Oliver Finding

In “Viagravation” ( July 15), The Sunday Times Magazine reported on, among others, the case of Olly Finding and his alleged experiences with Viagra. We have since been informed that Oliver Wedlake, an acquaintance of Olly Finding, tricked our journalist, in a series of conversations, into believing she was speaking to Mr Finding when she was actually speaking to Wedlake. We accept Mr. Finding’s assurances that he has never used Viagra, cannot therefore be addicted to it and certainly has never obtained it illegally. Wedlake accepts full responsibility for the publication of this fictitious element of the article and unreservedly apologises with The Sunday Times for the embarrassment and distress caused to Mr Finding by the article.

It was billed as the great marriage saver of the late 20th century. Viagra was the drug that would fix all but the most broken-down of relationships, sending all those involved onto a lust-soaked cloud of successful sexual chemistry. But no one in those heady days could quite imagine the side-effects – emotional as well as physical.

Since Viagra launched it has become – in common with similar drugs – a pill that is popped for recreational use. As this has happened, its users have become more and more demanding physically – and less and less discriminate in their sexual preference.

There is plenty of evidence that a generation of users are coming forward who would consider almost any form of sexual encounter. Hayley, a 24-year-old fast-track civil servant, said men in her social circle take Viagra because it counters the effect of cocaine and ecstasy, which raise lust but cause impotence. “By about 3am you might have run out of everything else, so you might get two girls and a guy, or maybe a bigger group, taking Viagra and going off to have sex for the next three hours. With Viagra, guys can do it again and again. It is part of a trend towards experimentation. People want to see what happens when you mix things up.”

Hayley believes, however, that most female users of the celebrated diamond-shaped blue pills take it merely to give themselves sexual licence – even though there is no evidence to suggest that it improves the physical sensation for women. And therein lies the root of a much deeper social problem: Viagra only works on men, providing mechanical “coupling” assistance only. It is not actually for couples and doesn’t make men into good lovers. For many women, it has merely highlighted the incompetence of their lovers. More crucially, it has laid bare a female secret that many men never knew. Penetrative sex does not necessarily give women the best orgasms – and, depending on which study you read, anything from a third to 52% of women never have orgasms in this way.

Since Viagra first went on sale nine years ago, more than 27m men in 120 countries have been prescribed it for impotence caused by age and illness. Millions more have bought it illegally on the internet and elsewhere for recreational use, and there is now concern about the wider social consequences of an increasing reliance on chemically-induced erections. An erotic act has been turned into a robotic one. “It’s like being 14 again,” said one middle-aged recreational user. “You get an erection and you are desperate to do something with it. You ejaculate and you soon want to do it again, then again. Apart from the side effect of blue-tinged vision, you also end up with extreme physical fatigue from too much sex. If the woman you are with is not up for it, things can get unpleasant. You can end up having a steaming row – and still have a hard-on.”

Armies of doctors, sociologists, sex therapists and counsellors warn that the drug encourages couples to buy into a “McSex” model of a “correct” way to have sex. This can damage relationships. A breed of men with sexual needs deeply unappealing to women is emerging – and many women, because of the ensuing pressure on them, now admit that penetrative sex never had the ecstatic effect that men imagine. The Viagra revolution has proved that although super-charged erections do a great deal for the self-esteem of men, for women they often create a trail of disaster. According to a study in The Journal of Sexual Medicine, half the men prescribed Viagra don’t go back for more. Lack of involvement of women in the therapy decision is cited as the main reason. Viagra is increasingly mentioned in divorce cases, yet black-market supplies still flood into Britain.

Until the 1980s, when doctors in the pay of the pharmaceutical industry began using the term erectile dysfunction to describe impotence as a medical condition, it was well recognised that such failures affected most men at some time in their lives, and that sexual performance generally declines with age. As erections happen spontaneously during sleep in healthy males, many doctors took the view that impotence was largely psychological, or a natural part of ageing.

