‘I was really struggling to get it up’: Why younger men are turning to Viagra

After the breakup of a five-year relationship, James was nervous about dating again. He was 27, healthy, and had a good sex life. But when it came to sleeping with new people, he was experiencing “performance anxiety”. “I was really struggling to get it up,” he says. “I got to this point where I was having sex with lots of people with like a 75 per cent error rate.” James assumed the problem was just nerves. He didn’t seek advice from his GP. Instead, he started self-medicating with sildenafil – better known as Viagra. It worked instantly.

“When you take it, you can actually focus on enjoying the sex and being in the moment,” he says, “as opposed to thinking, ‘Oh my God, my d*** is failing. No! No! Don’t stop! Keep going!’” When he started dating someone new, however, James felt an even greater need to rely on the drug. Wanting to make sure he wasn’t a disappointment, and sensing they were about to have sex, James decided that – just to be sure – he would “double drop” two maximum strength 100mg pills. His new partner, though, wasn’t in the mood, and fell asleep next to him.

“I felt like my penis was about to explode,” says James. “I was incredibly faint.” He recalls the blood capillaries on the surface of his eyes looming into focus as he stared into the darkness. He was deeply uncomfortable. “I needed to pee,” he says, “and so I was peeing from probably about two or three meters away to land it in the toilet.”

Now in his thirties, James still takes Viagra regularly. He never told his partner what he had done. And on that point, he is not alone. He estimates that as many as half of his male friends have told him they take Viagra, and he suspects that even more do so in secret. Some, like Josh, 27, admit to taking it mainly as a recreational drug to enhance the sexual experience – “I tried it and it was like I was 14 again.” The pill is usually associated with older men. But increasing numbers of men under 50 are now taking sildenafil too.

The possible side effects include a reduction in efficacy over time, as well as more serious outcomes. “Long-term use of Viagra can potentially increase the risk of psychological dependency and has also been associated with various problems affecting the hearing and visual systems and vision,” says Dr Shirin Lakhani, a doctor who offers specialised erectile dysfunction treatments at her private London clinic. “Short-term serious side effects include strokes and heart attacks in very rare cases, as well as diarrhoea and gastritis.”

Figures released to The Independent by pharmaceutical company Viatris show that between May 2020 and May 2021 Viagra Connect sold more than seven million tablets in the UK. According to the company, more than 60 per cent of UK users are between 25 and 54 years old.

The drug is far more accessible than it used to be thanks to a relaxation of controls. Viagra Connect, released in 2018, is an over-the-counter form that can be obtained without a prescription. It has become so popular that last month Boots announced the launch of its own generic version, which will be priced more cheaply than the big name brand. Generic sildenafil can also be bought online with a prescription, which can be obtained relatively easily by answering a brief consultation. “Of our erectile dysfunction custom base, 9 per cent are in their twenties and 21 per cent are in their thirties,” says Abbas Kanani, an online pharmacist.

That adds up to a lot of young users. And although erectile dysfunction is still a topic that is somewhat taboo among young men, it seems to be very common. According to one 2018 study, around half of British men in their thirties report difficulties getting or maintaining an erection. Like James, however, young men with erectile dysfunction are not necessarily talking to their doctor about it. “In my role as an NHS GP, I see almost no men in their twenties and thirties with erectile dysfunction,” says Dr Luke Pratsides, who also works for a commercial men’s health website. “This is likely because young men do not access traditional channels of healthcare and perhaps do not want to have multiple touchpoints to discuss sexual function, which for many can be difficult to talk about.”

In bypassing their doctor, men are missing out on a proper diagnosis. James has never asked his doctor about the underlying cause of his erectile dysfunction – but he suspects that he is experiencing some level of performance anxiety. This is broadly defined as men who don’t necessarily have a problem every time they have sex, or when they masturbate, but who – like James – take comfort in knowing that the pill will help them if they get locked in a boner-killing spiral of negativity. “If I was going to sleep with someone for the first time, I get anxious,…