Viagra: The Little Blue Pill with

1
Viagra The Little Blue Pill with Big
Repercussions
Zoe L Barnett Nancy A Pachana
2
Overview

• Psychological Research on Viagra Reveals
• Normal ageing viewed as dysfunctional
• Lack of discussion with key users
• Lack of consultation with partners
• Limited research on the
• - social
• - psychological and
• - emotional impact

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Erectile Dysfunction (ED)
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Erectile Dysfunction (ED)

• In 2003 six million men had used Viagra
  (Sildenafil Citrate)
• Remarkable effects of Viagra
• Significant improvements millions of mens sex
  lives
• Previously not possible with other treatments
• 322 million men worldwide (ED) by 2025 (Fisher et
  al., 2005)
• 90 remain untreated (ED)
• The impact is enormous

5
Inflated Expectations

• Very high public expectation
• Viagra marketing taps into wishful fantasies
• Providing certainty and a quick fix
• Research indicates men believe in 100 success
  (Tomlinson Wright, 2004)

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Inflated Expectations Cont/

• Research indicates drop out rate of 40-80
  (Fisher et al., 2005)
• Failure to return to prior sexual norm
• Limited assimilation of Viagra into lovemaking
• Lack the psychological, relational and
  emotional skills (McCarthy Fucito, 2005)
• Unmet expectations compound relationship issues
  (Potts, Gavey, Grace Vares, 2003)

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Viagra Dialogue?
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Viagra Dialogue?

• opening the door to frank discussion (Melchiode
  Slaon, 1999)
• Media attention ensured Viagra and ED became
  household names
• Physicians are uncomfortable discussing sexuality
• Wait for patients to bring up sexual matters
  (Boisaubin McCullough, 2004)
• Only 30-50 consult a physician for ED (Fisher et
  al., 2005)
• Assessment without partners present (Kleinplatz,
  2004)
• Lack of joint decision or negotiation (Potts et
  al., 2003)

9
Psychosocial Issues
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Psychosocial Issues

• Viagra is a socially embedded phenomenon
• Huge public interest in Viagra
• Men with and without ED share Viagra stories
• Complex interplay self image, belief systems,
  interpersonal relationships (Potts et al., 2003)
• Partners are largely peripheral ( McCarthy
  Fucito, 2005)
• Unwanted changes to sexual relationships,
  tension, communication
• Wide ranging impact
• - infidelity
• - risk taking behaviour

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Psychophysiological Issues

• From Psychological (20th c) to Vascular (21st c)
• Up to 90 Physicians focus diagnostically on
  organic causes (Fisher et al., 2005).
• Viagra advertising to physicians claims
  regardless of the etiology (Pfizer promotion
  targeting NZ physicians, 1998)
• Disregard psychological causes
• - work, relationship, sexual performance,
  preference and depression (Boisaubin
  McCullough, 2004).

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Psychophysiological Issues Cont/

• 17 of ED is psychogenic in origin (Pallas et
  al., 2000).
• 12 out of 37 participants experienced a new
  sexual symptom (Pallas et al., 2000).
• Important clinicians recognize the psychogenic
  influences
• Little research how ED influences the lives and
  well being of patients.
• Focus on sexual function over and above mens
  feelings (Tomlinson Wright 2004)

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Viagra and Older Women
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Viagra and Older Women

• Proliferation of efficacy literature re men's
  physiological response ( Boisaubin McCullough,
  2004)
• Common for research to vicariously assess
  partners response ( Tomlinson Wright, 2004)
• Assumption that women automatically benefit from
  Viagra ( Potts et al., 2003)
• Women report unwanted advances, unwanted stress
  and vaginal injury ( Katz Marshall, 2003)
• Lack of serious consideration of womens
  perspectives ( Bancroft, Loftus Long, 2004)
• Sexual dysfunction not always related to
  dissatisfaction (Bancroft, Loftus Long, 2004)
• Many women report a sense of obligation and guilt
  (Loe, 2004)
• Confusion re sexual health and risks (Loe, 2004)

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Viagra and Ageism
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Viagra and Ageism

• Group poorly represented in the research on
  Viagra
• Research tends to calculate research results and
  apply to older men ( Calasanti King, 2005)
• Sexuality does not equate with ageing
• Restoration of youthful sexual vitality
• Viagra as a fountain of youth
• Terms including ageing well growing old
  without ageing (Katz Marshall, 2003)
• Erections through the lifespan equate to
  successful living ( Katz Marshall, Potts et
  al., 2003)
• Some research older people have described Viagra
  as interfering with the ageing process (Potts et
  al., 2003)

17
Conclusions

• Many individuals report disappointment with
  Viagras results
• Refill rate for Viagra prescriptions
• Many older users report erection did not solve
  their relationship problems
• Couples are forced to deal with more profound
  troubles in the relationship
• Consultation is an opportunity to discuss
  distorted cognitions
• Some physicians lack the counselling skills to
  address these
• Disturbing lack of inclusion and dialogue with
  partners

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Conclusions Cont/

• Older women rarely considered in the Viagra
  dialogue
• Normal ageing pathologised as dysfunction
• Feminist and social discourse but limited
  clinical research
• Increased longevity requires new definitions of
  ageing life
• Research focus on the perspectives of older men
  and women

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Questions