Viagra is one of the most popular prescription drug names in the U.S. market. In the sun 1998 US Food and Drug Administration approved a chemical compound called sildenafil citrate for use as a prescription drug for erectile dysfunction. 

The small blue pill Viagra was the very first phosphodiesterase 5 (PDE5) inhibitor approved to treat erectile dysfunction (ED) which, at the time, wasn’t even a recognized medical condition.

It’s almost roughly 30 million men in the U.S. and almost around 100 million men worldwide suffer from ED. A huge U.S. survey shows that about 50 percent of men 40 to 70 years of age experience some degree of ED.

How Viagra Discovered

Those who discovered Viagra weren’t even looking for it. They discover that sildenafil could lead to an erection that was an unexpected event. This drug’s active ingredient was originally developed to treat cardiovascular problems—specifically to dilate the heart’s blood vessels by blocking a particular protein called PDE-5. 

Early the heart, clinical trials were a bust, and by 1993, Pfizer was considering abandoning the project. But researchers discovered that the drug was more effective at inducing erections than treating angina. That is until they see the men enrolled in the study did something weird whenever the nurses went to check on them.

The researchers find out a lot of the men were lying on their stomachs,” John LaMattina, who was the head of research and development at Pfizer while this research was ongoing, told the STAT Signal Podcast (listen in around 7:15) a very alerted nurse reported this, saying the men were embarrassed [because] they were getting erections. The blood vessels were dilating, but not in the heart but in the penis.

In the year 1998, the FDA approved Viagra, the first oral treatment for erectile dysfunction, under a priority review.

The Approval of Viagra

Pfizer’s drug comes in the market just a year after US regulators eased up on the rules regarding direct-to-consumer drug advertising. In the year 2003, the FDA approved Cialis and Levitra, two new ED drugs to compete with Viagra. This Cialis commercial is the best example of what basically every ED drug advertisement tries to do: to be sexy without even talking about sex. These commercials have historically gotten a lot of play during programming, like football games, that invite a lot of family viewers—so the commercials need to be PG. Even though the bathtubs don’t even really make any sense, at this point they’re iconic.

Many ED drug commercials have reached the same levels of cultural iconicity. At this point how can we forget Pfizer’s “Viva Viagra!” campaign of the mid-year of the 2000s, while Levitra was introduced to the world in 2003 on a TV spot centering on a legendarily bad metaphor for sex.

For so many men the shame and embarrassment of talking to their doctor about ED have declined since the introduction of Viagra and other PDE5 inhibitors.

What about Female Viagra 

Sexual dysfunction drugs tend to focus on the penis, which makes up at most only half, and few times none, of the horizontal tango. Pharmaceutical companies try and failed to find and market a female Viagra equivalent. 

Pfizer tried to use Viagra to treat “female sexual arousal disorder” in the early years of 2000s-one critic called it “a textbook case of disease mongering by the pharmaceutical industry”—but clinical trials were unresolved and the efforts were scrapped.

In the year 2015 October Sprout pharmaceuticals got clearance from the FDA to start selling Addyi, which reportedly increased women’s libido. Unluckily it was a flop—doctors had written only 4,000 prescriptions for it by the following April.

You might wonder why for one thing, unlike Viagra, Addyi, the pill needed to be taken daily, as opposed to when a woman was planning on having sex—yet each pill cost the same as a dose of Viagra. Plus physicians had to be “certified” to prescribe Addyi. ( the course is just for 10 min but…doctors) and at last, Addyi only worked “modestly,” even for women who took it daily as recommended.

The very recent history of the study of female sexual dysfunction is a perfect example of a beginning with some ideas, and a non-proof based diagnostic classification for women’s sexual diseases based on the male model, and then to be supported in that structure further research is required. John Bancroft is head person in the Kinsey Institute at Indiana University, told the medical journal BMJ. It is becoming more and more clear that women’s sexual problems cannot be considered useful in that way.”

Can Viagra Save you life

Most probably not but a trip to the doctor for an ED prescription just might be. There is various type of underlying causes of ED and most have to do with the circulatory system. (A few important special cases are psychological issues and direct injuries.)

if isn’t blood isn’t flowing properly to the penis, chances are it’s not flowing properly elsewhere in the body, and ED can be a very early warning sign for much bigger issues, heart disease in particular. 

The Mayo Clinic recommends that men without any clear cause for ED should be screened for underlying heart problems and Dr. Michael P. O’Leary informs the Harvard Health Blog that erections “serve as a barometer for overall health.”

Pfizer beyond any doubt tapped into this dynamic when it began marketing the drug. We had to give physicians a reason to talk about this  Ken Begasse, formerly of the Viagra ad agency Cline Davis & Mann, told the trade magazine Medical Marketing & Media. 

That meant linking [erectile dysfunction] to the things physicians were Mostly concerned about diabetes and cardiac conditions in particular. In simple words it was pretty much, ‘Hey, doc, you should be asking about erectile dysfunction, because it often happens 18 months before a cardiac event.

Other Viagra options for Erectile Dysfunction

The simplicity of taking the Viagra pill for erectile dysfunction has revolutionized treatment. But PDE5 inhibitors may not work in about 30 percent of men. It is very important for men to know that there are other options available for ED. These solutions were used early before Viagra  and are still available today:

• Penile self-injection (Caverject)
• Vacuum-assisted erection devices
• Transurethral Suppositories (MUSE)
• Surgical penile prosthesis

These options may be useful for some but for many men they can be complicated, painful, and more expensive. Make sure to talk to your doctor about all the other options. 

Viagra tablets by number 

• 6: The number of prescriptions you had to fill to on your Viagra frequent-user “value card” in order to get a free seventh script in 2004

• 62 million: number of men who take Viagra little blue pill globally, according to Pfizer

• $15: cost of a single Viagra pill in 1998 (adjusted for inflation)

• $65: cost of an individual Viagra pill today 

• $1.2 billion: Viagra tablets revenues in 2017

• $359 million: Is Estimated amount of revenue Viagra will generate in 2018