The ‘blue pill’ that changed male sexuality turns 25. On March 27, 1998, the Food and Drug Administration (Fda) recognized Viagra* (Pfizer) as the first oral medical therapy for the treatment of erectile dysfunction. A quarter of a century that has seen the drug dominate world sales in the sector and pave the way for other molecules that have arrived later and recently for generics. Imitated and falsified, it is the most popular tablet online, the ‘blue pill’ has not only influenced the fantasies under the sheets, but also the costume ending up protagonist of films and songs. The latest Osmed report (2022) indicates drugs for erectile dysfunction among the “most expensive” categories, with residents of Campania “among the most users”.
“Before the ‘blue pill’ for erectile dysfunction there were only injections or hormonal therapies, I remember in my early years as a doctor that in scientific congresses it was said that whoever invented a pill against erectile dysfunction would win the Nobel. And in fact whoever discovered nitric oxide ‘as a signal molecule for the cardiovascular system’, then at the basis of the mechanism of Viagra, won the Nobel Prize for Physiology and Medicine in 1998 – Alessandro Palmieri, president of the Sia, the Italian Society of Andrology – The arrival of this drug has given us a valuable tool to help patients and has brought andrology out of the shadows, highlighting our specialty and how it is necessary for the overall health of the In fact, we will hold a congress on Mont Blanc to address the effects of climate change on men’s health, from erectile dysfunction to fertility”.
The arrival of Viagra has also given way to a line of scientific research that did not exist before, “new molecules and oral therapies have arrived and then the approach with the patient has changed – continues Palmieri – In the past we acted on the symptom, but now we are able to cure erectile dysfunction, for example we use shock waves on the corpora cavernosa. An approach that improves the quality of the erection: in a high percentage of cases we can solve the problem. We have completely different medical therapies compared to Viagra that melt in the mouth similar to a postage stamp. Or, there are very valid vasodilator supplements. In recent years – observes the president of andrologists – progress has been made in this sector and we can say that today the ‘blue pill’ and those that came after they are used less and less, often general practitioners and pharmacists can recommend them, but specialists have other tools”.
Finally, there is the chapter on penile prosthesis surgery. “There has also been a boom here: in a few years we have gone from 3-400 implanted devices to over 1,500 – concludes Palmieri – They are increasingly technological and safe”.
“But what we care about is prevention and as a scientific society we are now aiming to involve other categories: the armed forces, the Italian Red Cross and driving schools. On June 21 there will be an Andrology village in Rome, on the Pincio terrace , dedicated precisely to prevention”, he concludes.
“I remember well when Viagra arrived in Italy in 1998, I was a young doctor and the impact was enormous. Fundamentally then andrology didn’t exist yet, so having a pill available was a revolution for the specialty. But above all it lengthened the sexual life of millions of men. At the end of the 90s it happened to hear many 60-year-olds who gave up on erectile dysfunction and let’s say that they hung up ‘their shoes’, with the arrival of Viagra life changed for them. it was also an important turning point on diseases related to erectile dysfunction”, explains Gabriele Antonini, surgeon and urologist-andrologist of ASL Roma 2, speaking on the 25 years since the arrival of Viagra.
Before the ‘blue pill’ “there were phentolamine injections, but they were uncomfortable because they had to be practiced almost at the time of intercourse – he continues – With the tablet, everything has changed and the quality of sexual intercourse has once again become central for men But above all andrology has begun to be taken seriously, difficulty in erection is an alarm bell for other diseases and prevention has become central.Men understood that they had to have their own specialist to help them in “tackling the problems of the sexual sphere, as well as the health of the prostate. It should not be forgotten – concludes the surgeon – that where drug therapy does not arrive or after major prostate surgery, there are penile prostheses, which today are increasingly ‘hi-tech’ and with less invasive systems that really solve the problem”.
