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In 1998 , Viagra was first introduced to the world , and it is fair to say that the world has not been the same since . The impact of this medication has been enormous , not just in the narrow area of treat- ing erectile dysfunction ( ED ) for which it was approved , but also in the way we think of sex and sexuality , and even in the realm of relationships between men and women . Millions of men in the United States have tried Pfizer ‘ s wonder drug , sildenafil , better known as Viagra , and there are thus millions of women who have also seen its effects on their husbands , boyfriends , and lovers . Many other millions of men and women wonder about whether Viagra can offer a solution for their own sexual and emotional problems or for the problems of their part- ners . We human beings are sexual animals , after all . And unfortu- nately , our sex lives are not always the way we want them to be . So it ‘ s no surprise that when sex goes sour , relationships suffer in other ways as well . As a practicing urologist in Boston on the faculty of Harvard Medical School , I have treated many men with sexual problems and many couples who have sexual issues in their relationships . I knew about the development of Viagra before it was introduced to the public and was involved in its clinical application as soon as the Food and Drug Administration approved the new drug . I had anticipated using Viagra primarily for older patients with well- established erectile dysfunction , but it didn ‘ t take long before I real- ized that I had completely underestimated the huge extent of public interest in trying this new medication . For example , shortly after Viagra became available , an orthopedic surgeon came up to me in the surgeons ‘ lounge as I was having a cup of coffee between operations . ” Tell me ,” he said , ” what should I know about prescribing Viagra ? I have a patient who I think should try it .” Now I have great respect for my orthopedic colleagues , but I have yet to meet one who would take on the treatment of a problem outside his area of expertise in bones and cartilage . It was quite clear that this surgeon ‘ s patient was none other than himself ! Everyone wants to know about Viagra , and many are interested in trying it , whether or not they think they have an erection prob- lem . When I lecture to students at Harvard Medical School about sexuality , there are always a good number of Viagra questions , such as , ” What happens when a young , healthy man with normal sexual function takes Viagra ?” Or ” Can a woman tell during sex that her partner has taken Viagra ?” Or ” Is it true that Viagra increases a man ‘ s sex drive ?” No one ever falls asleep in those classes ! Viagra quickly tapped into a set of wishful fantasies that mir- rored our culture ‘ s hunger for certainty and the quick fix . Supported by stories that described elderly men restored to such sexual vital- ity by Viagra that they abandoned their wives in favor of younger women , a conventional wisdom arose that Viagra was a fountain of youth , a sure cure , the real deal . Baby boomers could now look for- ward to fabulous sex well into their nineties . Men shared Viagra stories with each other at cocktail parties or around the office water cooler . ” All I can say is ‘ Wow !”‘ says one man , and other men listen- ing in wonder how their lives might be different if they also took the magic blue pill . Women too have been targeted to confirm Viagra ‘ s ability to create satisfaction and serenity within a relationship where frustra- tion and friction had once been the rule . One of the most success- ful early Pfizer ads showed a series of couples happily dancing together after Viagra apparently cured the loss of rhythm in their relationship .

Former senator and presidential candidate Bob Dole appeared in Pfizer ads soon after Viagra ‘ s introduction and instantly turned into household words the terms Viagra and ED . Viagra jokes became a staple of comedy acts on late-night television ( Have you heard the one about the man who swallowed Viagra , but it stuck in his throat ? He wound up with a very stiff neck !), thus ensuring its place in our cultural lexicon . Viagra tapped into both our fantasies and our embarrassment about sexuality in a way that no other drug had ever done . When , for example , was the last time you heard a joke about a new cholesterol-lowering medication ? Skillful marketing contributed to our perception of Viagra as the pill that put the ” man ” in ” manly .” Star professional athletes- vigorous men such as baseball ‘ s Most Valuable Player Rafael Palmeiro of the Texas Rangers and NASCAR driver Mark Martin-endorse the medication in widely seen advertisements . Other kinds of athletes use Viagra as well . Hugh Hefner , the aging head of the Playboy empire who is known for his bevy of beautiful blondes , gives Viagra credit for maintaining his pleasure quotient . Rumor has it that he provides bowls of Viagra tablets at his famous parties . Magical Viagra . A wonder drug . Or so we have come to believe . But does the reality live up to the myth ? Is it really that good ? Can it truly solve erection problems ? What about relation- ship issues ? What does Viagra do for a man who has lost his sexual desire or for a man who is simply nervous about having sex with a new partner ? What ‘ s the real story ?