Viagra Falls: Older Men Just Aren't That into Erection Drugs By Michael Castleman [email protected] © Michael Castleman. Reprinted with permission. In March 1998 when Viagra was first approved, Maryland anesthesiologist Ken Haslam, M.D. (Cal B.S. 1956) was 64, single, and dating. "I was meeting lots of women. It was exciting. And for me, new relationships lead to great sex. I heard about Viagra, of course. But with all the excitement in my life, I didn‟t need any erection help, so I didn‟t try it." A few years later, however, Haslam became concerned about his erections. Sexual thoughts no longer caused a stirring between his legs. Raising an erection took effort, vigorous manual or oral stimulation. His erections were not as firm as they‟d once been. And minor distractions wilted them. As a doctor, he recognized mild erectile dysfunction (ED), normal for men over 60, but still annoying. "So I tried Viagra, 50 mg. It worked. It worked well." Today, at 75, Haslam still leads an active sex life, and he still uses Viagra—but for only about 10 percent of his lovemaking. "There‟s more to sex than an erection," he explains. "Erection is not the goal. Shared intimacy is, a close, loving relationship. I‟ve had wonderful sex and great orgasms without an erection. Occasionally it‟s fun to use Viagra. But most of the time, I don‟t even think about it." Viagra-Vation Haslam‟s reaction is not what the experts predicted a decade ago when Viagra became the most successful new-drug launch in pharmaceutical history. Pundits proclaimed that older men would embrace the little blue pill the way type 1 diabetics use insulin, as an indispensable part of daily life. Analysts forecast sales of $4.5 billion a year or more as the male population aged, and as advertising wars among what eventually became the three brands—Viagra, Levitra, and Cialis (both approved in 2003)—heated up and continually reminded men and couples about the medications. Social commentators even coined a new word, "viagra-vation," to describe the distress women felt when partners using Viagra pressed for more frequent sex, or when men with newly restored erections suddenly became interested in philandering. However, through 2005, sales of erection medications reached only about half of the predictions, just $2.5 billion annually. That‟s still a great deal of money, but older men did not flock to the drugs in anywhere near the numbers the experts anticipated. During the first two months after Viagra‟s approval, U.S. doctors wrote 275,000 prescriptions. But seven months later, only one-third of those men—fewer than 100,000—had obtained refills. According to Pfizer, maker of Viagra, as many as half of men over 40 experience some ED, but only about 15 percent of them have even tried erection drugs, let alone become regular users. Recent research makes the Pfizer estimate look optimistic. In 2007, German researchers surveyed 3,124 older men. Forty percent of them had some form of ED. Of that group, 96 percent could name an erection drug, but only 9 percent had used one. And last year [2008], researchers at Cornell‟s medical school surveyed 6,291 men in 27 countries. Almost half—48 percent—reported some ED. How many had tried an erection drug? A mere 7 percent. Only One Thing on Their Minds? In other words, the vast majority of men who might benefit from erection medications don‟t try them, or try them and then stop. This flies in the face of a key cultural assumption about men and sex—that men are perpetually horny, and therefore, obsessed with erection. Who hasn‟t heard: "Men have only one thing on their minds." "Men have two heads—and the little one does the thinking." "Women have sex to gain relationships. Men have relationships to gain sex." Now this stereotype contains more than a germ of truth. Most men think about sex a great deal. According to the Kinsey Institute at the University of Indiana, the average male teen has a sexual thought once every five minutes, while the typical man over 40 has one about every half hour. But if that‟s true why don‟t more older men try the drugs? And continue to use them?