The Rise of Viagra: How the Little Blue Pill Changed Sex in America

Is there any aspect of human life more connected to one’s sense of self than sex? If we change the way we think about sex, surely we are changing the way we think about ourselves? If we change sex, we change ourselves. This is the simple, frightening argument at the heart of Meika Loe’s sociological analysis of sildenafil (Viagra)—frightening not because some dark commercial conspiracy is revealed, but rather, because it seems that some profound and perhaps unwelcome changes may be taking place in our culture and in our bedrooms, imperceptibly. ​ imperceptibly.

Figure 1

An external file that holds a picture, illustration, etc.
Object name is viagra.f1.jpg

New York University Press, $27.95, pp 288 http://www.nyupress.org ISBN 0 8147 5200 4

A self described activist scholar and assistant professor of sociology and women’s studies at Colgate University, New York state, Loe has a strong academic interest in men and sex. She even spent some time as a waitress at a restaurant chain called Bazooms in the 1990s, where the women “wear short shorts and tight tank tops,” on a kind of undercover research mission. Relating a short account of her experiences at Bazooms, she contrasts the restaurant’s tawdry reality with its prefabricated fantasy, setting the stage for her critique of the costs and benefits of the Viagra nation, a modern America where “our sexual status quo has shifted dramatically.”

The chief focus here is not the blue pill itself, but the marketing of both the pills and the new disorder of erectile dysfunction or “ED” that helped create the market for those blue pills. Loe is part of a wider global group of researchers taking an active interest in the corporate sponsored medicalisation of ordinary life, in this case arguing that the promotion of erectile dysfunction is another example of “blurring disease and discontent.”

Attending company sponsored scientific conferences, academic seminars, and educational meetings featuring industry funded researchers who are “raising awareness” about sexual dysfunction, Loe has gathered and now published a wealth of extremely valuable evidence. Rather than science, she concludes it was a potent cocktail of the profit motive, seductive rhetoric, and exaggerated statistics that helped build the disease that became the mass market for Pfizer’s Viagra. “This was largely a result of the work of a handful of Pfizer investigators and consultants, who claimed, adapted, and expanded the medical category `ED,’” she says, pulling no punches. “These spokespeople, with the help of journalists, constructed a sexually dysfunctional populace—a market primed and ready for Viagra.”

The power of The Rise of Viagra lies in its clear observations of this fresh new process of disease creation, which is transforming normal sexual difficulties into the symptoms of treatable illness. There are many revealing and engaging interview quotes from some of the key players in the ongoing conflict around the medicalisation of sexual problems, from both the proponents and the critics.

The book’s weakness, for me, is that the interviews with men and women using Viagra, experiencing it first hand, are not well enough integrated with the wider arguments and analysis. While the sociologist Loe clearly has a deep and warm respect for the subjects of her research, many of whom are candid about personal sexual experiences with the drug, and some of whom have had very positive experiences with it, she doesn’t succeed in drawing these characters or their testimony into the major drama of the book. Sometimes they feel a little bit too much like extras in the cast.

Medication and medicalisation carry risks and benefits. Without doubt there are men and women everywhere whose lives and selves have been improved for the better by the enhanced sexual life a drug like sildenafil can sometimes help deliver. But on the other side of the ledger are the costs and side effects of both the drug and the new disease. How many sexual lives have been harmed around the world, as Pfizer and its competitors have pumped millions into saturation advertising campaigns, dressed up as “awareness raising” about sexual dysfunction, promoting the idea that almost half of all men have some problem that may require a pill to fix it? We don’t really know the answer to that question, because scientific inquiry into the processes of disease mongering is at such an early change. Large, rigorous, and multinational research projects that attempt to understand and document the impacts of disease marketing on individual thinking and behaviour would be extremely timely. Some observers, included Loe, are convinced there is a real danger when healthy people are bombarded with advertisements telling them they are sick: “worrying about ED may in fact cause ED,” she says. It is time for the research community to see if she is right. ​ right.

Figure 2

An external file that holds a picture, illustration, etc.
Object name is pv1902.f1.jpg

Loe examines how Pfizer created a market for its blue pills

Credit: THE IMAGE WORKS/TOPFOTO

Some of the more interesting and provocative insights come when Loe has her feminist hat on, suggesting that the marketing of Viagra, with its obsessive and narrow focus on the hard penis, is helping men reclaim dominance, and (re)“erect the patriarchy.” She is clearly right when she observes that “a hard penis is not always the best solution to relationship or self-esteem problems,” but her wider arguments linking the rise of Viagra to a reassertion of patriarchy require more fleshing out.

Part of the problem with any discussion about Viagra is the confusion around whether it is a pill for healing a medical problem or an aid to sexual enhancement. The difficulty in trying to find the line between ordinary life and treatable illness is that marketing departments are spending hundreds of millions of dollars and pounds every year deliberately trying to blur them.

Notes

Items reviewed are rated on a 4 star scale (4=excellent)