• Warning: Explicit content intended for an adult audience

It can affect one in four men so why is no one talking about it? Nadia Bokody looks at the issue of getting it "up" before men hit 40.

I've just stripped down to a set of very complicated lingerie the saleswoman promised me will "knock the socks off any guy".

My skin is glistening with the coconut oil I slathered on in preparation for this encounter and my body – thanks to a gym membership I can barely afford – has frankly, never looked better.


This is the moment.

I unzip my lover's fly and – oh, nooo …

This has never happened before. He's, well, there's no delicate way to put this; he's soft.

Have I stumbled into some bad lighting? Did my blow-dry fall flat? Should I have gone with the red lingerie? Oh God. I've been silent too long.

I think to myself: "Say something, anything, before he thinks you've freaked out on him".

"Wow, you're so sexy!" I finally sputter, before self-consciously adjusting my bra straps.

Perhaps if I just ignore it, it'll go away, like the annoying neighbour who tries to sign me up to his pyramid scheme every time I'm in the communal laundry.

It doesn't go away.


Our encounter finishes almost as awkwardly as it began, and, as if responding to the defeat and frustration in my eyes, he says, "I'll pop a V next time, so we can go all night", before planting a kiss on my cheek and sauntering out.

He's talking, of course, about Viagra, a drug that's become a household name in the past two decades, breaking records with some of the fastest prescription uptakes and sales growth of any medication in history.

Originally UK-92480, a drug developed by Pfizer scientists Peter Dunn and Albert Wood for treating high blood pressure, Viagra was quickly rebranded and marketed as an erectile dysfunction (ED) treatment in the late nineties, when its creators realised they'd stumbled upon pharmaceutical gold.

Early patient trials of the blood pressure medication had discovered something remarkable: users were reporting an unexpected sexual side effect in startling numbers: improved erections.

Viagra quickly rose to stardom, named "the hottest new drug in history" and amassing $2 billion in annual sales by 2008, Questia reports.

Though it's recently been superseded by a generic version, the hunger for a solution to ED remains undeniable and overwhelming.

It's estimated as many as one in four men will experience some form of ED before they hit 40, reveals a study by NCBI.

Essentially a spectrum disorder, it can manifest differently from one man to another. While some men experience it only sporadically, for others, the issue is chronic.

Its causes are equally as complex – ranging from physical conditions like diabetes, obesity and heart disease, to psychological issues like stress, depression and performance anxiety.

This may explain why, despite the explosion of the ED drug market, we're no closer to a real solution for it than we were two decades ago.

Less talked about are the disturbing side effects that come hand-in-hand with prescription treatments for the sexual disorder.

Sildenafil, the active drug in Viagra, was linked to over 1,800 deaths during its first decade on the market and a 2018 study found that when taken in higher doses, the drug's active ingredient can also cause vision disturbances, including permanent retina damage.

In fact, Viagra's own website lists, "abnormal vision, such as changes in colour vision (such as having a blue colour tinge) and blurred vision" as a "common side effect".

Unfortunately, these side effects are often ignored by most patients, who are desperate for a solution to what ED drug companies have cunningly marketed as an "embarrassing issue" that must be disguised at all costs.

The reality is, there's nothing innately embarrassing or abnormal about not being able to get your penis to perform on cue.

Blood flow to the genitalia can be interrupted easily; even the simple act of downing a couple of beers before sex can cause your member to say, "Sorry mate, not tonight".

For this reason, there's barely a bloke alive who hasn't had a case of limp dick at some point in his life.


The male body is arguably equally as sensitive and finicky as the female body.

Much like I advise men not to expect their partners to be naturally lubricated after a few minutes of rushed foreplay, I advise women too, not to take it personally if their other half isn't, er, "up" to the occasion sometimes.

It's information I only wish I'd had back when I had my first encounter with a penis that wasn't performing on command.

Unfortunately, while the race to cash in on more effective treatments for ED continues, so too, does the stigma surrounding it.

While it's tempting to write ED off as a "bedroom issue", it affects most men well beyond the realm of what goes on between the sheets – often resulting in low self-image, relationship breakdown, and even depression.

And it's why breaking the silence on it and wading through the discomfort is the only meaningful way to tackle it.

The first step is acknowledging its presence in your sex life and then not centring your intimacy around penetration.

In this way, ED can be a blessing in disguise, offering couples a chance to reconnect with the more subtle aspects of their sexual connection, through kissing, oral sex, foreplay and touching.

Unfortunately, the risks of the pharmaceutical routes for dealing with ED still far outweigh any perceived benefits of being able to sexually perform on cue.

That said, there are safer alternatives for improving your chances of achieving an erection.

There's unlikely to ever be a miracle cure for ED, largely because it's not a disease.

You're not broken, less of a man, or in need of drug therapy if you can't always get it up.

See the act of going soft for what it is: a reminder that you're human.