How was it for you? Viagra can leave a trail of ruined lives and shattered hopes, says expert

When it was launched five years ago, Viagra was hailed as a wonder drug that would revolutionise the sex lives of millions of men and women.

The diamond-shaped pills became a bestselling brand and a designer accessory favoured by everyone from Robbie Williams to the former US presidential candidate Bob Dole.

But a new book by a leading American doctor reveals the anti-impotence drug is failing to rise to the occasion. Dr Abraham Morgentaler, a urologist at Harvard Medical School who helped with the implementation of Viagra, says it is causing more problems for some couples than it solves.

His book, The Viagra Myth, reveals for the first time the drug's popularity is waning as it leaves a trail of broken relationships and shattered expectations in its wake.

He says: "The Viagra Myth has less to do with the effectiveness of the medication than with our cultural propensity to look for the easy fix. Many of my male patients, together with their partners, have come to realise that finally achieving a great erection does not solve their relationship problems. In fact, it has frequently made them worse."

The book, to be published in November, discloses less than half of prescriptions for Viagra are refilled, meaning the majority of men who take the drug are not coming back for more.

According to Dr Morgentaler, Viagra is triggering a male sexual revolution in a similar way the Pill did for women during the 60s.

But far from liberating men from impotence, it is forcing them to confront previously hidden emotional problems in relationships - and many are opting to return to the physical frustration of the bedroom rather than face other issues.

Dr Morgentaler, president of the Men's Health Forum in the US, says he has seen male patients who have decided to stop taking Viagra because it has increased their partner's expectations of them between the sheets. Others are taking Viagra - then leaving their partners after realising that while they may now be able to have sex, they are simply not attracted to their wives or girlfriends.

According to Dr Morgentaler, the drug has been hailed as a quick-fix cure-all when it may be anything but. It seems our love affair with Viagra has become a flop - and it all began so romantically.

Like many scientific breakthroughs, Viagra was discovered by mistake. In the late 1990s, researchers for the pharmaceutical company Pfizer were concentrating on developing a drug to beat heart disease. They began work with an active ingredient called sildenafil, which they hoped would help to increase the blood flow through the blocked arteries caused by heart disease.

Early trials were started, with volunteer patients given either sildenafil or a dummy, placebo pill. But the results were disappointing - the drug seemed to have no effect on blocked arteries. The researchers decided to scrap the trials and asked the volunteers to return the unused pills.

Then something strange happened - the men in the trial who had been given the "real" sildenafil were curiously reluctant to hand back the drug. When questioned, they admitted that while the pills had done nothing for their heart problems, they had reached another part of their body entirely - with incredible effects.

Patients who had previously experienced sexual problems because of their heart disease reported that, within an hour of taking sildenafil, they were rising to the occasion with no problems.

From that moment, Pfizer knew that it had a hit on its hands. At the time, erectile dysfunction (ED), as impotence is termed in medicine, was a love problem that dared not speak its name.

One in ten men in the UK was estimated to suffer from ED, but few were willing to go to their GP, partly because of the dearth of effective treatments.

Men who did ask for help had to cope with the indignity of cumbersome vacuum pumps and variations on the rubber band, or resort to a plethora of quack creams, potions and ointments available on mail order.

Viagra, as Pfizer called its new wonder drug, changed all that. From the moment it was launched in the US in January 1998, it became a bestseller. It not only transformed the treatment of impotence - it made the condition something to be talked about in the open.

Pfizer scored a coup when it signed up Mr Dole to star in television commercials for Viagra. The Playboy publisher Hugh Hefner gave the drug untold publicity when he revealed that he regularly took it. Viagra became one of the first drugs to enter the English language as a global brand almost equal to Coca-Cola.

When Nicole Kidman stripped off in a West End play, her performance was described as "pure theatrical Viagra". Such is its potency that recent studies have claimed it can work on everything from limp plants to sex-shy female pandas.

When it was licensed for use in the UK in March 1998, it caused a national debate over whether such "lifestyle" drugs should be available on the NHS.

Amid dire predictions that Viagra could cost the health service £1bn a year, the Health Secretary at the time, Frank Dobson, slapped a restriction on all impotence treatments, which limited them to men with specific medical conditions.

Overnight, impotence went from being something that wasn't talked about but which most men could get help for, to a condition that was a national talking point and only a minority could be treated for.

Despite the restrictions, doctors and patients have found ways to get their hands on the little blue pills. Since Viagra was launched, prescriptions for impotence treatments have doubled.

More than a million NHS prescriptions were written for the condition last year - and while there is no official breakdown, the overwhelming majority of them would be for Viagra. NHS recipients are restricted to four pills a month.

Millions more people in Britain are buying the drug over the Internet, sometimes for as much as £10 a pill. The drug makes more than a £2bn a year but its dominance in the market is being threatened by the emergence of similar drugs.

More worryingly, Dr Morgentaler says the hype surrounding Viagra is being replaced with disillusionment that it has not proved to be a panacea for problems in the bedroom. His book recounts tales of men who decide to stop taking the pills because once the physical problem has been cured, their partners have become more sexually demanding.

HOW THE BLUE PILL HAS CHANGED ONE MAN'S LIFE

By Danielle Demetriou

When Tony Wilkinson tentatively swallowed a Viagra pill four years ago, he had little idea that it would be the first of many that would transform his life.

Having endured years of involuntary abstention from sex due to injuries sustained in a fall, the drug finally brought the satisfactory love life that had eluded him and his wife, Kathy.

But while Mr Wilkinson is the text-book candidate for Viagra, which he obtains on the NHS, he has become increasingly concerned at the growing number of men who take the drug for the wrong reasons.

"There are more and more people who seem to be turning to the drug to sort out all their problems," said Mr Wilkinson, 51, from Camberwell, south-east London. "It has been called a magic blue pill that can transform your life and it certainly has changed mine.

"But I can see that there are lots of people who take it thinking it will sort out a relationship that may not be right in the first place. It may be magic for certain people, in terms of the physical effects, but it's not going to solve every single problem if there are other issues to deal with too."

Mr Wilkinson was working as an industrial door-fitter when he suffered serious injuries from a fall that led to impotency.

While he and his wife tried a series of remedies, ranging from injections to pumps, he failed to find a satisfactory method until he was prescribed his first Viagra in 1999.

"I haven't looked back since I took my first pill," he said. "As far as I'm concerned it's the best thing since sliced bread. It means me and Kathy got our love life back."

But Mr Wilkinson remains acutely aware of its limits.

While he takes the drug within a stable, loving relationship, he voiced concerns that some men may be turning to the drug for the wrong reasons, with negative consequences.

"As someone whose life was totally transformed by it, and who needed something like this very badly, it does make me angry that there are people who are taking it for the wrong reasons," he said.

"It does make me angry that there are some idiots who take if for so-called recreational reasons. I think it's a bloody stupid thing to do when there are people who really need it.

"People shouldn't see it as a magic pill that will solve everything. It only works in the right situations."