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Viagra users are getting younger and younger
By Valerie Reitman
Los Angeles Times
September 12, 2004
Hawkers in popular bars whisper that they have "blues" for 5 bucks a pop -- less than the pharmacy price.
Friends pass pills along to others, often drug users who use them to counter the effects of drugs such as methamphetamines or Ecstasy, which can leave them unable to get an erection.
Web sites sell the drugs -- or counterfeits -- to nearly anyone.
And many healthy young men with normal sexual functioning are asking
their general physicians for Viagra,
Levitra or Cialis
to help them conquer anxiety or offset the effects of smoking and
partying.
At the same time, the makers of erectile-dysfunction drugs are running racier campaigns targeting younger men and straying from the depictions of the drugs as medicine. "Get back to mischief," woos the latest Viagra slogan, with devil's horns seeming to emerge from behind a middle-age man's ears.
These are all part of the rapidly changing face of erectile-dysfunction
drugs. Since the first, Viagra, debuted in 1998 to address a physical
problem some men face, it and newer drugs Levitra and Cialis --
the latter produced by Eli Lilly and Co. -- have been used increasingly
by healthy younger men for perceived performance-enhancement purposes
or as psychological life-preservers to alleviate performance anxiety.
"When Viagra first came out, the whole emphasis was on older men, with Bob Dole doing the marketing and the age group being around 70," says Dr. Abraham Morgentaler, a urologist and associate professor at Harvard University.
"Now we're seeing the bar lowered, not just for men wanting it but for physicians giving it out to those who are younger and less severely affected."
Myths and males
One concern is that the drugs may be psychologically addictive, says Morgentaler, author of "The Viagra Myth," a book on common misperceptions about the drug. Healthy men may begin to feel inadequate without it, he says.
Many seem to have the wrong idea about the drugs. A cardiologist tells of a healthy man in his 20s with no apparent functional problems who asked for a prescription to help him celebrate his anniversary in Las Vegas.
And a sex therapist says that boys as young as 16 have sought her help, thinking they need Viagra to have sex or to compensate for a small penis.
The pills enable some men who have hypertension, diabetes or prostate problems to get an erection by increasing blood flow to the penis, provided the brain kicks in with some sexual stimulation. They don't make people better lovers, instantly mend broken relationships or enlarge body parts.
Still, drug companies and many doctors say they don't believe the drugs are being overused and, in any case, see little danger in them. About 75 percent of the erectile drugs are now prescribed by general practitioners rather than urologists or cardiologists.
Dr. Louis Kuritzky, a clinical assistant professor at the University of Florida's department of community health and family medicine, says he generally prescribes them when asked. "There's no way to prove they have it any more than a woman having menstrual cramps or headaches. We trust them unless there's reason to believe otherwise."
May restore confidence
Even if the cause is psychologically rooted, Kuritzky says, many people can't afford the money or the time that therapy would require. The pills, he adds, can offer a temporary quick fix to restore confidence, which may be all that's needed.
"When you have garbage that is rotting, the best thing to do is to take it out," he says. "But if you can't, sometimes it's best to spray perfume on it. Sex therapy is a luxury for only the economically elite."
Pfizer, which sold $1.9 billion worth
of Viagra last year and says 23 million men worldwide have tried
it, maintains that it is not promoting the drug for enhancement
purposes.
Pfizer spokesman Daniel Watts says the company believes that if a man is troubled enough by problems, then he should consult a doctor about a possible underlying condition.
Carole Copeland, a Lilly spokeswoman, says the company "strongly discourages" use by those seeking enhancement only. "It's just not safe. People who don't have a condition that necessitates it shouldn't use any drugs," noting that erectile dysfunction drugs can be deadly if taken with nitrates.
Dr. Sanjay Kaul, a cardiologist at Cedars-Sinai hospital in Los Angeles, questions whether some of the purported need for the drugs has been drummed up by the drugmakers' advertising and reports that 30 million men in the United States may suffer erectile dysfunction. "It seems the disease was created overnight with Viagra."
There's little doubt that the age of users is falling. Express Scripts, which, with 50 million members, is one of the nation's largest managers of employee prescription-drug benefit plans, said the fastest-growing segment of users who applied for reimbursement of Viagra prescriptions was men ages 18 to 55 from 1998 to 2002.
The number of men younger than 45 using the drug tripled during that time, although it is still small compared with the majority of users, who are older than 50. Pfizer says the average age of men taking it now is about 53, lower than previously, although exact comparisons aren't available. As of earlier this year, about 8 percent of prescription Viagra users were age 34 to 40, about 26 percent were in their 40s, 36 percent in their 50s and 22 percent in their 60s, Pfizer's data shows.
Some healthy men who have used the drugs say they enable longer-lasting erections and reduce "refractory time," the interval between erections.
Kuritzky, the Florida physician, says that since the brain is critical to sexual functioning, the "placebo effect" can play a big role for some men.
Believed safe for most
The U.S. Food and Drug Administration and physicians say the drugs are safe for most men if used as directed, except for those taking nitrates or those in poor cardiovascular health.
They acknowledge that some men experience headaches or flushing and in rare cases extended and painful erections.
Cedars-Sinai cardiologist Kaul isn't convinced that the drugs are safe and says he probably wouldn't take them himself if he were to need them.
In 2000, he and colleagues at Cedars-Sinai analyzed 1,473 major adverse reports associated with Viagra use filed with the FDA. Of those, 522 people died, most due to heart attacks. Most had taken the standard 50 milligram dose within the previous few hours, and most were younger than 65 and had no known cardiac risk factors.
Some of the deaths occurred in patients who had taken the drug with nitrates, but 88 percent of the deaths had occurred in those who had not.
Kaul notes that one cannot be sure that the medication caused the attacks, just that there was an association with taking the drug. It also could be that some of the victims had previously been sedentary and the drug enabled them to engage in sexual activity, which in itself caused the heart attack
source :-http://www.indystar.com/ | 
