How the 'little blue pill' helped create men's health field 20 years ago


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It’s been 20 years since the U.S. Food and Drug Administration approved Viagra for the treatment of erectile dysfunction. Nicknamed the "little blue pill," Viagra has become one of the most recognized drugs on the market.

But Viagra's impacts go far beyond the impotence the drug was designed to treat, says Dr. Jesse Mills, director at The Men's Clinic at UCLA. According to Mills, its launch (on March 27, 1998) essentially created the field of men's health.

"Because Viagra addressed such a common problem and men had to go to the doctor for a prescription, it opened the lines of communication between men and doctors," Mills says. "Most men’s health specialists work backwards from Viagra now."

Erectile dysfunction affects about 30 million men in the United States, according to the National Institute of Diabetes and Digestive and Kidney Diseases, part of the National Institutes of Health. When men began visiting the doctor to see whether Viagra (now one of several U.S.-approved medications for erectile dysfunction), could help with their condition, doctors had an opportunity to screen and treat men for a host of other health issues.

"When we know a man experiences erectile dysfunction, we can identify the risk factors at play and the potential lifestyle changes they could benefit from as they improve their erections with medication," Mills says. "If it turns out a patient doesn't exercise much or get enough sleep each night, for example, we have a way forward with simple improvements they can make in their routine that will benefit their health."

Prior to Viagra (known generically as sildenafil), men with erectile dysfunction were likely to be treated by a psychologist before seeing a urologist. At the time, urologists had effective treatment options – including penile injections and penile implants – but they were very invasive.

"If a man declined either of those treatments," says Mills, "he had no options."

Adding difficulty to the situation was the fact that sexual health wasn't so easy to broach in conversation 20 years ago.

"Once Viagra hit the market, there was a level of social acceptance to discuss erections and intimate sexual matters for the first time," Mills says. "TV ads for all the medications in this class made erectile dysfunction impossible to ignore."

Twenty years later, Mills says medications for erectile dysfunction have helped bring men averse to regular medical care to the doctor’s office.

"Now we have more men enfranchised in the medical community than ever before."

UCLA researchers – including Nobel Laureate Louis Ignarro, professor emeritus of molecular and medical pharmacology, and Dr. Jacob Rajfer, professor in residence in the department of urology – were key contributors to the science that led to the creation of Viagra.