Sexual function became an increasingly respectable subject for medical curiosity after the milestone publication of Alfred Kinsey’s report on men’s sexuality in 1948. He thought that women’s experience of sex was closely related to the performance of the male partner. However, scientific studies began to appear showing that, for many people, a complete absence of sex life was normal. A 1994 study concluded that 52% of American men aged 40 to 70 suffered varying degrees of impotence.

Worryingly for the drugs industry, a lot of them did not seem to mind. A 1996 study at Keele University of 4,000 men and women with a median age of 50 concluded that 34% of men had such problems, and 41% of their partners found penetrative sex painful. Asked if they wanted help to re-establish a sex life, fewer than half of the respondents (of either gender) said yes. Since the advent of Viagra, the pharmaceutical industry has taken the view that such people don’t know what’s good for them.

The discovery of Viagra began in the 1980s with experiments on muscle relaxants, most notably when a British urologist, Giles Brindley, proudly demonstrated his own chemically-induced erection at an American Urological Association meeting in Las Vegas in 1983. “I had been wondering why Brindley was wearing sweatpants,” said one urologist who was present. “Suddenly I knew. It was a big penis, and he just unveiled it and walked around the stage.” Brindley had injected himself with the muscle relaxant papaverine, an early indication that such compounds helped to keep blood in the penis.

Others began trying to promote the notion of injecting stiffening compounds into the organ, a technique abhorrent to all but the most desperate.

Meanwhile, Geddings Osbon, who ran a tyre-repair business in Georgia, had surprising success with the sale of a vacuum pump he had invented to deal with his own problem.

Urology as a medical speciality also grew in status as male sexual dysfunction became perceived as a disease. Medical insurance in the US covered urology but not sex therapy. In the cash-driven US health system, urologists needed to persuade men they were abnormal in not wanting more sex – that way they would keep new patients coming through the door. The rising tide of obesity, heart disease and diabetes has, however, done much of the work for them – mechanical failure related to ill health now accounts for much of the impotence epidemic.

There is no question that large numbers of increasingly young, chronically sick men are distressed by their sexual incapacity. In Britain alone, there are estimated to be more than 1.5m male diabetics. The disease causes impotence in up to half of them. It is easy to see where the market for a treatment might be, and by the mid-1990s, the stage was set for the entry of Viagra.

Although it was originally promoted as a treatment for elderly men rendered impotent through chronic illness, Viagra is more effective in healthy men, producing a capacity to have repeated orgasms. The story of the discovery of Viagra has now entered the annals of popular science: Pfizer, the company that developed the wonder pill, was looking for a heart-disease treatment that would lower blood pressure. The healthy men who took part in the initial trials of the secret compound shyly revealed it had produced the unexpected, but very welcome, side effect of super-charged erections.

It was already known that sexual-arousal messages from the brain spark the production of cyclic guanosine monophosphate (cyclic GMP), which relaxes pelvic muscles and allows the penis to become engorged with eight times its normal blood supply, the necessary volume to sustain an erection. Pfizer’s compound was sildenafil citrate, subsequently named Viagra (a combination of vigour and Niagara). Sildenafil suppressed an enzyme called phosphodiesterase type 5 (PDE5), whose normal role was to break down cyclic GMP and cause the erection to subside. Without this breakdown of cyclic GMP, the possibilities were very exciting indeed.

Pfizer knew they had a potential goldmine on their hands, but they were terrified the slightest marketing slip could leave sildenafil dismissed as a sleazy love potion that respectable people would not want. Development of the compound continued in secrecy until The Sunday Times revealed to the world in a front-page story in 1996 what had happened at the company’s laboratories in Kent: the discovery of what would become the fastest-selling drug in history. Pfizer was horrified. The company blocked all questions from the newspaper as they set about managing the launch of their money-spinner.

