I worry the blue pills are being misused

VIAGRA, the little blue pill that can conquer impotence (or erectile dysfunction as we doctors call it), has been the subject of bawdy jokes ever since it first became available nearly 20 years ago. However, news this week that Britain is to become the first country in the world where Viagra can be purchased from pharmacies, without a prescription, is nothing to laugh about.

The decision by the Medicines and Healthcare Products Regulatory Agency is designed to combat the illicit internet trade in the drug and has been applauded by the police and public health bodies.

Every day countless thousands of men worldwide order ‘Viagra’ from unlicensed websites, unaware that it may be illegal to do so, possibly counterfeit and ineffective at best, or possibly toxic at worst.

Last year, stocks of fake Viagra worth an estimated £17 million were seized in Britain.

As for GPs, I’m sure, too, that there will be a fair number of them relieved that they will no longer have to contend with ‘patients’ who have nothing wrong with them medically, but who are simply trying to secure a prescription for Viagra to boost a flagging sex life or for their ‘recreational’ use.

This is not only a waste of NHS time, it also denies valuable appointment slots to those who really need them.

For myself, I have deep concerns about easier access to Viagra. There are many reasons why men suffer erectile dysfunction, including heart and circulatory problems, especially in older men, and diabetes. Impotence is also an unwanted side- effect of certain drugs, such as antidepressants, while psychological problems such as stress and ‘performance anxiety’ can affect arousal in otherwise healthy men.

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of the above necessitate a discussion with a GP who is, ideally, familiar with the individual and who can establish the cause.

In some cases, perhaps where heart disease or diabetes is undiagnosed, or getting worse, it could quite literally be a life-saver.

Viagra — its chemical name is sildenafil citrate — also has significant side- effects including heartburn, headaches, flushed skin and, in rare cases, hearing loss.

Buy a pack of tablets over the counter and you might not be aware of this unless you study the small print.

A GP can insist on explaining these to a patient.

But with all due respect, I’m not sure that a pharmacist or pharmacy assistant carries the same authority, or will be as alert to the lies men might tell about their health in order to get the drug.

And most users or potential users are completely unaware of how dangerous Viagra can be when taken in combination with common heart medications (as well as recreational drugs such as ‘poppers’ which, like it or not, are widely used by thousands of people during a night out).

Of course, for the manufacturer Pfizer, it’s all about profit. The drugs giant aims to have Viagra Connect, in packs of four and eight tablets, retailing at £19.99 and £34.99, available in pharmacies by early next year.

By the time their 15-year patent on Viagra lapsed in 2013, Pfizer had made almost £1.5 billion from the drug worldwide. Now it has to compete with cheaper, generic brands of erectile dysfunction drugs, as well as counterfeit trade.

The over-the- counter opportunity opens up a lucrative and legal new market. It is a market that will be fuelled by — and this is at the heart of my concern — the growing perception among all age groups, of Viagra as a ‘lifestyle’ rather than therapeutic drug that will guarantee better sex. Hence the booming illegal trade online.

Myths about its use, such as the idea that it never fails, or that it can permanently increase the size of the male member, are widely taken as gospel.

I also think the ease of access to hardcore porn, which is viewed more and more by young men, is undoubtedly a factor in the demand for Viagra and similar drugs. What once could be viewed only in a ‘top-shelf’ magazine or on screen at a Soho cinema, is now instantly available online.

Men see well- endowed male porn stars engaged in prolonged sexual activity with cosmetically enhanced females, and expect their sex lives to mirror what they see on their laptop.

And if a little blue pill can help, then so be it.

I also worry about ‘chem sex’ — an Orwellian term for chemically enhanced intercourse.

Casual drug use at weekends is common among the under30s, both heterosexuals and even more so in gay circles.

Lots of the so- called ‘party drugs’ such as cocaine and crystal meth, don’t just loosen inhibitions, they can also make it difficult to get and sustain an erection, so men rely on Viagra.

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rise of chem sex — again, inexorably linked to the ready availability of Viagra and similar drugs online — has been linked to an increase in sexually transmitted infections, including HIV and it is becoming a major public heath concern.

I accept that it’s almost impossible to devise and enforce a law that thwarts the online trade in Viagra (both illicit and fake).

But I am sceptical that making it as easy to buy as strong painkillers or a cough medicine is the answer.