A secret weapon to swell the male ego

Dubbed `the good love pill', the new drug to cure impotence is not an aphrodisiac. It can boost performance, but only when the spirit is willing

A glass of water, a quick swallow, and sexual satisfaction guaranteed. Or so the pharmaceutical company Pfizer, maker of the first pill for male impotence, would like the world to think.

Yesterday, the company confirmed it is to submit the pill - which, when taken an hour before love-making, is said to promise "enhanced sexual response" - to the US Food and Drug Administration for approval. If it is granted, probably later this year, it is certain to focus attention on the delicate matter of male performance and its importance in the achievement of conjugal bliss. For let us be clear about one thing. Despite being misleadingly dubbed the "good love pill", the new drug is not an aphrodisiac. A fortune still awaits the inventor of the potion that can truly stimulate sexual desire.

Pfizer's pill, the chemical name of which is sildenafil, boosts the male erection - but only when the spirit is willing. The company plans to market it under the name Viagra - a neat combination of "vigorous" and "Niagara" conveying, to North Americans at least, the sense of an unstoppable flow. It has taken four years of tests and pounds 30m of investment to get this far and the indications look good. Nine out of 10 men who have tried it reported feeling 18 again, according to the company, although when one recalls the clumsiness, uncertainty and problems of premature ejaculation that bedevil that age group, it may strike women as a questionable accolade.

None the less a safe, effective treatment for impotence that was simple to use would bring much-needed relief to the one in 20 men said to suffer seriously from this distressing condition. It is its potential use by the rest of the male population - those, that is, who suffer temporarily from the problem (most common when it is also most embarrassing, at the start of a new relationship) - that raises more difficult questions.

It is the very unpleasantness of the existing treatments for impotence - injections, suction pumps and surgical prostheses - that deters all but the most seriously affected from using them. There is no doubt, however, that even these can transform a man's image of himself.

In Martyn Harris's novel Do It Again, which contains one of the finest accounts of the triumph a hard-won erection can bring, the protagonist visits a Harley Street clinic for an injection before leaping into a taxi to get home to his lover before its effects wear off. As the taxi speeds along the raised section of motorway known as the Westway, he gazes out of the window at the concrete tower blocks soaring beside the road to pierce the sky and grins with manly pride.

This experience is not restricted to those who require an injection to achieve potency. A Durable and Excellent erection - hence the name Durex - is a thing of pride; and whatever polite women may say, size matters. A pill that delivered all this would have a serious, probably black, market.

Anyone who doubts that size matters should consider the difficulty condom manufacturers have had in selling their products in different measures. Even the addition of lines such as "a snugger fit - for extra sensitivity" have not succeeded in shifting the smaller versions. There is a story, although probably apocryphal, that during the war, when Russia appealed to Britain for extra supplies of condoms for its troops, Winston Churchill only agreed after ordering that the packets should be stamped "extra small".

Sildenafil, or Viagra, works by blocking the effect of an enzyme which causes erections to subside, thus prolonging and strengthening them. It does not automatically trigger an erection as the injections do, leading to embarrassment at choir practice or on the bus home, but enhances the natural response to sexual stimulation. Despite company denials that it is a "penile enlargement" drug, this is clearly what it does.

It was originally investigated at Pfizer's laboratories in Kent as a treatment for heart problems. Although it had little effect on the cardiovascular system, male volunteers reported a pleasing side-effect. It was subsequently tested on 350 men in Bristol, Belfast, France and Sweden, who used it for four weeks. The results of that trial, presented to the American Urological Association last year, showed that 9 out of 10 reported better erections.

Some ludicrous claims have been made for the drug, such as that men using it have been able to sustain love-making for up to three hours at a time. It is not recorded how the lovers of these supermen felt, probably because their response was unprintable.

New studies of the drug are reported to have taken place in women, with similar impressive results. As with men, it sustains sexual arousal for longer by maintaining increased blood flow to the genitals, but has no aphrodisiac effect. None the less, this has fed fears that a market for the drug could develop among unscrupulous men who wanted it to spike the drinks of girlfriends. Pfizer was saying little yesterday because of fears of breaching the industry code that forbids promotion of drugs.

A pill that improves the mechanics of sex is viewed with suspicion by women who think men's chief failing is that they regard sex as a mechanical process. Relationship counsellors warn that men who have difficulty with sex are aiming for the wrong thing if they treat it as a mechanical failure.

Suzie Hayman, author of the Good Sex Guide, said a man with the drug who had no care or skill would have far less of an effect than a man with smaller genitals who knew how to use them. "Many men think their equipment has to be the sexual equivalent of a Porsche. Women know that a well-driven Ford Escort is infinitely preferable to a badly-driven Porsche," she said.

But, for readers of Do It Again, it is London's landmarks that could be changed for ever by the arrival of such a pill. Will Cleopatra's Needle, Nelson's Column and even Canary Wharf, the tower in which this newspaper is based, be viewed with the same innocence again?