Bob Dole, then 75, the Republican presidential candidate in the 1996 American election, was the first public face for Viagra. He had already led campaigns telling men to get regular checks for prostate cancer, a disease causing impotence from which he himself had suffered. Although he was not required to say he was impotent, he appeared on American TV adverts clutching the arm left withered by a world war two combat injury and indicating nothing else about him was withered since he had discovered Viagra.

In 2002, Pfiizer began using the 37-year-old Texas Rangers baseball star Rafael Palmeiro as the front man for an American TV advertising campaign. Although Palmeiro also never had to claim he was impotent to receive his reported $500,000 fee, the message was clear enough: if even the most virile of sporting heroes could benefit, then so could the average healthy man.

Although the drug is only available on the NHS for a limited range of impotence-creating conditions, including spinal-cord injury, diabetes and prostate cancer, everyone knows it will work on nearly all healthy males beyond puberty.

Since Viagra was launched, two other similar drugs, Cialis and Levitra, have been marketed by Pfizer’s competitors Eli Lilly and Bayer. The problem is, however, that away from the drug-fuelled hedonists who flock into nightclubs, the existence of this new breed of potency wonder cures has promoted the goal of penetrative sex and orgasm as the definition of “normal” sex, highlighting enormous differences between men and women. “Male sexuality is penis-centred,” said one middle-aged man who took part in a study of the emotional effects of Viagra on couples in New Zealand. “Men have to shift the focus from penis to mind. Such control comes with experience and maturity.”

Brain imaging is providing clues about the different patterns of sexual response between the genders, but obtaining clear information about the gulf between how different individuals view sex is proving difficult. John Bancroft, the former director of the Kinsey Institute for Research In Sex, Gender and Reproduction in Indiana, acknowledges there is a vigorous debate in the medical profession about the effect of applying a male model of sexuality to women – not to mention the risks of medicalising sexuality by marketing a “normal” pattern of activity.

“Increasingly,” Bancroft says, “we are realising there are important differences in sexual arousal and responsiveness between men and women, and considerable variation between individual women – more than there is in men – in their sexual responsiveness. Although many men, like women, are motivated by the desire for a close, intimate interaction with their partner, rather than being motivated purely by sexual pleasure, women need to understand how troubling it can be for a man to have difficulty with erections.”

According to Dr Lori Boul, a Sheffield-based psychologist specialising in sex therapy, that understanding is often missing. Women are pressured into accepting Viagra-fuelled “acts of lust” rather than an emotional connection or sexual satisfaction for themselves. “There’s a lot of money in this idea that penetrative sex is the key, that if you get that right everything will be fine,” she says. “But from a woman’s point of view, it’s only part of it. Poor communication and poor technique among men will never be fixed by a pill. It never ceases to amaze me how limited and inhibited many middle-class, intelligent people are in their sexual practices.” Her concerns are echoed by Susan Kellogg Spadt, the co-founder of the Pelvic and Sexual Health Institute in Philadelphia. “The worst problems occur when a man recognises he has a communication problem with his partner and covertly gets a supply of Viagra thinking that will help,” she said. “All that happens is he gets an urgent erection that he must do something with, and the communication problem gets worse.”

The sexual-dysfunction industry cannot agree with her: there must be something wrong with the clitorises of these women. A recent paper in the US Journal of Obstetrics and Gynaecology described an earnest effort to investigate “pudendal nerve integrity” after discovering 48.2% of its sample had “desire disorder, arousal, orgasmic or pain disorders”. Not great if you are selling a drug that gives men urgent erections.

Annie Potts, a psychologist specialising in gender studies at the University of Canterbury in New Zealand, is one of a group of researchers investigating the wider issues around Viagra use. In the journal Social Science and Medicine, she described the effects of the drug on long-term relationships. Female partners of Viagra users in her research voiced standard complaints: doctors prescribing Viagra to men rarely asked about the relationship, and there was little interest in how normal ageing affected people’s attitudes to sex. “Women in their fifties and sixties were being pressured into having repeated or prolonged sex with their husbands because of the desire not to waste an expensive tablet,” she said. “Most importantly, sex incorporating Viagra was more likely to have the urgent coupling sought by teenage boys, with less time spent on pleasurable activities other than penile-vaginal intercourse.”

