Erection problems? Don’t just reach for the Viagra

By going straight for the little blue pill, young men may miss the opportunity to find out what the underlying issue is, writes Ian Hamilton

None of this would be necessary if we managed to break the taboo around men’s health – and their sexual health in particular (iStock)

It isn’t just older men who experience problems getting an erection. In fact, one recent study estimated that over half of men in their thirties have this issue. This finding will be a surprise to many, which highlights the continuing stigma and shame associated with young men having problems getting or maintaining an erection.

Unlike their older peers, young men are bombarded with messages and images of what it means to be a man. This helps shape their perception that they should be capable of performing anywhere and at any time. Paradoxically, this adds to the pressure and does little to help with the mechanics of sexual arousal. More critically, it leads to silence and a reluctance to share the problem with anyone, which can be the first step in resolving the issue.

Given these feelings of shame and with no one to confide in, many young men seek their own solutions. One of the most common of these is to try sildenafil – more commonly known as Viagra.

Originally a prescription-only drug, controls were loosened in 2018 so Viagra can now be purchased over the counter. Making the medication accessible removes one potential barrier which may be alright for some, but undoubtedly creates a risk for others.

As with any medication, it isn’t risk-free. Unfortunately, some of these risks or adverse effects won’t be apparent until the drug is taken. They range from diarrhoea through to cardiac problems. It is also easy to see how taking these pills could become a habit. After all, how do you know when you no longer need to take them and would you be willing to take that chance with a sexual partner?

Buying these pills is far from a niche activity, as figures from Viatris who supply Viagra showed more than seven million pills were sold last year, and most of these to men aged between 25 and 64.

This points to a wider problem with men and health. It isn’t just shyness about sexual functioning, it is a wider reluctance to seek help for physical or psychological problems. The example of erectile dysfunction is a useful one as it highlights how men will seek to solve the problem themselves rather than ask their GP for help. This in turn has the potential to create other problems, in addition to their original issue.

Taking Viagra to overcome erectile problems means men miss the opportunity to find out what the underlying issue is. This could range from a mental health concern such as anxiety, to a physical problem such as circulation or other physiological fault.

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We know that women are far better at seeking help with their health and sharing a problem with friends, which can be beneficial in itself. But for men this doesn’t fit with their image of masculinity, and too many men believe that they shouldn’t have the problem in the first place, or they should simply “man up” about it.

While this may not cause much harm for trivial things like a cold, it clearly has the potential to be very harmful when the problem is more serious and could be fatal. What starts as difficulty getting an erection can soon gnaw away at confidence and culminate in deteriorating mental health.

None of this would be necessary if we managed to break the taboo around men’s health – and their sexual health in particular. We have to encourage men to learn from women and start talking to each other, not just about football, but about sex. They might be surprised to find that they are not the only one with a problem.

Ian Hamilton is a senior lecturer in addiction and mental health at the University of York