In the fifteen or so years since Viagra hit the market, followed, a few years later, by competitors like Levitra and Cialis, commercials for erectile-dysfunction drugs have typically been neither very honest about sex nor very sexy. Instead, they’ve tended toward the euphemistic, the celebratory, or the modest—ultimately putting forth an equation in which a purely physiological problem is neatly solved by taking a pill.

In this environment, the newest Viagra ad, which has been filling the breaks during this year’s baseball playoffs and elsewhere, stands out as particularly blunt. The minute-long spot opens with a closeup shot of a blond woman lying on her stomach, with the thin strap of her dress showing on her right shoulder. “So, guys, it’s just you and your honey,” she says, in a sultry, British-accented whisper. A wide shot reveals that she’s lying in an open-air cabana in a tropical location. “The setting is perfect. But, then, erectile dysfunction happens again,” she continues, alternatively purring and pouting. “You know what, plenty of guys have this issue, not just getting an erection”—she raises an eyebrow—“but keeping it.” Though she ends by advising her audience to talk to a doctor, the effect is reminiscent of a 900-number ad: good times are just a phone call away.

Press coverage of the new ad has focussed less on its breathy directness than on the fact that it is the first commercial for an erectile-dysfunction drug to feature only a woman onscreen. The Associated Press even suggested that the ad was targeted toward women, noting that executives at Pfizer, the maker of Viagra, hope the ad “will nudge women to broach the subject with their mates.” Speaking with Advertising Age, John Osborn, the president of BBDO, the agency that made the ad, explained its premise saying, “This is an example of a very simple, straightforward story well told via an execution that I would say uses direct, honest, compassionate approach to simply let men with E.D. know they are not alone.” Yet it is still quite clearly the men (“So, guys”) who are being nudged; their partners, the “honeys,” seem unlikely to be persuaded.

Still, although the ad is essentially a come-on by a beautiful woman, it is refreshingly frank about sex, which means that it is markedly better than past ads that relied on silly or crass innuendo: Levitra’s football-through-the-tire-swing ad; Viagra’s “We Are the Champions” mass male celebration; Cialis’s adjacent his-and-her bathtubs. The rare exception  is the first television commercial Viagra ever ran, which turns out also to have been the brand’s best, featuring the former Senator and Republican Presidential candidate Bob Dole. That ad, which looks rather oddly like a campaign spot, became a punch line, mocked later by even Dole himself. But, watching it now, it seems far more forthright, honest, and even dignified than the ads that followed. Dole makes note of the ways in which the subject might make viewers uncomfortable, but he tells the audience, basically, to grow up: “You know, it’s a little embarrassing to talk about E.D., but it’s so important to millions of men and their partners, that I decided to talk about it publicly.” It was a little embarrassing; that was the point. In the intervening years, Viagra steered away from talking much about sex in its TV ads: its most recent campaign had showed ruggedly capable men at work, and alone.

The new ad, however, gets remarkably specific. The problem under review is “not just getting an erection but keeping it”—the woman says this twice in less than a minute. The suggestion is that male sexual performance isn’t an all-or-nothing proposition but something that exists on a continuum—and it implies that men could be performing better. In another context, this plain talk about erections might have been the beginning of a more comprehensive, and truly honest, discussion about sex: it might have included the psychological and relational aspects of sexual experience; it could have suggested to men that sex wasn’t a sporting event, and that it need not be judged in terms of wins and losses; and it might have included the voices of real women. Here, the solution to a complicated issue remains simple: get yourself a prescription.

In this way, Viagra’s renewed emphasis on erectile dysfunction resembles the so-called disease-awareness campaigns that pharmaceutical companies have mounted in the past to share information about a disorder for which they produce a remedy. These include the controversial campaign for “Low T” (lower than normal levels of testosterone in men), which has been funded by AbbVie, maker of AndroGel, the best-selling testosterone-replacement drug in the United States. According to the Web site isitlowt.com, which was created by AbbVie, symptoms of the disorder include decreased energy, a loss of muscle mass, mood changes, and reduced sex drive. Critics of Low T-awareness advertising point out that lower testosterone is common among older men, and that it is a natural part of the aging process. In a 2013 paper in JAMA Internal Medicine, the Dartmouth physicians Lisa Schwartz and Steven Woloshin note that neither the long-term health risks of low testosterone in older men nor the long-term effects of testosterone replacement have been fully studied. They also write that drug-company-backed public-awareness campaigns often “lower the bar for diagnosis (turning ordinary life experiences into conditions that require medical diagnoses).”

In the A.P. article about Viagra’s newest commercial, the physician Irwin Goldstein, a pioneer in the study of impotence and one of Pfizer’s earliest paid consultants for Viagra, says that more than fifty per cent of men over forty suffer from E.D. but just ten per cent are getting treatment. This, perhaps, is the ad’s intended market: not just the men who have been too shy or otherwise unwilling to ask their doctors about getting a prescription but also men to whom it had not even occurred that there was a problem.