Her work also explored the decline of the “orgasm imperative” in older men, who said that peaceful, less aggressive sex lasted longer and was more satisfying. “Instead of focusing on an assumed adverse effect of erectile changes and perpetuating a sense of inadequacy and abnormality, we might redefine such changes in terms of opportunities for increased sensuality, intimacy and experimentation,” Potts says.

And it is not just older women who are uninterested in penetrative sex. Katherine Angel, a Cambridge philosopher researching cultural attitudes to sexual problems, thinks it applies to most women, whatever their age. “Women are being told they must have a male attitude to sex. It is becoming procedural and technical, and if you are not having lots of penetrative sex and reaching a climax, you are dysfunctional. The majority of women fail to reach orgasm during penetrative sex, which must mean the majority of women have a disease. The drive to narrow the definition of what sex is about is very worrying.”

Such complaints attract little sympathy in the erectile-dysfunction camp. John Dean, a doctor specialising in sexual medicine in London who took part in the original trials of Viagra, insists that its use has brought happiness to millions of couples, saved the cost of treating epidemics of depression and other illnesses linked to mental health, and allowed many men to increase their economic productiveness. He acknowledges that doctors may have been reckless in giving prescriptions to men on their own, but says: “If you insist they only have it with their partner’s consent, it raises other ethical issues. How do you know they are planning to use it with their partner? I don’t agree that we are unnecessarily medicalising sexual function, any more than wearing glasses is medicalising short-sightedness. There probably are examples of undesirable consequences, but that does not mean the drug is not beneficial for the majority.”

It is not known how many of the 900,000-plus British men who have tried Viagra have genuinely found it beneficial. A Pfizer spokesman pointed to a study showing that men had to persevere for eight or nine attempts with Viagra before they might achieve a strong enough erection for sex. However, The Sunday Times Magazine reported in 1998 that even if it created a better erection, it deadened sensation and was like wearing an invisible extra condom.

Clearly, the drug’s effect is highly individual. And there is growing concern that for some users it may be psychologically addictive. In America, Jerry Springer was one of the first to go public with a claim of dependency on Viagra, and more recently the lurid evidence in the trial of the murderers of the 66-year-old Earl of Shaftesbury included allegations that his addiction to a combination of Viagra and testosterone had turned him from a kindly old man into a compulsive “dragueur”, prowling the ritzy clubs of the Côte d’Azur in search of high-class prostitutes. The party that led to the death of Stuart Lubbock at the home of the disgraced Michael Barrymore also involved Viagra. And in the US, a rise in HIV in elderly men has been attributed to it, though Pfizer has so far resisted demands for safe-sex warnings on packaging.

Raoul Felder, a New York divorce lawyer, claims to have dealt with over 100 “viagramony” divorces. Rates of sexually transmitted disease in pensioners are increasing in affluent retirement communities where invigorated elderly men finding themselves shunned by their elderly wives are picking up prostitutes. “You get them cruising the red-light area looking for prostitutes and contracting venereal diseases,” says Felder. “Not surprisingly, that too leads to divorce.”

A lawyer from Oxford, Barbara Simpson, tells a similar story: “My firm deals with around 2,000 divorces a year, and excessive sexual demands linked to Viagra use does come up,” she says. “It is not a regular theme, and the marriages are probably failing anyway, but for some couples the drug is what tips them over into disaster.”

Paula Hall, a psychotherapist for Relate, is counselling a couple where Viagra “dependency” is a factor in the breakdown, with the woman distressed that her husband needs a chemical prop to find her desirable. “I don’t know that it is ever a primary cause; it is more likely to be the last straw,” she says. “But I worry about so many people becoming habitual users. We simply don’t know what the long-term effects might be.”

