“Viagra stories”: challenging ‘erectile dysfunction’

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Abstract

Medical approaches to sexual difficulties prioritise the physical aspects of sexuality over other aspects, locating ‘disorders’ primarily in the anatomy, chemistry or physiology of the body. In accordance with this perspective on sexual matters, physicians look to physical interventions (for example, hormones, drugs, and surgery) to treat any ‘abnormalities’. Following the discovery of popular—and profitable—sexuopharmaceuticals such as sildenafil citrate (Viagra™) for the treatment of erectile difficulties affecting men, the medical model has gained increasing influence in the domain of sexual health and well-being. However, while medical definitions of—and interventions related to—sexual difficulties are underpinned by an understanding of a ‘universal’ body (that is, an essential biological body that transcends culture and history), and by the categorisation of the normal and the pathological, the accounts of users of Viagra, and their sexual partners, do not necessarily support such understandings. In some cases, the experiences and perspectives of those affected by erectile difficulties directly challenge the reductionist model of sexuality and sexual experience espoused by medicine. In this paper, we report on a New Zealand study investigating the socio-cultural implications of Viagra, involving 33 men and 27 women discussing the impact of erectile difficulties and Viagra use within relationships. The diverse experiences of participants are discussed in relation to two key issues: the notion of ‘sexual dysfunction’ itself; and the idea of drugs such as Viagra acting as a ‘quick fix’ for sexual difficulties affecting men. We argue that the existence of a range of Viagra ‘stories’ disrupts a simplistic mechanistic portrayal of the male body, male sexuality and ‘erectile disorder’.

Section snippets

Introduction: The medical construction of sexual response

“Erection is defined as a physico-pharmacological penile stiffness resulting from the relation between vascular, cavernosal and neurological structures” (Basar et al., 2001, p. 403).

“The sexual act is a continuum of separate but linked processes; libido, erection, ejaculation, orgasm, detumescence, refractory period” (White, 1997, p. 41).

The medical model of sexuality subscribes to a mechanistic view of the body, in which ‘sexual response’ is broken down to a series of consecutive stages as

Sample

In early 2001, advertisements calling for participants for an independent national study on the social impact of Viagra (funded by the Health Research Council of New Zealand) featured on radio and in local newspapers and popular magazines throughout the country. In response to these advertisements, 33 men volunteered for a study on men's experiences of using Viagra. With the exception of one man who had experimented with Viagra for recreational purposes (MP33), the men had all been prescribed

Participants challenge the idea of ‘sexual dysfunction’

“Erectile dysfunction is a medical condition” (Pfizer pamphlet targeting NZ consumers, 2000).

While the narratives of some participants were firmly positioned within a medical framework, and accepting of the portrayal of erectile difficulties as part of a ‘disease process’ or ‘disorder’ of the male body, others did not subscribe strongly to this perspective; some men and women explicitly resisted the idea that erectile difficulties were ‘abnormal’ or ‘dysfunctional’. In this section, we present a variety of viewpoints and experiences that challenge the medical representation of erectile

Participants complicate representations of Viagra as a ‘quick fix’

“Viagra: Love life again” (Pfizer advertisement, NZ Listener, 2000).

Viagra has been promoted as a ‘quick fix’ or a ‘magic bullet’ for erectile difficulties (Loe, 2001). This representation is assisted by the prevalent division in western culture of human subjectivity into mind (psychological) and body (physical) components. Accordingly, the medical model views an individual man's ‘physical’, bodily sexual responses as distinguishable from his ‘desires’; if anything, medications like Viagra are understood to facilitate the ‘matching’ of a man's taken-for-granted

Conclusions: Diversity disrupts ‘dysfunctionality’

The medical model of male sexuality assumes the universal application of the sexual response cycle and therefore the commonality of experience of the separation of desire, arousal, and orgasm; the imperative of orgasm; and the centrality of penetrative intercourse for men, masculinity and sexual relationships. Our analysis of the accounts of men in this study, who have experienced erectile difficulties and women whose partners have experienced such difficulties, indicates, however, that the

Acknowledgements

We are immensely grateful to the men and women who participated in this study, and to the Health Research Council of NZ for funding this research. We thank Philip Armstrong for helping with the interviews with men, and for his valuable feedback on this paper. Thanks also to Roxane Vosper and Sharon McFarlane for transcribing interviews.

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