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Love And Sex In The Time Of Viagra — 16 Years On

Mountains of "little blue pills" and their chemical kin have transformed the way many people think about sex and aging. (Gamma-Rapho/Getty Images)

The lives of older men have changed in a significant way since 1998, or at least their sex lives have changed. That's the year Viagra was introduced. Cialis and Levitra followed a few years later.

The once taboo subject of erectile dysfunction is now inescapable for anyone who watches TV. Late-night comedians continually mine the topic. By 2002, Jay Leno had told 944 Viagra jokes, according to the Wall Street Journal. We couldn't independently verify that number. Actually, we didn't try.

The drugs have been pitched by former Sen. Bob Dole, Chicago Bears coach Mike Ditka and dozens of attractive, anonymous actors canoodling on sofas and lounging in bathtubs.

A retired Marine Corps pilot named Mike — he asked us just to use his first name — says his own experience wasn't much different from the scenes on TV.

"It was fantastic," he says.

Mike's been married for 47 years. He's been using either Viagra or Cialis for the past 10.

"I was having some 'issues,' " Mike explains. So he discussed the problem with his son, who's a doctor and suggested Mike try the drugs.

Mike's wife was all for it, too, and he says they've lived happily ever after. "I believe my wife and I became closer," he says, because a source of anxiety vanished from their relationship.

Before Viagra, relieving that anxiety required measures that could cause plenty of anxiety themselves, says Dr. Edward Schneider, a professor of gerontology, medicine and biology at the University of Southern California. They're "just medieval, these things," he says.

For example, there's the vacuum pump, "where you essentially cause an erection by creating a partial vacuum around the penis, drawing blood into the penis," Schneider explains. He's never tried it himself, he says, but "I imagine it's awful."

Schneider says other remedies on the market include a surgically implantable pump; a Viagra-like drug you can inject directly into the penis; and a little pill that can be inserted directly into the tip of the penis.

All these methods are still in use, explains Schneider, because some men can't take the oral medications. But the men who can take them have made Viagra, Cialis and Levitra wildly successful: The three drugs took in more than $2.5 billion last year.

Dr. Jacob Rajfer, a urologist at UCLA Medical School, says there's another reason the drugs are so profitable: Erectile dysfunction "happens to all men."

Not all at once, but gradually over time, "such that men in their 40s have a 40 percent chance of having this problem," Rajfer says. "For every decade after 40, there's a 10 percent increase." That means that a man in his 70s would have a 70 percent chance of having a problem, at least once in a while.

Rajfer says this happens because after a man's prime reproductive years, smooth muscle — the type found within the walls of blood vessels and in the penis — starts to deteriorate. In fact years before Viagra hit the market, Rajfer helped identify nitric oxide as the chemical in the body that acts on smooth muscle and makes erections possible. Viagra-type drugs work by keeping nitric oxide from breaking down too quickly.

The drug is much more than the sum of its chemical parts — and its physiological effects, says a man named David, who also asked that we not use his last name. "It's something that gives that sense that intimacy can continue," he says. "You can feel less alone as a result."

David is 66 years old, a recently retired community college professor, and a widower. He's now in a new relationship.

"I was simply concerned at my age that I wasn't as capable as I wanted to be," he says. "And after I got the prescription I told her I had done that so that she would know.

And he says she was fine with it.

"Women have their own concerns as they age," says David. "She was also concerned about how we were going to be as older people making love."

With people living longer, David notes that he and the new woman in his life could spend 25 years together.

"I wanted to keep that intimacy as long as possible because I love this person and I expect to be with her for a long time," he says.

And now because of a little pill, being physically intimate with the woman he loves isn't something that will be lost to old age.

Copyright 2014 NPR. To see more, visit http://www.npr.org/.

Transcript

ROBERT SIEGEL, HOST:

Viagra was introduced in 1998. A few years later, Cialis and Levitra hit the market. NPR's Ina Jaffe covers aging, and she has this report about how the drugs work and the impact that they've had. And we'll be hearing, of course, about the male anatomy and human sexuality.

