Critics say sex drug ads pitching younger

BY FRED TASKER

ftasker@herald.com

When Viagra came out in 1998, its poster boy was the grandfatherly, 75-year-old Bob Dole, who had had prostate surgery. Today it's ''Wild Thing,'' a fit, 40ish guy who grows horns at the sight of a bikinied department store mannequin.

When Levitra came out last year, its spokesman was former Chicago Bears coach Mike Ditka, 65, who had suffered a heart attack and had both hips replaced. Now there's also former Dallas Cowboys star Tony Dorsett, dark-haired and unwrinkled at 50, looking fit enough to strap on a helmet and go back in if needed.

Quite a change. Have male potency drugs become, as the 1950s Old Gold cigarette ads used to say, ''a treat instead of a treatment?'' Morphed from medical into recreational, aimed at an ever-younger, ever-healthier audience?

They have for ''Andy,'' a 23-year-old South Beach bartender who gets Viagra from a friendly MD (it sells for about $15 a pill) and pops it not for any dysfunction but so he can have sex four or five times a night with his girlfriend.

''I feel like Superman,'' he says. But he admits his girlfriend is less enthusiastic. ``She says after a while there's nothing romantic about it.''

Why would drug companies market to younger men?

Easy. There are 15 million American men 65 and over, and 45 million ages 40 to 64, the Census says. Broadening the age range would quadruple their target audience.

Stakes are huge. Drugs for erectile dysfunction, or ED, are a $2.6 billion market in the United States this year, on track for $3.1 billion by 2006, says Paul Latta, a market analyst with McAdams Wright Ragen Inc. There's a big battle for market share. Viagra leads with 70 percent, Cialis has 19 percent and Levitra holds 11 percent, Latta says.

`PROFOUND MISTAKE'

Not everybody approves.

''This medicalization of sex is a profound mistake,'' says Dr. Leonore Tiefer, psychologist and sex therapist at the New York University School of Medicine. ``It creates a performance orientation toward lovemaking that isn't sensual or emotional or intimate.''

Kenneth Goodman, co-director of the University of Miami's Ethics Program, has little sympathy for the 23-year-old: ``It's not as if he isn't able to have sex -- even a lot of sex. He just wants to fool around.''

Still, ED drugs are an important treatment for many, urologists say.

''A typical patient is a 60-year-old man who had prostate surgery, who has a poor, short-lived erection and is unable to have intercourse,'' says Dr. Robert Puig, chief of urology at Baptist Hospital Miami. ``Viagra can give him an adequate erection.''

Drug companies vow they seek only customers who need the drug.

''We absolutely only condone it for appropriate use,'' says Michael Fleming, spokesman for GlaxoSmith Kline, makers of Levitra.

`WORKS FOR ME'

Dorsett is unapologetic about his role as a Levitra spokesman.

''If anything like this is on the market, people are going to try it for recreational use as well,'' he says. ``I don't recommend it.''

Dorsett is touring the United States in a ''Tackling Men's Health'' program sponsored by the National Football League and Levitra, talking to men about diabetes, heart disease and erectile dysfunction. And about Levitra.

''It works for me,'' he says. ``Maybe your recovery time is not like it used to be. Once you're over 30, you stand a chance of this.''

A study in the August 2004 issue of the International Journal of Impotence Research says that, since the end of Viagra's first year in 1998, prescriptions have increased by 312 percent for men 18 to 45 and only 216 percent for men 46 to 55.

''Certainly the average age of users is less than when Viagra started,'' says Dr. Ira Sharlip, spokesman for the American Urological Association. ``And ads are now pitched younger.''

Adds Latta: ``The actors in some Levitra ads look like they're in their upper 20s.''

Fleming bristles: ``Those couples on TV are in their mid-40s.''

He compares it to adopting reading glasses as a man ages: ``People are living healthier lives these days. They want help for more active sex lives.''

''The ads are simply an acknowledgement that ED affects men of all ages. We see it at 30, 40, 50, 60,'' says Daniel Watts, spokesman for Pfizer, maker of Viagra.

It raises a question: If younger men are using ED drugs, is there anything wrong with that? For that matter, how do you draw a line between medical and recreational use?

''There's no clear distinction,'' says Sharlip. ``I think the younger man who takes the drugs because it gives him a better erection has some mild form of erectile dysfunction. But there's also evidence that men try it who don't need it.''

For the most part, there's no danger for younger men using the erectile dysfunction drugs, even if they don't need it, most doctors say.

''Probably not,'' says Soloway, the UM chief of urology. ``I know some urology residents who have taken it.''

''I do get younger patients and you can tell they want it for recreation,'' says Puig. ``I don't prescribe for them.''

One rare problem that might happen more often with young men is ''priapism,'' in which the blood that engorges the penis during erection becomes blocked there. That's why the ads warn men to call their doctors if their erections last more than four hours.

''The blood becomes sludge, and the erection won't come down,'' says Puig. The wince-inducing solution is to use a hypodermic needle to remove the blood from the penis. Then there's surgery. It's a higher risk in younger patients because they already have enough blood in their penises, Puig says.

SENSITIVE ADS

Advertising ED products on TV is sensitive, especially in the aftermath of the Janet Jackson ''wardrobe malfunction'' and Desperate Housewives debacles.

An early Levitra TV ad, during an NFL football game, was a marvel of euphemism, showing a man throwing a football through a tire swinging from a tree, mentioning the name of the product, but not saying what it was for.

'That was an `unindicated' ad, said Fleming. ``It created awareness, and it tied us in with the NFL.''

More recently, Viagra's ''Wild Thing'' TV ad got it in hot water with the FDA. The ad implies that Viagra not only helps a man get an erection, but also restores his old sexual arousal, FDA says. ''FDA is not aware of substantial evidence or substantial clinical experience demonstrating this benefit for patients who take Viagra,'' it says.

The ad has been pulled.

Watts, the Viagra spokesman, shrugs: ``We will modify the ad.''

In the future, doctors and analysts agree that newer, better ED drugs will only increase their use -- proper or improper.

And some will continue to decry the role models it creates for men. Says Tiefer: ``You're not going to see an ad in which a guy is writing a poem, and looks up and makes eye contact with his lover.''

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