Sildenafil citrate (VIAGRA)

Viagra was launched in 1998 and is said to have as much brand awareness as Nike. According to makers Pfizer, it’s been used by 16 million men worldwide. It’s also said to be the most successful prescription drug ever launched in America.

It’s not an aphrodisiac, and in the absence of normal sexual stimulation it won’t be effective. Although it helps erection, it doesn’t improve ease of ejaculation.

Viagra is only recommended for men. It works by helping to relax the blood vessels in the penis, allowing in blood when sexually stimulated. You should not take Viagra if you’re a woman.

The “little blue tablets” come in three strengths - 25mg, 50mg and 100mg. It normally takes between thirty minutes and one hour to work. Viagra stays in the body for three to five hours.

In 1999, the NHS Executive announced 15 categories of men entitled to Viagra on the National Health Service - including Multiple Sclerosis, spinal cord injury, Diabetes, Parkinson’s Disease and Spina Bifida. GPs can still issue private prescriptions to men not eligible for prescriptions on the NHS.

The ration or approved supply from GPs is one pill per week. This is based on what is thought to be the “average frequency of intercourse”. However, GPs have discretion to prescribe more than this.

Viagra even made it onto EastEnders as a plotline, when Dot Cotton’s husband Jim tried to buy a herbal substitute - “Niagara” - off Patrick in the Queen Vic. Well, it was just before his wedding. Actress June Brown said she thought it was all “a bit vulgar”.

Viagra is hugely talked about online. The Google search engine has more than four million references to the drug. That’s ten times more than Prozac and twenty times as many as Botox.

There are websites full of Viagra jokes. Have you heard the one about the Viagra computer virus that turns your 3½ inch floppy into a hard disk? Oh dear.

Medicines that Viagra can’t be taken with include poppers - amyl nitrate. There are also some medical conditions that mean you can’t take the drug. It’s important to remember that Viagra is a prescription drug and you should speak to your GP before using it.

As well as people with spinal injuries, another large user group of Viagra are men with MS. Jim is in his mid-forties and has had relapsing remitting MS for ten years. He’s been using Viagra for seven or eight months to help him have sex.

“Frankly I was surprised to be having sexual problems because my MS isn’t that apparent. But something like MS takes its toll. I had been noticing several of my problems getting worse - especially leg spasms and urinary difficulty - so I don’t suppose I should have been surprised when I found I was also having difficulty with sex.”

Jim says it was the start of a new relationship that provided the catalyst for him to sort out his problem. “I had been out of relationships for a couple of years before I met Carol, and it was having sex for the first time after a long absence that made me realise that I definitely had a problem. Carol was very sympathetic and also very matter of fact, which I think helped me.”

“Of course, I wanted to sort the problem out because I worried that it could damage our relationship. Also, if you can’t get a good erection as a man you feel a bit of a failure. But I kept on telling myself that it was the MS, not me. Carol agreed. That’s why it was easy to see my doctor about the problem, which I did.”

“I think I’m so lucky because I can talk to Carol about all this. I’m lucky as well because my self esteem has been preserved more or less intact.”

Jim’s been using Viagra for eight months. “I get four 50mg tablets every four weeks. I’ve heard that 50 mg is the dose they start you off with. There is a bigger dose - 100 mg - but 50 mg seems to do the trick for me, so I’m sticking with that for the time being.”

“I read in a couple of places that I could get four tablets, which I think is a small amount. But I only see my girlfriend every couple of weeks - we live a long way apart. I’ve read that four tablets is the approved amount based on what is thought to be the average frequency of intercourse.”

Jim too has tried other things, such as a vacuum erection device. “Yes. I bought one of these,” says Jim. “I got it from a sex shop. It made me laugh because it’s quite unwieldy! Somehow it looks out of place in the bedroom. I’ve also tried a technique called ’stuffing’, which I read about in a magazine for people with MS, but I found this a bit awkward.”

How does Viagra compare with these? “It’s much easier and more straightforward. Viagra’s had a phenomenal effect. I can’t really put into words just how good it’s been for me and for Carol too.”

What about side effects? “On the leaflet that goes inside the Viagra box there’s a list of possible side effects,” says Jim. “But for me it’s all been positive. It does exactly what it says on the label - or rather the leaflet inside the pack. It helps me get an erection.”

Like Bob, he has no complaints. Neither do their partners.

“The single greatest improvement I have enjoyed since my injury … fantastic stuff.”

With endorsements like that, it’s hardly surprising that Viagra has earned a special place in the affections of disabled men and their partners. In an age when we talk a lot about access, Viagra has given large numbers of disabled men and their partners access to a fulfilling sex life.

Bob and Alison
Bob Melville is 46 and lives in Aberdeenshire. He sustained a spinal injury in 1996, and has been using Viagra for the past three years.

Bob met his wife Alison after his spinal injury, so she was aware of the limitations that it imposed on him from the start. “Before taking Viagra our relationship was fine, but the sex was far less natural,” he says. What Viagra has done for Bob and Alison is to increase the options that are available to them in the bedroom. Bob speaks highly of the little blue pills, but he is quick to point out that “good sex doesn’t necessarily rely on an erect penis and penetration. You can have good sex in other ways.”

“I would say I had quite a high libido before the injury, and to suddenly find I was impotent was really quite a blow. When I came out of hospital, the two options that were open to me were either using a vacuum erection device or injections - and both of them were rather complicated procedures that one went through. With Viagra, you just take the pill and everything happens far more naturally.”

Bob uses a 50mg dose of Viagra and is lucky to have a GP who is sympathetic to his needs. “Access to Viagra has helped me tremendously - and due to improved feelings of self-esteem, it may well be the single greatest improvement I have enjoyed since my injury in 1996.”

“The only side effect I notice regularly is a sort of heartburn sensation, but that’s flushed away with a good drink of water.” According to the package leaflet, the most common side effects are headache and facial flushing - but these are normally mild to moderate in nature. Indigestion is one of the less commonly reported side effects listed.