Some wonder drugs are truly wonderful. Penicillin is wonderful — none of my friends have ever died from minor cuts. Protease inhibitors that keep AIDS patients from dying are wonderful, too. And new treatments being developed that, if they pan out, could cure cancer are potentially wonderful beyond belief.
And then there’s the hottest new prescription drug, Viagra. From all the hype, Viagra — a pill that treats male impotence and enhances sexual performance even for older men — appears to be among the most wonderful wonder drugs of all, promising youthful virility to the men who take it. As a male who will inevitably grow older, I suppose I should herald the arrival of a pill that will ensure my continued manliness. I should embrace this new wonder drug.
Instead, I just wonder.
Anytime something appears on a cultural landscape that people label a “craze” — and as doctors’ phones ring off the hook because of demand, Viagra qualifies — it says something about the needs of that culture. Since its introduction in mid-April, the drug has spawned a black market, rip-off imitators and (most likely) a few embryos. It’s sent stock in Pfizer, its manufacturer, through the roof. Two weeks after Viagra’s introduction, the number of new prescriptions to treat male impotence tripled; 79 percent of those prescriptions were written for Viagra.
But what do we know about this drug? We know it causes side effects such as headaches, sleeplessness, flushing, indigestion and altering of color vision, and we know it only worked about 70 percent of the time in clinical tests.
We also know that some lab-tested drugs bear unexpected results when released to the wider public — last spring’s wonder drug, the sometimes-lethal phen-fen, is the most recent example. We also know that, given a national obsession with sex, irresponsible prescriptions could easily get out of hand.
These considerations are ignored in the rush for the impotence miracle cure. Viagra isn’t just another sex aid; it’s a fountain of eternal youth, and it’s for males. These two considerations are more than enough to drive the hype.
Few new prescription drugs are the subject of a Newsweek cover article and network news stories before they are even available. Why did this drug get all the attention when other breakthroughs like Tamoxifen, which might prevent breast cancer, get only a couple days of news stories before fading from public attention?
The subject matter, male impotence, is the key. People don’t like to grow old in America, and the most personal sign to a man that he’s “losing it” is sexual dysfunction. As the population ages, the number of men with sexual anxiety is bound to be rising — give them a new lease on their “manhood,” and they will beat a path to your door.
These anxieties are trumpeted by members of the mass media, who are for the most part the same people most interested in Viagra. Although workplaces are becoming more diverse, American business is still pretty much run by middle-aged males, and media businesses are no different. Viagra is being held up as a boon to men worried about losing their youth, men who are uneasy that their sexual performance is slipping. Could insecurity in the bedroom be related to insecurity in the boardroom?
And would a drug that helped females achieve orgasm get the same attention? Probably not. First, the drug would have to be developed. Male social fears and male social dominance isn’t just embodied by the hype surrounding Viagra — the drug’s creation itself reveals much about the society that produced it. The strangest, most unexamined part of the Viagra phenomenon is its development as a product exclusively for men. Male and female orgasms develop in similar ways biologically, and in theory Viagra could help with both. But the drug was only tested in men, and is thus only available to them, even though anecdotal evidence seems to point toward usefulness for women as well (Now that the drug is out, testimonials from women have prompted belated FDA testing of the drug on females).
No good explanations exist for why the drug wasn’t tested on women, except to say that the drug’s effects were first noted in men, and research proceeded in that direction. Apparently, it never occurred to Viagra researchers that women might be interested in heightened sexual experiences also. In response to charges that Viagra research didn’t pay enough attention to the drug’s potential for women, Pfizer spokesmen weakly stated that such research is under way. They note that better sexual response among men obviously helps women by increasing their pleasure.
Great. The passivity of a women’s sexual role implied by that statement has all the attractiveness of an old corset. While Pfizer’s experiments were grounded in 1990s medical research, their thinking was firmly planted in the Victorian era.
The fact is, researchers don’t know much about women’s sexual needs because they haven’t done much research on them. That says a lot about the current state of gender relations in America. While men get Viagra, a performance enhancer, women get Rohypnol, the “date rape” drug that causes amnesia and loss of personal control. Doesn’t this seem like a dangerous combination? The 20th century’s devotion to wonder drugs is making 21st century parties look more and more dangerous.
The hype about Viagra reveals much about America’s power structure and current social anxieties. It also says much about how people deal with their problems, and what a pill-driven society we’ve become.
As any doctor can tell you, impotence is often a psychological phenomenon. To make a sexual relationship work, people need to work on all aspects of the relationship, not just the chemical reactions within it. But that’s tough to do. Personal problems are complex. They require facing the anxieties that make Viagra such a popular and well-publicized miracle cure.
So pick a pill. At the end of the century, we got em. Baldness, obesity, sex — no need to face life’s imperfections. I hope historians looking back on the Era of Wonder Drugs will concentrate on penicillin and cancer cures, and find our emphasis on overhyped, socially self-serving “miracles” like Viagra hard to swallow. But don’t believe the hype about easy answers — the solutions to life’s problems can’t be found in a pill.
Alan Bjerga’s column appears Wednesdays in the Daily. He can be contacted at [email protected]