Young Men Lead Surge in Viagra Use

Aug. 5, 2004 — Erectile dysfunction apparently isn’t just an older man’s problem anymore. Young men, even some who are college-aged, are leading the surge in Viagra use.

New research indicates that the use of Viagra skyrocketed 312% among men aged 18-45 between 1998 and 2002. There’s also been a twofold increase — 216% — among men between ages 45 and 55, says Tom Delate, PhD, whose research analyzed data on medical insurance claims by some 5 million patients across the country.

“We tried to see if these patients had an underlying medical condition and we couldn’t identify one in the majority,” says Delate, director of research for Express Scripts, Inc., a St. Louis-based firm that conducts pharmaceutical research for insurers, managed care organizations, and other companies.

“What we found was that problems typically seem to start in a man’s 40s and affected only about 40% of the men in these age groups.”

Enhancer Rather Than Remedy?

Does this suggest a growing trend in using the drug for recreational rather than medical purposes — such as for a sex enhancer?

“That would be my guess,” Delate tells WebMD.

While Delate notes that men older than age 56 continue to fill the lion’s share of prescriptions for Viagra, his study — published in the August issue of the International Journal of Impotence — also shows a 13% increase in Viagra prescriptions for women between ages 18 and 45. While some studies indicate that Viagra can increase sex drive and satisfaction levels in women, especially before menopause, this is not a consistent finding.

Delate also finds that two in three prescriptions came from primary care physicians, rather than urologists.

“One suggestion about what may be going on: It could be that patients are coming in, asking for the drug, and the prescriber wants to please the patients and meet their expectations,” he tells WebMD. “It could be the primary care physician doesn’t have a lot of time to spend with them, and may not be asking questions.”

Better Performance, Even if Not Needed

Viagra was the first oral drug approved for erectile dysfunction, which transiently affects nearly all men at some point, but occurs on a continued basis in as many as 20 million Americans. Erectile dysfunction can occur at any age, but typically affects men after age 50. Since Viagra, two other erectile dysfunction medications — Levitra and Cialis — have been approved by the FDA.

There is evidence that Viagra, at least, is used by some without erectile dysfunction to enhance sexual performance. A study two years ago in the journal AIDS shows that roughly one in three gay men without ED who were treated at San Francisco health clinics admitted to using Viagra as a sex enhancer, often in combination with illegal drugs.

The benefit? The belief it will lead to longer and stronger erections. In a January 2000 study in Human Reproduction, Italian researchers note men without erectile dysfunction who took Viagra cut in half their “refractory period” — the time it takes to get another erection following orgasm — from the typical 20 minutes to about 10.

Andrew McCullough, MD, director of male sexual health, fertility, and microsurgery at New York University Medical Center, agrees there has “definitely” been an increase in Viagra use by younger men. But he says many are getting it from doctors because of psychological, not physiological, problems.

“Yes, there is a subset of young guys who are using Viagra who don’t need it, but they can easily go on the Internet and get it without a prescription,” he tells WebMD. “They don’t need the stigma of going to their doctors. They get [email] spam advertisements every day.”

In his practice, he notes that young men often seek Viagra because of performance anxiety. “These are often men who are anxious about new relationships and can’t perform. Is that sexual enhancement or a reaction to sexual intimacy? They are taking Viagra and I think they should. Certainly they need to address the psychological issues, but I don’t want them to withdraw from relationships because they don’t want to go through the humiliation of not being able to have an erection or perform well. Everyone is watching Sex In The City and there’s a lot of pressure and performance anxiety.”

Older Men Still Best Customers

Pfizer spokesman Daniel Watts says the typical Viagra user is age 53 and that his company doesn’t keep records of users younger than 33. Company data indicates that 8% of prescriptions are written for men between ages 34 and 40. That compares with 26% of prescriptions for men in their 40s, 36% for men in their 50s, and 22% for men in their 60s.

“We can only assume the physician is prescribing Viagra on an erectile dysfunction diagnosis,” he tells WebMD. “It’s difficult for us to determine what level the drug is being used for sexual enhancement. It could be happening out there, but we don’t know to what degree.”

But he does acknowledge that his company (as well as Viagra’s competitors) has shifted direct-to-consumer advertising. Former senator Bob Dole, who pitched Viagra to treat a common problem for men in his age group, has been replaced by younger drug “spokesmen” such as under-40 baseball player Rafael Palmeiro. Just weeks ago in Venezuela, 63-year-old soccer legend Pele was dropped as that country’s Viagra pitchman in favor of a popular 40-year-old game show host for a new $2 million marketing campaign.

“There are young men suffering from ED,” explains Watts.

Show Sources

SOURCES: Delate, T. International Journal of Impotence Research , August 2004; vol 16: pp 313-318. Kim, A. AIDS , July 5, 2002; vol 16: pp 1425-1428. Aversa, A. Human Reproduction , January 2000; vol 15: pp 131-134. Tom Delate, PhD, director of research, Express Scripts, Inc., St. Louis. Andrew McCullough, MD, director, male sexual health, Fertility and Microsurgery, New York University Medical Center; associate professor of urology, NYU School of Medicine, New York City. Daniel Watts, spokesman, Pfizer, Inc., New York City. Bloomberg News, July 30, 2004.