Viagra Turns 20: The History of the “Little Blue Pill”

Lisa Beebe
February 12, 2018

Viagra Turns 20: The History of the “Little Blue Pill”

576 324 Romanhood

When British scientists first studied sildenafil citrate in the late 1980s and 90s, they were looking for a potential treatment for hypertension. Early test results were unremarkable—except for one unusual behavior from the male participants. Roman’s physician in residence, Dr. Michael Reitano, explains, “When the study was over, the patients didn’t want to give back the unused medication.”

Viagra was initially tested as a treatment for high blood pressure

In another study, Reitano notes the discovery of a curious “side effect” of sildenafil. “One nurse noticed something strange when she went around to check the patients’ blood pressure. They were all lying on their stomachs. That’s when she discovered a prominent side effect of the blood pressure medication—erections. To hide the unexpected erections, the men had turned over.”

Before Pfizer shelved sildenafil as a failed high blood pressure medication, this unexpected side effect quickly became the main feature. Further testing (of a more sexual nature) soon followed. On March 27, 1998, Pfizer received FDA approval to sell the new drug as Viagra, the first oral treatment for erectile dysfunction. And the way we talk about and treat erectile dysfunction—and sexual health—has never been the same.

The Age of Viagra

viagra timeline

When Pfizer released Viagra in 1998, it attracted immediate attention. Sex sells—especially to men who haven’t been able to have sex in a while. “Men everywhere were coming in to doctors’ offices requesting the medication,” recalls Reitano. “They overcame any and all anxiety.”

After the launch of Viagra, Dr. Steven Lamm, the Medical Director at the NYU Center for Men’s Health, appeared on the Today show to talk about it. Last year, he recalled to Bloomberg, “They said, ‘What are you gonna say, Dr. Lamm?’ And I said, ‘I’m going to say ‘erection,’’ and they said, ‘You can’t say the word erection.’ I said, ‘It’s a physiologic term, what are you talking about?’ They said, ‘Okay, if that’s the way you feel about it.’ It resulted in the changing of how we speak and think about things.”

Later in 1998, the conversation continued to evolve with a peculiar erectile dysfunction spokesman. The first TV ads for Viagra featured former presidential candidate Bob Dole sharing his concerns about erectile dysfunction after experiencing prostate cancer. In the commercial, Dole urged people to be courageous and “Get educated about E.D.”

Redefining “Impotence”

Despite the floodgates opening, Pfizer was careful about the words they used to promote Viagra. Previously, doctors had referred to erectile dysfunction as “impotence.” Pfizer moved away from this lackluster terminology. Reitano says, “Impotence carries such a negative connotation, because it’s such a broad definition. It doesn’t refer to anatomical function. Impotence refers to an incapacity to do so many things.” The term is depressing, and men didn’t want to be associated with it.

“Why identify yourself as having such a significant condition with so many different social implications if there’s nothing that your doctor—or anyone—could do about it?” Reitano asks.

With the introduction of Viagra, there was something doctors could do, and the word ‘impotence’ didn’t reflect that. Reitano explains, “When doctors switched to ‘erectile dysfunction” it changed the entire dialogue. Suddenly, you could have conversations with patients. And not just about erectile dysfunction, but about the conditions associated with erectile dysfunction.”

Erasing the Stigma

As erectile dysfunction became a treatable condition, the stigma associated with it lessened. More men felt comfortable talking about it with their doctors, which is important due to the potentially life-threatening implications of ED. The blood vessels in the penis are smaller than other parts of the body, which means that erectile dysfunction can be an early indicator of other more serious problems like hypertension, diabetes, and heart disease.

20 years after its release, generic viagra is available for as little as $2 a pill (20mg)

It’s estimated that ED affects more than 30 million men in the US. Erasing the stigma around this potentially life-threatening condition has lead to explosion in reported cases—and younger patients. “I think what’s happening now is that more and more often, younger patients are beginning to come forward, because they’re recognizing erectile dysfunction earlier,” says Reitano.

Counterfeit Viagra

viagra

However, the path toward adoption hasn’t been completely smooth. As Viagra swelled in popularity, so did the number of impostors selling fake versions at discount prices. Reitano blames it on the medication’s cost. “When a pill costs $70, you have to think about using it—even sparingly. It was a financial issue. People took a chance on getting something that wasn’t full strength—or maybe even toxic—rather than nothing at all.” That’s how badly men wanted the medication.

Combine the cost per dose with taking time off work to see a physician, and you can see a gap. “It was a price and a barrier that was too much for many people,” laments Reitano.

Most health insurance companies still don’t cover Viagra. But for the men who use it today, the medication’s price is no longer the financial burden it once was. Reitano says, “Telemedicine and generic alternatives ($2 per 20mg pill) make it much easier for people to avoid the risk of those foreign, fake medications.”

Viagra Turns 20

Twenty years after the “little blue pill” first rose to fame, the word “impotence” is a thing of the past. Erectile dysfunction still affects millions of couples, but sildenafil citrate is affordable as an inexpensive generic medication, and we’re officially living in the first tentative days of telemedicine.

As Viagra enters its third decade, the stigma around ED is fading, quick, easy online doctor visits are mainstream, and prescription prices are plummeting. Viagra is all grown up and continuing to move men’s health into the future as men everywhere lead healthier, happier lives.

Lisa Beebe is a freelance writer based in Los Angeles. She’s written for everyone from Nickelodeon to Playboy.

Lisa Beebe

Lisa Beebe is a freelance writer based in Los Angeles. She's written for everyone from Nickelodeon to Playboy.

All stories by:Lisa Beebe

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Lisa Beebe

Lisa Beebe is a freelance writer based in Los Angeles. She's written for everyone from Nickelodeon to Playboy.

All stories by:Lisa Beebe