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A spoonful of prejudice helps the medicine go down

An advantage of my specialization with unusual sex is how I can leave serious sexologists to deal with the kind of evergreen tragedies fueling the profession: arousal and orgasm problems, pregnancy-related issues and erectile dysfunctions. How incredibly cooler is it to write about BDSM and to study the weirdest paraphilias instead? However, sometimes I get dragged into more academic context too.
This is how a few weeks ago I attended – the lone male amidst a horde of female “couples’ issues” bloggers – the presentation of a Doxapharma survey about the world of erectile dysfunction drugs. Sildenafil, Tadalafil, Vardenafil and Avanafil, which are not elves from The Lord of the Rings but the molecules at the heart of real superstars among pharmaceuticals: Viagra, Cialis, Levitra and Stendra respectively. Together they represent a roughly 5 billion dollars market and a much more complex (and unusual) phenomenon than I was aware of. 

Framing the question correctly requires starting from one basic fact. Excluding erectile difficulties caused by particular illnesses such as for example multiple sclerosis or certain forms of diabetes, some performance decrease in this field is an absolutely normal effect of aging, progressively experienced by almost every man: the percentage is equal to the age, so 40% of forty-years old live with it, 70% of seventy-years old and so on.
During the presentation professor Emmanuele Jannini, sexologist at the Tor Vergata university in Rome, reminded us of the Richard Dawkins theory according to which this is by all means an efficient evolutionary tool. Human males are in fact among the very few primates without a baculum, the bone that ensures penis erection in the majority of mammals: this apparent cruelty guarantees that only healthy men can mate, thus keeping the species’ genetic pool in top shape.

Broken banana

But if this is the case, how come erectile dysfunctions (woe betide those who call them impotence, like in the past) are seen as such a serious illness? If the question sounds stupid, blame it on our cultural background. All things considered, having children isn’t exactly indispensable and there are lots of ways to experience sexual pleasure with no need for erections… yet a penis always ready to attention has always been synonimous with being “real men”, and possible défaillances are cause for public derision since the times of ancient Romans, who bequeathed us with entire comedies on this topic.
As if we ever needed that, this was confirmed during the conference itself when we were shown a video of the street interviews held by a young female researcher. She stopped passerbys asking «did you ever use a pill to help you in bed?», and all subjects rushed to point out that no, they’d never ever needed that. Maybe a justifiable reaction to a possibly too aggressive approach, but what struck me was something else entirely.

Each time a man blushed, stammered or patently lied, the room we were in filled with barely restrained laughter and sarcastic comments – although this was a public composed by unquestionably educated women and sex experts to boot. What amused them wasn’t so much the victim’s embarrassment but his inadequacy, which was some times eloquently commented by the faces of his lady companion standing by.
I don’t know whether this was an involuntary “gender revenge” by persons who are socially used to be judged by and large on the basis of their sex appeal, but I am positive that seeing those strangers get instantly mocked for their hypotetical suboptimal erectile performance really disheartened me – and taught me several things.

The first is that, when I’ll come to need them, I won’t have any problem to join the millions of erection difficulties pills users. I deeply wish that my partners aren’t among those who evaluate men on the basis of how hard their cocks are, but if this is really such a fundamental factor to appreciate a person, I can sure ask my doctor for a prescription, dammit!
In fact, as pointed out by Jannini these pharmaceuticals are getting better and better. Provided you don’t have particular circulatory issues they are «safer than aspirin» (his words), and avanafil in particular solved two issues typical of its competitors: having to take them quite in advance and collateral effects such as the typical “pill-popper’s shiny eye” and other minor setbacks. Just imagine where will they be in 2070, when I’ll begin needing them myself!

Sexy elder couple

But seriously, witnessing the sexual prejudices that clearly exist outside of my beloved (and illuminated) extreme eroticism explorers community allowed me to understand another data from the presentation. Although just 12,5% of the population really has serious erectile dysfunction issues, over 60% of those who buy this sort of drugs confesses not to take them for a real medical need but to “ensure the expected performance”, boost their self-esteem and overcome performance anxiety. I can buy that: in another research, 21% of interviewees said they had been dumped due to their hydraulics being not on par with expectations!
This reminded me a chat I had some time ago with doctor Alberto Caputo from the Sexual Evolution Institute of Milan, who told me of the raising incidence of performance anxieties caused by… online porn. Turns out that ease of access to any sort of video let more and more women discover the endless mounts of male porn performers – and to make them demand similar performances from their partners, who however don’t do that for a job, nor are supported by direction and editing magic like porn stars are.
Another major cause of andrologic drugs abuse is using them as “antidotes” to the ill effects of alcohol, drugs and mundane exhaustion, which infamously are the worst enemies of 10-Mohs towering dongs. Being a party monster isn’t as glorious as it is supposed to be, after all.  

