Should You Be Ashamed of Using the Blue Pill?

Last night I received an e-mail from a reader who has a birthday on the horizon and has recently been consumed by fears not unfamiliar to many men, such as being able to achieve an erection. The following excerpt of Dr. M‘s message is reproduced here with permission, in order to give context to my response, which follows. He writes:

My friend in London talked to me last night. Her latest lover — mid-40s, moneyed, a law professor with transatlantic connections, athletic — hadn’t been able to get it up all week, and she was baffled. She tells me she’s been with men into their 70s, and this has never happened to her, ever. She’s 32 now, so that’s… in eighteen years of sexual adventures, no man has ever failed to be hard with her. The current lover did everything else with her, but couldn’t do basic PIV [penis-in-vagina] sex. She was… concerned. Or at least concerned that something physical (blood pressure, undiagnosed diabetes, depression) might be wrong. She has, she says, a cache of generic, probably illegal, Indian black-market Viagra and wonders if she should give him a few.

I told her about Caverject. Caverject is what male porn stars use. It’s… injectable. Which would be… very, very painful. But as soon as I said that, I thought about aging seducers carrying three or four Caverject syrettes in a chic, stainless-steel Art Deco cigarette case. There it would be in the inside jacket pocket of your suit jacket, and you’d take one out and just… use it. It’s probably sad that I’m far more intrigued by the idea of the elegant case than I am by whether Caverject works as advertised.

[…] Anyway — I’ve never used Viagra or its relatives, and so far I haven’t needed it. But… having talked to my friend, I’m now afraid that it’ll happen any time. Yes, I’m probably hypochondriac — talking myself into being so afraid of this that it will happen. This is my usual “taking counsel of my fears” procedure.

So… should I be afraid or ashamed if I needed the Blue Pill? If men have to take one with you, how do you feel? If a man has an erection problem, how do you react? What would you think if a guy did inject himself with Caverject there on the bed with you? Would you ever laugh at a guy?

We live in a society that teaches women that men are extremely sexual creatures who can’t be expected to control themselves. From teachers that tell young girls that wearing spaghetti straps is “distracting” to boys, to judges telling women that wearing a tube top sends “signals” to an attacker, women are told, again and again, that men are basically beasts that live in a perpetual haze of desire; as a result, it’s entirely unsurprising that women are shocked when men don’t pop a boner the second a woman undresses before him.

The truth is that men and women are equally sexual, but they both require some level of seduction to get to a place where sex is optimal. I don’t like the phrase “turn on” because it suggests we have a switch that can be flipped instantly to get us to a place of complete arousal. There is no switch — arousal is a dance, and anyone is capable of experiencing issues, at any time, that interfere with this arousal or with a sex act itself. (This piece discusses men exclusively, but you can learn about the issues affecting women such as vulvodynia and vaginismus.)

Regardless of my partner’s age, the most important thing I can do is make him feel comfortable and help him see that sexual pleasure — both for me and for him — doesn’t require a “performance” — and it is telling that we use the word “perform” as a euphemism when we talk about a man’s ability to achieve an erection or have penetrative sex. I’m not in it for performance, but for mutual pleasure. To establish this tone in the bedroom, I make a point to give equal time to sexual activities that have nothing to do with the requirement of an erection, sometimes foregoing penetrative sex entirely. It’s not that I don’t like penetrative sex — I love it. But it’s critical for me that my partner understand the possibility of pleasure beyond it, and that we both participate in sexual experience paying tribute to that understanding.

As Masters and Johnson discovered decades ago, taking away this looming requirement frees a man from the positive feedback loop of anxiety engendered by the fear of failing to become erect, which, in time, can dispel psychological blocks to penetrative sex. I think pills like Viagra and Cialis likewise help in psychologically reducing this anxiety — as well as assist an erection physically, obviously. For that, I applaud their existence and encourage their usage so long as it’s done safely. By “safely,” I mean that it is imperative to consult a physician about Viagra or similar products because of how they can interfere with alpha-blockers — taken for high blood pressure or prostate issues — nitrates, and other treatments, as well as conditions such as kidney and liver disease.

Black-market products, or products from internet sites that are not subject to regulation, might not even be selling real Viagra. At best, it will not work. At worst — well, don’t ever take anything if you don’t know what it is. Nothing good can ever come of that. The good news is that as a common prescription to treat erectile dysfunction, Obamacare should be of assistance in acquiring low-cost access to a healthcare professional to discuss whether Viagra right for you, and in filling the prescription without breaking the bank.

I don’t see the use of treatments for erectile dysfunction as being different than using a lubricant or engaging in prolonged foreplay to get a person in the mood. Neither do I think it’s a man’s failure if he can’t get erect without them — or my failure that I can’t seem to inspire an erection by simply standing before a lover naked.

The takeaway here is that it is a worthwhile investment for everyone to create a space of physical and sexual pleasure with their partner or partners that exists beyond simple body mechanics. Think outside the box — or within the box, but beyond the phallus. Pleasure is always possible. But pleasure can’t exist in a place where anxiety reigns.

Header image by Adam Brill.