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It is because of the potential for abuse and, more to the point, the traditionally seedy associations that cling to impotence remedies (witness the ads in the back of low-rent men's magazines for spurious Spanish fly, hard-on creams and the like) that drug companies have only recently turned their attention to sexual dysfunction. This would account for the tone adopted by Pfizer chairman and CEO William Steere even as he figuratively licks his chops over the potential market in "aging baby boomers." He is careful to point out that "quality-of-life drugs are gene-based just like those for serious medical conditions. In areas like impotence, aging skin, baldness and obesity, the science is just as profound as if you were working in cancer, asthma or anti-infectives." In other words, Viagra is sober stuff and not at all akin to Sy Sperling's Hair Club for Men.
Along related lines, a brochure for Pfizer employees points out that while "jokes and puns are often used in conversation about sexual health topics...you can redirect humorous remarks to more appropriate discussion by not joining in the humor and pointing out the seriousness of the subject matter, reminding the people with whom you speak that ED is a significant medical condition that affects the lives of millions of men and their partners." This is true, of course. It also speaks to the tricky questions of taste and exploitation that Pfizer will have to navigate in marketing the drug. So far, without an official launch or virtually any promotion, Viagra is doing fine. But why hold back? Advertisements will begin appearing in medical journals in about six weeks, followed by consumer ads this summer. A company spokesman says they will be "tasteful and emotional, emphasizing [impotence] as a couple's condition." One can imagine.
At any rate, it's an emphasis that should remind us that human sexuality is far too rich and complex for the entire subject to be balanced on the delicate fulcrum of an erection. As with the debate in psychiatry between traditional talk therapists and their more pharmacologically minded colleagues, controversy over Viagra and its cousins may well provoke a rift among sex researchers. Raymond Rosen, a professor of psychiatry at the Robert Wood Johnson Medical School in Piscataway, N.J., makes the obvious but necessary point that Viagra will not be the final word on sexual dysfunction or dissatisfaction: "There's a danger that we could lose sight of the fact that a lot of sexual problems relate to poor relationships or poor self-esteem or anxiety, depression or other factors." Or as Petersen, the Playboy adviser, puts it, "You can take an angry couple and give them Viagra, and then you have an angry couple with an erection." Oddly, that's reassuring.
--Reported by Edward Barnes and Lawrence Mondi/New York, Wendy Cole/Chicago, Greg Fulton/Atlanta and Arnold Mann/Washington
Discuss Viagra with the experts online Thursday, April 30, 7 p.m. ET, at time.com