Pfizer vehemently denies the notion of Viagra dependency, still less addiction, but a spokesman did admit that it was not possible to predict its long-term effects: “How can we see into the future? All we know is that this is a remarkably well-tolerated drug that has alleviated a great deal of misery suffered by millions of people.”

Away from the untypical world of Hayley and others, sexual attitudes in most societies are as sexist as ever. While very few American health-insurance plans cover the contraceptive pill, they all rushed to cover Viagra. Japan took more than 30 years to approve the contraceptive pill – and about six months to approve Viagra. In many countries there has been discussion about whether the drug simply masks chronic communication problems in poor relationships.

Women who are unenthusiastic about their partners using it risk being labelled dysfunctional themselves and being channelled towards medical treatment, as companies race to find a “pink” Viagra to cure the social, psychological and emotional “malfunctions” of female sexual response.

The condition of hypoactive sexual-desire disorder has been invented to give low libido the correct, respectable veneer in the face of studies indicating that up to half the female population either don’t want or don’t enjoy sex. A number of treatments are in the final stages of trials as well as a variety of lubricants designed to stimulate blood flow and neural sensitivity in the vaginas of women worn out by the demands of their Viagra-fuelled partners. Results are due from trials of one, Zestra, which promises more pleasurable sex and superior orgasms. A straw trial of the lubricant, carried out by The Sunday Times last month through Mumsnet, a women’s internet site, produced a huge range of responses, many of which underlined how little satisfaction many women derive from penetrative sex.

The best of a poor choice already on the market in Britain appears to be Intrinsa, a testosterone-releasing patch, stuck to the skin of the woman’s abdomen, designed to increase sex drive.

As well as tackling the perplexing question of hyposexual desire in women, the pharmaceutical companies are forging ahead with defining other medical conditions such as premature ejaculation, to allow more men a “normal” sex life. A recent study in The Journal of Sexual Medicine, part-sponsored by Johnson & Johnson, attempted to define the problem by giving stopwatches to the wives and girlfriends of 1,587 men, and asking them to measure the period between penetration and ejaculation. Normal was defined as 7.3 minutes, while “premature” averaged 1.8 minutes. But the study found that anxiety over the issue varied greatly, with many couples not bothered. Nevertheless, a new generation of drugs in the pipeline will create an international norm of 7.3 minutes.

Meanwhile, the march of Viagra appears unstoppable. Other applications for the compound – making tulips stand up straight, or as a cure for jet lag, pulmonary hypertension, and the treatment of premature babies – have all been investigated as potential new markets for which licences could be sought.

The international pornographic film industry is said to be one of the main destinations of the billions of tablets consumed annually. Despite over-the-counter sales being technically illegal (the law is rarely enforced), the drug is available in many sex shops at about £3 to £4 per tablet.

As a means of stemming the haemorrhage in revenue resulting from this trend, Pfizer has authorised a limited trial of over-the-counter Viagra in Boots. The drug went on sale in three Manchester branches, apparently as a Valentine’s Day gimmick, earlier this year. Consumers were dismayed to be told that they first had to book an ED (erectile dysfunction) consultation with a pharmacist before handing over £50 for four tablets. For a repeat prescription, they will have to pay £37.50 to see a private doctor and £21.25 for subsequent packs of four tablets. Pfizer is trying to persuade the Department of Health to allow routine NHS prescription of the drug, and it is developing a programme to help GPs recognise erectile dysfunction. Critics point out that GPs would have to be in people’s bedrooms to diagnose it properly.

This lucrative and continuing incursion into the most intimate aspect of people’s lives by the pharmaceutical industry has shown us much that is wrong, but it has also shown us that medication to make people experience the correct emotions is futile. Thomas Szasz, an 87-year-old emeritus professor of psychiatry at Syracuse University in New York, is a vociferous critic of the drive to medicalise sex: “We are diminishing and debasing what it is to be human, and it will come back to haunt the people using this drug when they find that others are treating them in an equally dehumanising, mechanical way.”

