The Viagra Myth

It was quite exciting at the time, but afterwards I felt a vague sense of dissatisfaction. Perhaps I was expecting too much from a big, shiny hardback, but The Viagra Myth by Abraham Morgentaler didn’t quite match up to my expectations.

Seriously, this book does provide a useful and thought-provoking angle on a drug that has had a big impact on the sex lives of millions. Since it was written by a practising doctor who prescribes Viagra, and is ‘an expert in the field of male sexual function and dysfunction’, I was hoping for some more basic science. The mechanics of how Viagra’s active ingredient sildenafil improves a man’s ability to have and maintain an erection are dealt with briefly, because what this book is really about is what Viagra cannot do.

Viagra will not work for every man – although by medical criteria, it’s impressively effective when prescribed to the ideal patient. It works for 80 per cent of men with ‘psychogenic’ impotence (psychological rather than physical reasons for erectile dysfunction). Though there’s an interesting chapter on other treatments that may work better for men whose problems are mainly physical, most of the book is not about erections.

It is refreshing to read a doctor who is trying to de-medicalise human relationships. ‘The Viagra myth has less to do with the effectiveness of the medication than with our cultural propensity to look for the easy fix’, he says in the introduction. And it is fascinating to read his insights into Viagra at work with real people.

Unfortunately, the style Dr Morgentaler has chosen is painfully cheery and ‘accessible’, a frothy mix of rewritten-from-life scenarios and glib bullet-point conclusions. Like the relationship guide Men Are from Mars, Women Are from Venus, The Viagra Myth hammers home the obvious at the end of every chapter: ‘Men and women experience the world differently…’; ‘It is very easy for people to experience hurt feelings when the sexual part of their relationship becomes a problem.’

All his patients apparently talk in sickly therapy-speak. ‘I think Sean just needed to hear that I liked him for who he was, and then the penis took care of itself’, simpers Bonnie in a section entitled ‘A woman’s power to heal’.

But if you can get past the self-help language, there are some useful points here. Viagra can work by solving a short-term problem where sex is the issue – or by exposing the fact that sex is not the real issue. Half of all men prescribed Viagra in the USA never renew their prescriptions. For some, feeling that a drug, rather than desire for the partner, was driving the penis created more problems than it solved. Men report different pressures over sexual performance in homosexual relationships, though Dr Morgentaler is keen to emphasise the common elements in gay and straight relationships.

I was hoping for more exploration of the reasons why we so readily turn to a little blue pill to solve problems with love and close relationships. The book takes it as given that we look to the medicine cabinet in preference to talking to our partner – or searching for deeper social roots to problems with sex and intimacy. Behind the anecdotal evidence lies an untold story of people looking for answers, often from the wrong place, to the difficulties of intimate life.

My favourite chapter is ‘Frequently Asked Questions’, which provides a glimpse of the kind of bedside manner a doctor ought to have. ‘How do the new erection pills compare to Viagra? It’s too soon to tell.’ ‘Will Viagra make me want to have sex with everyone? Only if you already want to have sex with everyone.’ ‘Can a man be too old to take Viagra? Can a woman be too old to buy shoes?’ ‘Will Viagra make me more attractive? No.’

Tell it like it is, doc.

Timandra Harkness is a science and comedy writer and journalist.

The Viagra Myth : The Surprising Impact On Love And Relationships, by Abraham Morgentaler, is published by Jossey Bass Wiley, September 2003. Buy a copy of this book from Amazon (UK)or Amazon (USA).