Viagra is prescribed on NHS 1m times

The demand for impotence medicines has soared since the drug's release, but its availability on prescription is limited

Prescriptions for impotence drugs have doubled since Viagra came on the market five years ago, topping a million this year.

But British men - at least one in 10 of whom suffer from erectile dysfunction - still want more.

The little blue pill and its rival brands Cialis and Levitra are now so popular that as well as a million prescriptions on the National Health Service, which cost it more than £35m, millions more pills are being bought on private prescription or over the internet. They have appeared on the club scene.

According to Viagra's makers, Pfizer, 50 million pills have been used by men in 50 countries since the drug's launch in 1998. Nine tablets are sold every second, and 133 prescriptions have been written by six million doctors for 20 million men with erectile dysfunction.

New figures, revealed in parliamentary written answers, show rising numbers of men turning to their doctors for male impotence drugs. Last year, the NHS issued more than a million prescriptions for them.

But in Britain, prescriptions are strictly limited on cost grounds, and for the first time ever a Health Secretary (Frank Dobson) intervened to ration NHS treatment. At nearly £50 for eight pills, a healthy sex life comes at a price.

Ian Banks, a GP and chairman of the Men's Health Forum, said: "The Government said they didn't want men using Viagra for recreational sex. If sex wasn't recreational there really would be standing room only on this planet. It is a very moral stance they are taking on this - and absolutely ludicrous. Just because it's something nice and pleasant you shouldn't prescribe for it ... If we had the same rationale for HRT for women, there'd be an outcry."

The Impotence Association hears some sad tales from men too embarrassed or afraid to seek help when they encounter sexual problems. Some have waited 20 years before plucking up the courage to see a doctor. Others ask to be referred to specialists away from home. Some become depressed and even suicidal because of erectile dysfunction.

"We get some harrowing letters from people," said Ann Tailor, the association's director. "The Government has taken away these people's human rights by recommending restricted treatment."

However, the NHS Confederation disagrees and has repeatedly warned that any plan to extend prescriptions for impotence drugs would end up costing other NHS patients the treatments that they need.

Despite a renewed call for a review led by Sandra Gidley, a Liberal Democrat MP and vice-chair of the All-Party Men's Health Group, the Government has saidit does not intend to lift restrictions on the availability of impotence drugs. They will continue to be available only to people suffering from impotence, and those with diabetes, multiple sclerosis, Parkinson's disease, polio, prostate cancer, prostatectomy, pelvic surgery, renal failure, severe pelvic injury, single gene neurological disease, spinal cord injury and spina bifida.

Campaigners believe that is wrong and short-sighted. They say the health benefits from encouraging people to seek treatment for impotence - it is an early sign of heart defects and prostate cancer - and the positive effect that decision can have on strained relationships are evidence of the need to make treatment more widely available.

Denise Knowles, a sex therapist at the relationship counselling service Relate, said: "People who come along to us suffer a lot with erectile dysfunction ... Men are embarrassed and frightened about the experiences they are having. If it is not spoken about or understood then it has the potential to break up a relationship."

Ms Gidley said: "I'm asking the Government to look at the wider impact of looking at this purely as a mechanical problem ... this affects men, women and families."

'For me, it is the best thing since sliced bread'

Tony Wilkinson, 51, a retired industrial door fitter from Camberwell, south London.

He started taking Viagra in 1999, after a serious fall at work left him with a broken back and nerve damage to his testicles. He qualifies for the anti-impotence drug on the NHS, but only at the standard amount of four tablets per month.

"Viagra is the best thing since sliced bread," says Mr Wilkinson. "I've tried other treatments, including injections into the side of the penis, but my wife and I just found it too clinical, too stressful, and not for us."

The only drawback, says Mr Wilkinson, is the fact that he is restricted to four tablets a month. "It's like the Government are saying that I'm only allowed to make love to my wife four times a month," he says.

Mr Wilkinson has made no secret of the fact that he is taking the drug - which has led to many neighbours and acquaintances asking him where to get it.

Charles Leveson (not his real name), 57, has used Viagra on private prescription for the past year.

He was diagnosed with "significant testosterone deficiency" at the Wellman Clinic in London last year. Since then, he has been undergoing treatment at the private clinic, including testosterone implants - and Viagra.

"I've been using Viagra quite regularly, maybe once a week for the last year or so," says Mr Leveson. "It works very well, and has made an enormous difference to my life."

Mr Leveson does not qualify to receive Viagra on the NHS, and has to pay about £30 for a packet of four tablets.

"I think both Viagra and testosterone implants should be available on the NHS," he says. "It's wrong that if one person has a bit of extra pocket money they can do something about their condition, but if somebody else hasn't got that money, they are stuck with it."

James Peterson (surname changed), 31, from north London.

He used Viagra for recreational purposes on two occasions earlier this year, with two women. He describes himself as "very happy" with the results: "I got the Viagra through a friend of mine, who orders it over the internet," says Mr Peterson. "The tablets cost about £10 each, but they were pretty strong ones. "

The only drawback to Viagra, claims Mr Peterson, is that you have to balance the time taken for it to work with the possibility that there may not be an opportunity to use it.

Jonathan Thompson