INA JAFFE, BYLINE: OK, let's just get the giggles out of the way. So here's Jay Leno.

(SOUNDBITE OF ARCHIVED RECORDING)

JAY LENO: There's a very small risk that men who take Viagra could go blind. Oh, great. What is that - go blind? I mean, for years they tell you, oh, you satisfy yourself, you go blind. Now if you have a partner you go blind. We can't win.

JAFFE: According to the Wall Street Journal, by 2002, Jay Leno had told 944 Viagra jokes. We couldn't independently verify that number. Actually, we didn't try.

But we did confirm that Viagra has, as Leno said, been associated with sudden blindness, though that's very, very rare. Most users are like 71-year-old Mike.

MIKE: (Laughter).

JAFFE: Mike, who asked us to use just his first name is a retired Marine Corps pilot. He's been married for 47 years, and he's been using either Viagra or Cialis for the past 10.

MIKE: I was having some issues and discussed it with my son who's a physician. He thought I should try it.

JAFFE: And did you discuss it with your wife too?

MIKE: I did. And she was all for it as well.

JAFFE: Because his performance issues had become a source of tension in the marriage.

MIKE: But after using the drug, I believe my wife and I became closer.

JAFFE: Because there was a source of anxiety that was removed?

MIKE: Yes.

JAFFE: Before Viagra, relieving that anxiety required measures that could cause plenty of anxiety themselves.

EDWARD SCHNEIDER: They're just medieval, these things.

JAFFE: Doctor Edward Schneider is a professor of gerontology, medicine and biology at the University of Southern California. One of the devices he finds medieval is the vacuum pump.

SCHNEIDER: Where you essentially cause an erection by creating a partial vacuum around the penis, drawing blood into the penis. I've never done it, but I imagine it's awful.

JAFFE: There's also a surgically implantable palm and a Viagra-like drug you can inject directly into the penis.

SCHNEIDER: And the other way is you actually put a little bit of a pill into the tip of the penis, and that works too.

JAFFE: All of these methods are still in use because some men can't take Viagra-type drugs. But the men that can, have made Viagra, Cialis and Levitra wildly successful. The three drugs took in more than $2.5 billion last year. Doctor Jacob Rajfer, a professor of urology at UCLA medical school says there's another reason the drugs are so profitable.

JACOB RAJFER: This is what happens to all men.

JAFFE: Gradually, over time.

RAJFER: Men in their 40s have a 40 percent chance of having this problem. So for every decade after 40, there's a 10 percent increase.

JAFFE: So a man in his 70s, says Rajfer, for would have a 70 percent chance of having a problem, at least once in a while.

RAJFER: Because after our prime reproductive years, mother nature begins turning that off. And one of the ways she does that is she begins the deterioration of that smooth muscle.

JAFFE: Which is the kind of muscle in blood vessel and the penis. In fact, years before Viagra hit the market, Rajfer helped identify the chemical in the body that acts on smooth muscle and makes erections possible. Viagra-type drugs work by keeping that chemical from breaking down. But for a man named David, the drug is much more than the sum of its chemical parts.

DAVID: It's something that gives that sense that intimacy can continue, and that you can feel less alone as a result.

JAFFE: David is 66 years old, a recently retired community college professor and a widower. He's now in a new relationship.

DAVID: I was simply concerned at my age that I wasn't as capable as I wanted to be. And after I got the prescription, I told her I had done that.

JAFFE: And what did she say?

DAVID: She was fine with it. You know, women have their own concerns as they age. She was also concerned about how we were going to be as older people making love.

JAFFE: Older people making love hasn't been something that most people have wanted to think about. But David says with people living longer, he and the new woman in his life could spend another 25 years together.

DAVID: And that meant I wanted to keep that intimacy as long as possible because I love this person, and I expect to be with her for a very long time.

JAFFE: And now because of a little pill, being physically intimate with a woman he loves isn't something that will be lost to old age. Ina Jaffe, NPR News. Transcript provided by NPR, Copyright NPR.

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