You're Taking Viagra? The Impact of Pharmaceutically Induced Erections on Mature Sexuality

“Dried up old woman,” “dirty old man;” these are the concepts of sexuality for seniors that have been prevalent in Western society. America’s focus on staying young and vital has led people to believe the idea that once a person reaches a certain age they are useless, and worse, neutered! In reality, even before Viagra and other such drugs, older people continued to have an interest in sex, and to enjoy it, even into the latest of years.

Before drugs for “erectile dysfunction,” the medical community—and most people—thought that changes in erections (their length, firmness, etc.) were a natural part of aging. Masters and Johnson stated in their 1976 article Sex After Sixty Five, “The informed older man will not be concerned by his response variants [changes in erections and sexually functions] if educated to understand that the variants are natural results of physiological involution.” Sheehy, quoted by Potts, Grace, Vares, and Gavey (2006), concurred saying, “It is normal for a man, after 50, occasionally to have a partial erection…A clever man will educate himself to graduate from adolescent ‘racing car sex’ to ‘surfing sex.'” In light of these changes, some men experience grief about the loss of their “masculinity” (since Western society values virility, and teaches that it is penis-based, loss of a “fully functional” penis can be seen as emasculation). However, others accept these changes as a natural part of aging, and view the potential problem as an opportunity to explore new forms of sexuality and pleasure.

With the advent of Sildenafil (Viagra) and other PDE5 inhibitors (Tadalafil and Vardenafil), the pharmaceutical community has labeled what used to be a natural phenomenon as a disorder; now changes in the erection, even at 65, are considered abnormal, a “dysfunction,” that requires treatment. This new labeling of erectile changes as a disorder is one of the reasons that the so-called “Viagra debate” has become so intense. Despite the fact that the medical community states that erectile dysfunction is age-associated (Potts, Grace, Vares, & Gavey, 2006), the makers of Viagra advertise that, “Many people believe ED is a natural consequence of aging. This just isn’t true!” (quoted in Potts, Grace, Vares, & Gavey, 2006).

The debate over whether so-called ED is a disorder or not has also led to deeper questions concerning definitions of sexuality. What is healthy sex? The makers of drugs for “Erectile Dysfunction” seem to believe that the only fulfilling sexual expression—the only healthy sex—is the result of penile-vaginal penetration. But what about other forms of sexual expression that don’t require an erection, like kissing and touching, or the use of toys, hands, and tongue to stimulate each other? Do these fit into our definition of healthy sex? What about orgasm; do both parties have to experience orgasm in order to have had a healthy sexual experience? Indeed, while many men have experienced a sense of nostalgia for sexuality as it was when they were younger, studies suggest that many men recover from that sense of loss, explore alternatives to what they used to do, and actually enjoy sex more as they age (Potts, Grace, Vares, & Gavey, 2006)! Potts, Grace, Vares & Gavey (2006) present older men’s experiences of sexuality; across the board these men talk about finally being able to experience relaxed sex, finding pleasure in lengthy foreplay and pleasing their partner, and letting go of the frenetic sexual drive of youth. They discuss gaining mastery of ejaculatory control and finding new erogenous zones; one man, who had completely lost penile functionality as a result of an operation, even describes having a new kind of orgasm without ever achieving an erection (Potts, Grace, Vares & Gavey, 2006)! In short, these men describe finally becoming the virtuosos of the bedroom that they’ve longed to become.

Another major issue that has cropped up with the use of Sildenafil is the pharmaceutical community’s complete disregard for the partners of the men using it. Although some women have tried these medications in order to boost their own sexual desire, the drugs have little effect on women, and there are no feminine counterparts. In addition, clinical trials have not focused on the physical or psychological effects of Sildenafil use on men’s partners, and in most cases, a man can be prescribed Viagra by himself, without consultation with his partner. A study by Potts, Gavey, Grace, and Vares in 2003, focuses on the experiences of women whose partners used Viagra. Few of these experiences were positive; most women voiced concerns about coercion, infidelity, having been comfortable with sex habits PRIOR to use of the drug, major increases in sexual activity causing pain, dramatic decrease in “foreplay,” fear of addiction, and anger over having not been consulted. Here are the experiences of just a few women from the study:

"Now and again I’ll think oh bugger, you know, I’m too tired or…you’re just not in the mood or anything…[so] you just play along, I mean if you know what you’re doing you can manage that alright, yeah, but you do have a guilt feeling a wee bit afterward yourself, but you think oh well, as long as he’s happy and satisfied, it doesn’t hurt me if I miss out this time" (FP5, 57 years).

