Sorry but there is no terribly elegant way to phrase this. Little blue erection pills hit America last week and with them the prospect of a sexual and social revolution not seen since the introduction of the birth control pill back in the 1960s.
The reception that greeted Viagra surprised everyone, even the pharmaceutical giant Pfizer, which had anticipated what they delicately called "some pent-up demand".
"The whole thing is such a phenomenon," Pfizer chief executive William Steere told company shareholders. "Everyone wants to know how much we are going to sell. We can't even make a projection right now."
Nobody complained. Pfizer's stock has risen from $45 a share to $118. Giddy Wall Street analysts, less reticent to predict sales, say that Viagra will bring in $1 billion dollars in sales by 2000. Health insurance companies agreed to pay for six pills a month. (They cost $10 each.) Time magazine aptly summed up the nation's response to the whole affair, proclaiming in a cover story: "Cheap gas, strong economy, erection pills - what a country! What a time to be alive!"
Even before its official launch on the US market, the drug had captured nearly 170,000 prescriptions by its second week of availability. And that was for those men who could get their hands on it. Taken an hour before intercourse, the pills do, with just a bit of encouragement, work.
Doctors were overwhelmed with requests. One Atlanta doctor wore out his hand after writing 500 prescriptions and quickly had a rubber stamp made. Demand was so intense that many chemists were worried. The Walgreen company, a chain of stores, sent a memo to pharmacists advising them to make special security plans against theft.
"It reminds me of the precautions we take when dealing with narcotics. The black market is new for urologists. Now we're in the thick of it," said Dr Kevin McVary, an impotence expert at Northwestern Memorial Hospital in Chicago.
So what is going on here? A clinical definition of impotence is a pretty narrow business really; it is the inability to have an erection. Period. That condition affects about 15 per cent of American men by the age of 70, according to Dr John Medina, author of The Clock of Ages.
Almost all of the problems can be traced to vascular changes in the penis, caused either by diseases such as diabetes, or by the accumulation of dense connective tissue and the narrowing of arteries that inevitably accompany ageing.
But Viagra is not flying off the shelves because wizened little elderly men are doddering out of nursing homes and hitching bus rides to their doctors' offices.
Viagra has taken off because younger men are seeking virility. Two out of five men over the age of 40 have periodic bouts of what is now called "erectile dysfunction," a condition that is simply defined as failing to get erections sufficient for satisfactory sexual performance, according to a 1994 National Institutes of Health study. Pfizer says the number of men experiencing the problem stands at about 140 million worldwide.
The reasons behind this shabby state of male architecture are now the subject of a national debate. What is not at issue is that penis size and penis performance are a matter that US men are very nearly obsessed with.
In 1996, they spent $25 million on penile implants and injectable drugs. They are gluing testosterone patches on their scrotums to increase libido. They are rush-ordering, via UPS Next Day Air, penile vacuum pumps marketed with names like Power Piston and Stallion Pump.
They are using a system called MUSE which channels soft medicated pellets into the urethra. They are visiting clinic nationwide to undergo two-hour surgery procedures to both lengthen and increase circumference at an average price of $6,200 per penis.
They are not, in reality, crazy to consider such extremes, or to think that is what society expects of them. Especially if they glance out the window. At this moment, Los Angeles and other major cities are adorned with 30foot billboards announcing the upcoming release of a new blockbuster movie, a remake of Godzilla. The marketing slogan - Size Does Matter.
Whether all this concern is warranted has got the social thinkers going with a vengeance. Author Gay Talese, currently hard at work on a biography of a penis, told Time: "The astounding success of Viagra testifies, I think, to how integral the erection is to men's self-worth."
Post-feminist social critic Camille Paglia, who also voiced suspicions that the hoopla has got something to do with the fact the country is not at war, declared: "The erection is the last gasp of modern manhood. If men can't produce erections, they're going to evolve themselves right out of the human species."
It is precisely that kind of rather unforgiving rhetoric that has produced all these flabby phalluses, charges Bob Guccione, publisher of Penthouse, the US-based explicit (for which read: pictures of naked women) men's magazine that is sold in 19 countries.
"Men don't feel like women need them anymore," Guccione said in an interview with The Irish Times. "Feminism has emasculated men. They're anxious and the fear that they won't be able to perform at that moment is devastating."
Guccione, whose magazine did a story predicting Viagra's success more than six months ago, says the pill is going to change the nature of sexual and social relations around the world.
"Men will know they're going to have an erection and they won't be worried. The impact of this is going to be huge and it's going to be economic. Think of it," says Guccione. "This will make older men want to live longer, be healthier, dress better and travel more. Younger men will use it as a recreational drug. It will allow them to go longer and harder than they ever have before."
Ahem.
Guccione predicted that the drug will have a huge impact in Italy, which is set to be the first European country to market the pill. "Italy has one of the lowest birth rates around because so much of the population is over 60. Watch what happens," he chuckles.
A lone Seattle editorial writer and the odd radio talk show host fretted about the Pharmaceuticalisation of America. Take Rogaine for your bald spot, Prozac for your blues, give Ritalin to quiet your annoying children, pop Redux to shed some weight. But they were in the minority. Most cheered this new development.
Barry Rabin, a Pennsylvania newspaper columnist, announced with tongue in cheek that Pfizer's female scientists already had preliminary results on some new drugs in the pipeline:
1. Directa : This drug given to men before leaving on car trips causes 72 per cent to stop and ask directions when they got lost.
2. Complimentra : In clinical trials, 82 per cent of middle-aged men taking this drug noticed that their wives had a new hairstyle. Currently being tested to see if effects extend to noticing new clothing.
3. Childagra : men taking this drug reported a sudden overwhelming urge to perform more childcare tasks.
Such frivolity on such serious a topic. Those who would use the success of Viagra as a way to analyse the male body politic may soon have to re-evaluate. By week's end, it was learned that Pfizer is conducting tests of Viagra on 500 women in England.
In addition, a University of Maryland urologist named Dr Jennifer Berman just received a grant to study the effects of Viagra and other drugs on women's sexual dysfunction.
One of Berman's patients, a Baltimore hairdresser, reported that Viagra gave her the first orgasm she'd experienced in the five years since her hysterectomy. Boston University is now studying its effects on women.
What a country.
