Honeymoon With Viagra Could Be Over, Say Doctors

June 9, 2011— -- Sales of the little blue pill that promised men they could be sexually active well into their 70s and 80s are going soft after flying off the shelves for more than a decade.

The market for Viagra-type drugs has stalled in the United States. Last year the total number of prescriptions for so-called ED drugs declined by 5 percent after growing just 1 percent annually the previous four years, according to IMS Health, a heath-care data and consulting firm. Viagra prescriptions were off 7 percent; those for Levitra plummeted 18 percent.

The market for these virility drugs still top $5 billion in annual sales to tens of millions of men. But for many, who saw the drugs as a powerful aphrodisiac that would cure all the things that were wrong in their lives, the drugs, some of the safest in the world, just didn't live up to expectations.

"It's not that these drugs don't work. If one doesn't work, all three don't work," said Dr. Thomas Jarrett, head of urology at George Washington University.

Cialis, which has a 24- to 36-hour window of effectiveness -- for when the "moment is right"-- is predicted to outpace the short-acting drugs this year.

Many insurance companies don't cover these so-called "lifestyle drugs," and those that do only pays for four pills a month. Out of pocket, they cost $12 to $15 a tablet, not exactly a cheap thrill.

"We still write a lot of prescriptions, but without any objective evidence, it doesn't seem like we write as many as we used to," said Jarrett.

A poor economy, coupled with market "over-saturation," and even disenchantment among men when more sex didn't improve their lives, may explain why prescriptions are down, he said.

"When people have money to spend, they are willing spend on their sexual health," said Jarrett. "But if it's a choice between the blood pressure medicine and their Viagra, you would hope most would choose to maintain their health."

Erectile dysfunction becomes more prevalent as men age. Though problems in their 20s is not unheard of, most men don't face ED until they are well into middle age.

"They get into their 50s and 60s unscathed, then they get hit with larger medical issues like diabetes and vascular disease, all of which put them at risk," said Jarrett.

These drugs work on about two-thirds of all men.

"You can't take someone who has no erections and give them strong ones," he said. "But it can improve what you have. People reach the point where they won't work anymore because of the aging process."

Couples often find that the drugs doesn't fit into their idea of spontaneous sexuality and it has side effects: headache, congestion and heartburn.

Doctors say that about 40 to 50 percent of all men who are given a first prescription for these drugs don't ask for a refill.

"You can't always get in the mood," said Jarrett. "You have to time it when you think you'll need it so it's at its peak efficiency. With cialis you avoid that and but lots of people have side effects from headaches to blurry vision."

Still, Jarrett writes a good number of prescriptions for older men who want to continue relations with their long-term spouses or new spouses.

But with Internet sales of the drugs, there is a lot of off-label use with younger men.

"You get the 24-year-old who thinks he has erectile dysfunction if they stay up all night and can't get up and do it five times the next morning," he said.