Although the majority of men would never show their erect penis to another male, the Giles Brindley story, and indeed the whole Viagra saga, does beg the question of whether it is all simply a manifestation of male competitiveness.

Nick O'Hare/Marketing

Nick, 49, spent years marketing vacuum pumps for impotent men. Then he found he was a candidate for treatment himself: “I developed high blood pressure in my early forties, suddenly couldn’t get an erection, and thought, ‘Bloody hell, it’s happening to me.’” He does not fit the current criteria for getting impotence drugs on the NHS, but he has tried Viagra, Cialis and Levitra, plumping for Cialis, which works for up to two days, while Viagra lasts only a few hours.

Because of his job he is more aware than most men of the complex issues. “Viagra does not actually work as well as you might hope in sick men. It works best in healthy men, and they can shag all night. If you do sex well enough though, you don’t need to do it more than once. Women don’t like being pressured to do it again and again. The question since this treatment arrived has always been, ‘What about the woman?’”

The problem was compounded because Nick’s girlfriend, Anna Sharpe, with whom he has two sons aged 11 and 13, experienced premature menopause at 39.

“The problem with all these drugs is that the problems they create for women have never been properly recognised,” Sharpe says. “You get men who are raring to go and their partners are not really up there with them.”

The couple, who live in Walton-on-Thames, Surrey, have discovered a “female arousal oil” called Zestra, which increases blood flow to sexual organs. Such is their enthusiasm that they are launching it in the UK on behalf of the American parent company. Although it does not work for everyone, they are hoping the results of an American government-sponsored trial involving 200 women, which are due to be announced this autumn, will endorse the product.

Peter Unruh/cosmetics

Peter, 58, from Maidstone, Kent, has a more positive experience of Viagra. He is 5ft 8in and weighs a hefty 14 stone. While struggling to revive the ailing cosmetics company he inherited from his father, he began drinking heavily. His wife, who is 54, shared the stress. The couple, who have both been married before, found their sex life dwindled to zero. Then Peter found his body would not perform anyway. His sexual potency had vanished. After a long period of distress that the couple initially attributed to their pressurised lifestyle, Peter finally saw his GP. The doctor diagnosed diabetes — and prescribed Viagra. “There is no question my inability would have pulled apart the relationship with my wife,” Peter says. “Sex may not be important to some people, but it is to us.”

The NHS prescription provides four tablets a month, and he buys a similar number off the internet at £5 a pill. He finds cutting them in half is perfectly effective. “I can make love twice and we are both happy. You have to keep some sort of equilibrium with your partner,” he said. “If I took a whole pill I would be up all night. You get an erection that is double the strength of a normal one, and a very strong urge to do something with it. A whole tablet is just too much. You would want to ejaculate three or four times, and you can’t go to sleep.”

After just four months on the treatment, Peter says that his marriage is happier than ever, and he ascribes the successful relaunch of the business to his improved state of mind.

Sheila Mackenzie/mother

Sheila, 56, from Kendal, Cumbria, has three adult children and has recently retired from her job as an office administrator. She reflects the views of many women in her dismay at the Viagra industry’s focus on men’s needs. “I’ve been happily married for 30 years, but I went through the menopause at 36 and I’ve had low libido ever since,” she says. She and her husband, who doesn’t use erection enhancement, have regular sex, but she says that is mostly because she is “obliging”. HRT, which is meant to aid flagging sex drive, had no effect on her. Her comments echo those of many women, and demonstrate why it has proved so difficult for drug manufacturers to capture the essence of female sex drive and sell it in a pill. For many women, sexual satisfaction lies in erotic anticipation and build-up as well as emotional closeness. “I still have orgasms and some of them are pretty intense, but I’m rarely in the mood beforehand,” she says. “I want something that will affect my state of mind before sex. I can still remember the level of interest I used to have. That’s what I want to recapture. Zestra didn’t really work for me. I’m not optimistic that the drugs industry is capable of bottling female sex drive.”