"He would have sex that night and again the next morning and…he can have more sex than I can because I get sore…I…got thrush and once I got a bladder infection…I was passing blood, so I presume perhaps having sex had something to do with it" (FP25, 65 years).

Please note that this participant doesn’t even include herself in the acts of sex with her husband in this instance “HE would have sex,” not we. This, more than anything, is indicative of how she feels about sex with the medication; she is not a part of it, even if she provides the needful anatomy.

More women’s experiences:

"What I noticed in the beginning which really concerned me…because I saw that it was such a powerful drug and it had such a powerful effect was that…this made sex inevitable. Sometimes there was no discussion about whether…the sex act was going to take place, so it would be…’I’ve taken the pill, OK, let’s go.’ And this pissed me off because it meant that [sex] seemed to be a given: “I’ve taken the pill, let’s f**k’…What Viagra did was, for a while anyway, remove that negotiation…he wanted a lot MORE sex…I mean, he would be saying things like ‘OK we’ll have it now, and then, you know, in another four hours we’ll do it again and then we’ll even try later on’ and I’m thinking, you know, give me a break!...it took away the whole notion of any kind of…spontaneity or you know, the REASON for the actual bonking, I mean you, you like to think it’s an act of love, rather than just lust" (FP7, 48 years).

"So here we are at that stage of our life and…as things are quieting down in your life and you’re…becoming friends and yes, there’s a closeness and a friendship and yes sex did happen occasionally but quite rarely as you’re getting older, and to me that wasn’t a major problem, it was part of nature, and all of a sudden Viagra became this…it became a main focus in the house for a wee while…One day [sex is]…not an option and the next day it’s full-on…Yes it is…very hard to get your head around it because if you’re not as interested you feel as though you’re abnormal…and not supporting and not being a good wife and helping him through" (FP26, 60 years).

It is quite clear that women’s voices and experiences are being ignored in the fuss about “Erectile Dysfunction.” Regardless of the argument about whether or not ED is a dysfunction or a natural phenomenon, it is not only a phenomenon that affects men. These men have partners, and in many cases of “ED,” the partners have not had intercourse for 2-5 years prior to use of the drug. Even if one disregards the other questions about Viagra use, it is clear that doctors or professionals need to prepare couples for the consequences of the use of the drug; obviously, couples will have to learn to communicate needs and desires even more clearly than before while using it. Just because a man has an erection doesn’t automatically open the door to healthy sexual functioning, especially if he’s using that paid-for erection to coerce his partner into sex she doesn’t want or isn’t prepared for. In addition to this, while there are warnings for men to “make sure you’re healthy enough” for sex, these warnings are not reiterated to women. Women, who may have lost vaginal muscle tone and some ability to produce lubrication as a result of aging, may be at risk for bladder infections, cysts, and torn tissue as a result of resuming penetrative intercourse, or having it too often.

It may be the case that Viagra and other similar drugs may be helpful for the treatment of sexual dysfunction—especially for those who experience it at younger ages; however, use of these drugs may have serious negative repercussions. They can serve to block people from exploring their natural sexuality, exclude partners in the sexual discussion, put an excessive and unnecessary emphasis on penetrative sex, and may even lead to coercive behavior (read intra-marital RAPE) within partnerships. Clearly, use of Sildenafil and other PDE5 inhibitors requires an incredible amount of further research, and should only be used in tandem with counseling.

References

Masters, W.H. & Johnson, V.E. (1976). Sex after sixty five. The Saturday Evening Post, 48-52.

Potts, A., Gavey, N., Grace, V.M., & Vares, T. (2003). The downside of Viagra: Women’s experiences and concerns. Sociology of Health & Illness, 25, 7, 697-719.

Potts, A., Grace, V.M., Vares, T. & Gavey, N. (2006). ‘Sex for life’? Men’s counter-stories on ‘erectile dysfunction’, male sexuality and ageing. Sociology of Health & Illness, 28, 3, 306-329.

Copyright © 2009 NinaCarmen Monroe. All rights reserved.