By Albert Samaha
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As even a cursory scan of the Internet shows, there are now thousands of cyberpharmacies dispensing Viagra. (One major search engine has links to 600 sites.) Potential consumers for Viagra are screened with a medical questionnaire, which is reviewed and, one assumes, almost invariably approved by an online physician; the pills are then prescribed in 50- or 100-milligram doses and delivered by overnight courier.
A potential problem with this system is cost, since a recent University of Pennsylvania study of 46 Internet sites selling Viagra online found fees as much as 10 percent higher than at pharmacies. The average fee for consulting an Internet physician is $70, roughly 16.7 percent higher than a typical doctor's visit, the study found. Add the price of the drugs-$10 a pill, usually dispensed in lots of 30-and an $18 FedEx charge and, as FDA commissioner Jane Henney notes, consumers not only hazard paying more for medicines purchased online, but "bypass state and federal regulations," thereby risking greater side effects and possibly missing diseases underlying a failure to achieve erection. "You often don't know what's in the drug you order, who made it, where it came from, where the online physician is, who is prescribing the drug, or even if he is a physician at all," says Bernard Bloom, research professor at Penn's department of medicine and lead author of the online pharmacy study.
To an enormous number of consumers this is valid but apparently irrelevant information. "Who needsViagra?" asks Eric Thom, whose 18-month-old confimed.com and viagraguys. com are leading online suppliers of the drug. "No one needs it the way you need streptomycin. Medically, no one requires an erection. Do I have the kind of erection at 42, the same ability to go as long as I did at 17? Probably not."
The ways consumers are now dosing may have less to do with being middle-aged than with being overworked, overstressed, overstimulated, less than fit, sometimes inebriated, occasionally stoned-in short, being average American males. In a sense, says Thom, Viagra is already "a lifestyle drug. It's about staying 17 longer. People use it to counteract lack of sleep, stress, alcohol, legal or illegal substances that affect them becoming erect." Even Pfizer's literature has a tacit tendency to indict the masculine quotidian: When the organ in question stops producing its magical transformation, is the cause undiagnosed adult-onset diabetes or latent prostate cancer? Or is it that its owner is "working late at the office or spending hours in front of the TV as a way of avoiding sexual intimacy," as one Pfizer fact sheet suggests? Either way, there's an easy fix for that lazy broken-down penis: Take a blue pill and rub.
"I know a lot of guys 25 and under who are taking it now, for insurance, or if they're going out to play," says 29-year-old Jonah Falcon, a local actor and sometime escort renowned for a penis once likened to a loaf of Wonder Bread. "They're also taking drugs to concentrate it in the system, stuff that makes the effects last a much longer time. I've used it myself, of course, but I should point out that it doesn't just work on its own. The spirit has to be willing. It doesn't work if you're not turned on."
In simplified form what sildenafil citrate, the active chemical in Viagra, does is set in play a series of chemical hydraulics. Released into the penis under stimulation, nitric oxide activates enzymes that relax the penis muscle and allow a sudden welcome inflow of blood. By inhibiting a second enzyme responsible for degrading the first-and for keeping men from walking around with inescapable hard-ons-Viagra produces a rush of local blood flow and the desired effect: an erection. Surprisingly, this biochemical response isn't limited to men.
As Dr. Julia Heiman, psychologist and director of the University of Washington's Reproductive and Sexual Medicine clinic, noted in an online interview last year, the physiology of the clitoris is similar to that of the smooth muscle inside the penis, so "it's likely that the drug will have some effect in increasing blood flow to the area." Female sexual response, adds Dr. Gregory Broderick, director of the University of Pennsylvania's Center for the Study of Male Sexual Dysfunction, "is a lot more complex than clitoral engorgement. So I think the thing that all women should be asking themselves before they take the drug is just how important clitoral engorgement is to their own personal sexual response."
For women at the Blue Flash party, the answer doesn't pose much challenge. "When I heard about it," says one partygoer, a 31-year-old painter?performance artist who asks to remain unidentified, "I was like, bring 'er on! And it's an interesting sensation, kind of rushy. Your clit feels really, not throbbing, but full. It's even more sensitive than before. But I'm interested in the drug for another obvious reason, which is that I find it really nice, whether I'm playing in public or at home with a partner, that I don't have to worry at allabout the psychology of a man's erection. If I'm in a mental slut space I think it's kind of lovely to know I never have to turn into understanding mommy the moment his dick goes south."