Erectile dysfunction

Let me be clear here: the general insecurity atmosphere isn’t all the partners’ demands fault. An important role is played by the chronic dudeism of men brought up with lockroom talk and second-hand Trumpisms; the terrifying ignorance of what a healthy sexuality actually is… and by the pharmaceutical industry itself.
It is no wonder that, if your job is to sell drugs, your interest lies in pathologizing even the most mundane situations. I love science – and not having to die in pain for very curable conditions – too much to jump on the ‘evil Big Pharma hates us all’ conspiracy bandwagon, yet it was hard not to notice the language used during the presentation. Just like it was perfectly normal, it was all a series of ‘illness’, ‘severe disorder’, ‘serious issue’, ‘invalidating difficulty’ and so worrying – words that were unconsciously and immediately adopted by the guests too, right when the figures projected on the wall showed that erectile dysfunctions very often are just occasional, minor episodes which only blow into a problem when they are exaggerated by their common perception. Watching the scene I found myself smiling as I recalled the old joke: ‘you have just a cold: here’s a therapy to cure it in seven days, or you can do nothing and it will pass in a week’.

Whatever the reason, there is no doubt that lots of men of every age live in terror at the very idea of not having thunderous erections like they had at 14 anymore. Since they are ashamed of “not being up to standards”, the Doxa survey showed that they tend to feign not to be afraid for an average two years they spend wallowing in anguish, during which the psychosomatic side of the situation obviously just grow and grow, making the disorder even worse. Then they eventually go to their doctor, who usually just prescribes a specific drug and solves it all. But just in 20% of the cases.
As a matter of fact, the remaining 80% does much worse, searching for “information” on the Web – which is never a good idea when it comes to health. Especially in this case, since the survey found the tendency to look for information… on female-oriented forums, for example. Or in the countless trap-sites specifically designed to exploit floppy bird panic: there are over two and a half millions of them all over the world, generating no less than 40% of all spam on the Internet.

The reason is clear. Since lots of insecure little men are terrified of talking to their doctor or a pharmacist about getting a chemical help for their virility, they see the opportunity of anoanymously buying andrologic products online as a godsend. Pity that things are really quite different.
To make a long story short, the sole legal way to buy pharmaceuticals online is from authorized pharmacies and with a medical prescription, buying exclusively registered products which are recognized in your country too. In practical terms, for Europeans this means buying from the few official online pharmacies in the UK that allow the self-certification of your clinical parameters. You spend about thrice you’d pay on regular channels, but it is all above the board. Including the drugs themselves.

Sure, because a hefty 26% of users think themselves to be more clever than the rest, and buy them from those “miraculous” websites that pollute our inboxes with proposal seemingly written by a dyslexic baboon. ‘95% off!’; ‘Four times better than Viagra!’; ‘You’ll leave her breathless!!!’ and promising on.
If you think only a handful of imbeciles can fall for that you are dead wrong: the market for counterfeit erectile dysfunction drugs is worth 75 billion dollars, and it grew 92% in the last five years. Just a little half of the buyers lives in the United States, where an atrocious healthcare system and the cult for competition contribute to create the ideal market for substances mostly produced in China, India and Singapore.

I am speaking about ‘substances’ because the vast majority of what’s sold online is counterfeit. The real drug is only delivered in one case in thirty – if anything comes through at all. According to an AIFA survey, 40% of the sites just steal personal data and credit card numbers, counting on how people ain’t going to sue them for being frauded… right while they were trying to procure illicit pharmaceuticals.
In all the remaining cases it is just a matter of luck. The most common types of counterfeiture are pills containing the wrong dose of active ingredient (from -70% to an incredible +170%), expired and repackaged drugs, complete lack of active ingredients, exchanged drugs (typically Viagra sold for Cialis). Some companies print on each original box a security code you can check with those published on the official websites, but that’s kinda moot when you are buying from shady vendors.

Fake erectile dysfunction drugs

Fake erectile dysfunction drugs

As I was driving back home after the presentation, I found myself looking with a new eye the impressive number of towers, obelisks, belltowers and oblong monuments all around the city: are they really a sort of unconscious exorcism of the lack of a baculum? And aren’t all these pharmaceuticals that would have made Priapus jealous undoing tens of thousand of years of evolution, when you think about it?
The professor who helped us interpret the survey data even posited that “sex pills” play an important role in preventing violent crimes, which are for a large part caused by the frustration of perceiving your virility as insufficient. Prostitutes for example dread those clients who cannot get it up, because they know that they tend to blame them for their humiliating performance and sometimes to exact revenge by attacking them. Honestly, I believe that gender-based violence – the so-called femicidehas much deeper cultural roots than that, but I learned a lesson anyway.

Stendra and its ilk should deserve less prejudices and to be known better… but so do many other aspects of sexuality which go beyond the scarily reductive vision of a mechanical to-and-fro that only values the inhumane quantification of ‘how long did it last’, ‘how often’ and similar nonsense that should be better left to schoolchildren. Actually, come to think of it: not even to them, so we’ll avoid to ruin their lives as grownups.
Sex is much more than athletic bodies and quantifiable performances. If so many years of studying unusual eroticism taught me anything, it is that even the most wonderful orgasm can give a few dozens of seconds’ worth of pleasure at best, but if we allow ourselves the possibility to imagine and explore a different sexuality, going beyond the borders of trivial penetration, the arousal and enjoyment can extend for hours and permeate every moment of the day, even when you are far beyond your twenties. To do that you don’t need Olympic physiques nor sex toys either: it will suffice to respect your partner and relate as persons instead of sad genital organs.


Unlinked data sources:

  • Doxapharma – 11 workshop presentation
  • A. Caputo – Contraffazione e vendita dei farmaci vasoattivi online, 2012


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