A Pill for Impotence?

By Leland, John | Newsweek, November 17, 1997 | Go to article overview

A Pill for Impotence?


Leland, John, Newsweek


New drugs awaiting approval by the FDA could be a boon to millions of men with erectile dysfuction. They're painless and discreet (no needles), a potential bonanza for pharmaceutical companies and the booming industry of male medicine. And if they make enough boomer guys feel like virile teenagers again, they could trigger another sexual revolution.

FOR ALL OF HIS LIFE, BOB BOWMAN HAD A HEALTHY RELATIONSHIP WITH Sex. It was good to him, before and after his divorce, a pleasure he took for granted. Bowman, 63, is on the dapper side, casually forthright. In his art-filled Los Angeles bungalow, he eases into intimate confidence. Three and a half years ago, he says, he underwent surgery for prostate cancer. The operation saved his life, but left him with a common residual effect. He was impotent. This seemed unfair, both to him and to his girl-friend. He visited a Los Angeles urologist named Harin Padma-Nathan to see what could be done. The answer: a lot. In early 1995, Bob Bowman found himself on the chemical cutting edge of the next sexual revolution.

Until recently, the only options would have involved body-shop mechanics, either a surgical implant or a pump of the sort advertised in the back of men's magazines. But by 1995, new research, which ironically studied the erectile tissues removed to make way for implants, had yielded insights into how this most basic of human functions worked. And with these insights came drugs-quickly. First Bowman tried a smooth-muscle relaxant called alprostadil, which was developed for newborn babies with circulatory problems. Before sex, he injected himself at the side of his penis: his erections were immediate, and could last for hours. He next tried a treatment called MUSE that the FDA hadn't yet approved (it since has): a tiny suppository inserted down the urethra via a thin plastic wand. For Bowman, "it didn't work."

Then, 18 months ago, Bowman entered clinical trials for a drug that could change everything: a pill called sildenafil (trade name: Viagra) that, combined with some stimulus, promised to return afflicted men to proud full function. No needles, no pellet down the shaft. It worked. He can make love again, and better than he had in years. "It's as easy to take as aspirin," he says. For a man who looked forward to a future of hypodermics or deprivation, the results are a modest miracle. His life under covers, he says now, "is like I'm 30 years old."

For millions of American men, this could be the future of male sexuality: better loving through chemistry. The National Institutes of Health estimate that between 10 million and 20 million men suffer from some degree of impotence; some experts believe even these figures are too low. Twenty million, says Dr. Leroy Nyberg Jr., director of urology programs at the NIH, is probably just "the tip of the iceberg." (Impotence is defined as an inability to get and sustain an erection: it does not address fertility, libido or orgasm.) The causes are everywhere, from hypertension to bicycle seats. Traditionally, men have been unwilling to discuss the problem or seek treatment for it. But now, as the 38 million men of the baby boom march toward their softening years, this well-kept secret may finally be coming aboveboard. "With our anatomies breaking down, this is a way of becoming, of acting, younger," says Alfred Pariser, a prostatectomy patient taking Viagra in the same trial as Bowman. "If women can get face-lifts, why shouldn't men do this?"

For the drug companies, treatments for impotence have the makings of a bonanza. "It's the one thing men will spend their money on," says Dr. John Bancroft, director of the Kinsey Institute for Research in Sex, Gender and Reproduction. "Anything that will improve their erections is big business. Sad, but there you go." In 1995, wholesale revenues from erection drugs were $6.4 million; already this year they've topped $117 million. MUSE-- the pellet treatment--hit the market in January; despite its unappetizing protocol, it has already been prescribed to 665,000 men. …

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