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It's a decade since the advent of the blue pill that, alongside Monica Lewinsky's blue dress, announced a new sexual era. Critics say the drug makers profit by pushing a shortcut to 'normalcy' that narrows our view of human nature. Happy users say, 'So?'

From Saturday's Globe and Mail

The first time, Allard Gee popped the little blue pill in secret and then slipped into bed. At 59, after a three-year dry spell, he couldn't be sure it was going to work. Better not to start the night with big expectations.

"It was a very unexpected pleasure," giggles his wife, Joyce, taking over the story. "Afterwards, we got up and had a drink and made a toast to good health. Had we known, we would have gone to the doctor sooner."

Ten years ago this month, wine glasses were clinking in bedrooms across North America, as men joined Mr. Gee in hustling to their doctors for a brand-new sex elixir called Viagra — named for "the vigour of Niagara" and promising to get the job done without the dreaded stab of a needle or the drastic step of an implant.

The Gees, who live in the Eastern Ontario village of Gilmour, enjoyed an early supply as part of a clinical trial. Many of their fellow Canadians, forced to wait one more year for Health Canada approval, scampered across the border. In the first six months, American doctors wrote 5.3 million prescriptions for the drug, which works by increasing blood flow to the penis within about an hour of being ingested.

The blue pill rivalled Monica Lewinsky's notorious blue dress as the story of the year for 1998 — and together, arguably, they took the blush off the public discussion of sex once and for all.

A decade later, Viagra is a cultural phenomenon, the product of a brilliant sales job to an eager, ever-widening market — the Coca-Cola, as one urologist put it, of erectile dysfunction. By many accounts, the company behind it, Pfizer, created the thirst by spending many millions to embed the term erectile dysfunction ("ED") in the minds of men, through persuading their doctors.

Two other oral drugs, Cialis and Levitra, joined the lucrative ED market five years later, promising to do the job even better and for longer than their trailblazing counterpart.

According to the most recent figures, as of last autumn, more than 1.8-billion Viagra pills had been dispensed around the world; in Canada, 1.6-million men had used it. And that number doesn't include Cialis or Levitra, much less the guys who've used all these drugs without prescriptions, including a population in their 20s and 30s who pop it recreationally. Not bad for an elixir discovered when test subjects for an angina treatment reported an unexpected boost in the bedroom, a happy-accident tale now central to Viagra lore.

But for all its amorous fans, the cult of Viagra gives some sociologists and medical ethicists a cold shower for what it says about drug-company influence peddling, the marketing of a masculine ideal and society's definition of what's normal. Singling out Viagra for ushering in an era of designer "enhancement" drugs, critics suggest we pause our passion to consider what it means to stock our future medicine cabinets with drugs that imply that human nature, with all its ups and downs, needs fixing, like a disease.

Barbara Marshall, a Trent University sociologist who studies the impact of Viagra, calls it the MacDonaldization of sex: "We need to think about whether we want sexuality to be like ordering a Big Mac, where it tastes the same time after time."

'Singing in the shower'

On certain nights, Réjean Brunet's wife decorates his desert with a blue pill and serves it with a sly grin after dinner.

"I get the message," he laughs.

Mr. Brunet, a 65-year-old retired government manager living on the south shore of Montreal, has been using Viagra for five years.

The first time he'd complained to a doctor about trouble keeping an erection, the urologist sent him away empty-handed. "He told me, 'Well, spring is coming, you're going to see beautiful girls and things will come back to normal.'" A few months later, he went to a different urologist, and got Viagra.

He admits he was worried about the long list of side effects on the papers the pharmacist gave him, including headache, flushed face, blurred version and — rarely, but most alarming — erections that won't subside for four or more hours. "When you read that paper, it's a bit scary."

Like Mr. Gee, he chose not to tell his wife. He took the pill after they went out to dinner. They ended up stopping at a motel on their way home, just as they'd done in their younger days. "I wanted to surprise her," he says. "Just to see her reaction at my new vigour."

In fact, he waited a month before telling his wife, worried — needlessly, he says now — that she would be disappointed. "It was like I was back to 20 years old, it worked that well," he says. "The good thing about Viagra is that it's two-for-one: We would have relations in the evening, and in the morning I would still be up and willing."

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