This article presents the standard sexologist assumption that ED is "psychological" (performance anxiety). In fact, it appears that in younger men, numbing of the pleasure center of the brain via overstimulation due to today's hyperstimulating porn is a big piece of the puzzle.
At first glance, Nick looks like any other fit, healthy young man of 30.
Smartly turned-out, well-spoken and the managing director of his own small business, he is perfect boyfriend material. But throughout his 20s, Nick was concealing a very intimate secret.
In his wallet, along with cash and credit cards, he always kept a small pack of Viagra. For years the little blue pills have been seen as an essential aid for older men with erectile problems, not normally men in their 20s. But Nick is not alone. He is one of the new generation of young males turning to the drug to deal with performance anxiety.
Unable to cope with expectations raised by the easy availability of internet porn – and intimidated by the growing sexual confidence of young women, Viagra becomes a crutch some can’t do without.
Therapist Raymond Francis specialises in sexual problems – and says he is contacted by about 15 patients a month who feel unable to have sex without taking the drug. And far from being men in their 50s and 60s, he says their average age is just 32.
Raymond, who is based at the Apex Practice in London’s Harley Street, says: “I think that’s only the tip of the iceberg. These men don’t have any physiological symptoms. Instead men feel they need it because they are putting too many expectations on themselves – based on what they believe women want in the bedroom. The result is psychological impotence.”
And Raymond links this feeling of insecurity to women’s growing confidence. “Women are now so empowered,” he says. “They want sex on demand. They feel they have just as much right as men to dictate the pace sexually.
“Yet young men can then find themselves unable to have erections on demand – and they can start to bring these performance fears to the bedroom long before any sex takes place. ”
For Nick, the problem began when he started viewing internet porn at the age of 12. It left a deep impression and the message he took away was that he had a lot to live up to.
He recalls: “I found it really stressful. Seeing all these virile men with huge erections lasting for hours on end just seemed to accentuate what I couldn’t do.
“Everywhere I looked I saw this expectation I had to be a great lover. I also found that a lot of the girls I met were quite sexually up front about what they wanted. I ended up panicking because I got scared I wouldn’t be good enough.”
Viagra was Nick's guilty secret
At the height of his addiction, Nick was spending up to £300 a year buying pills on the web, despite the risks. “I felt like I was living with a guilty secret all the time,” admits Nick.
“I’d cover my tracks when I ordered them and remove the history on my computer. I’d keep my supply hidden in a locked box in my desk so my cleaner wouldn’t stumble across them.”
But though Nick found that the pills nearly always did the trick – ultimately they did not provide an answer.
He says: “Throughout my 20s, I’d never attempt sex without taking Viagra. Timing was always a problem. I had to take the tablet a certain amount of time before I expected to need it. At the same time, I didn’t want to take it too soon in case it wore off. It was like spinning plates.
“When I was in a relationship, I‘d take Viagra first thing in the morning, so I’d get the sex over and done with. But it meant I could never fully commit emotionally because I couldn’t be honest about this most basic thing.
“It was all getting so stressful I actually started avoiding sex altogether. Overall, it really knocked my confidence in other areas of my life. My mates started to think I was gay because I’d give up trying to pull. I felt like a failure.
“The other problem was that sometimes I would get some of the well-known side-effects of the pills. They’d make me flushed and my vision would get a bluish tinge.”
It was when Nick met and fell in love with his current girlfriend Victoria, after meeting her at a wedding, that he decided to seek help.
“I took Viagra secretly the first time I slept with Victoria,” admits Nick. “But the expectations were very high because she was so special to me. So that time even the Viagra didn’t work. I could see she was worried it was her fault, so I decided to be very candid – and told her everything.
“With her encouragement, I plucked up the courage to get therapy for the underlying issues. It’s been difficult because Viagra’s been so embedded in my lifestyle for so long. But by taking the pressure off sex and proceeding slowly, I’m changing the way I think.”
Adele, an attractive bank worker in her late 20s knows what it’s like to be on the other side of the problem – as the partner of a young man taking Viagra. Looking back, she admits it was partly the high sexual demands she put on her fiance which helped trigger the anxieties that contributed to his impotence.
“I was very vocal about what I wanted in bed from the get-go – and that didn’t help,” she says. “When the sex didn’t live up to my expectations, I would also be very honest about how frustrated I was – which made the problem worse. We tried Viagra but it felt like a planned event. So now I don’t want him to tell me if he’s taken it or not. I just want to think the sex was naturally great.” Now, getting couple’s therapy has helped her recognise she needs to take the pressure off her boyfriend – and be more patient, she says. “It’s difficult, but I try to remember that if my fiance doesn’t get an erection, it’s not because he doesn’t desire me.”
As a young woman growing up post “girl-power”, Adele says many of her female friends have grown up believing they look confident if they are sexually forward. “I do find it important to be acknowledged as sexy. It validates who I am. My sex drive is also pretty high. Ideally, I’d like to have sex five times a week. But then my generation has grown up feeling entitled to be completely sexually satisfied.
“Women our age probably do have more of a sexual past. For example, I’ve had 15 partners, while my partner’s had five, so that’s another layer of pressure on him. Because I am quite skilled sexually, he probably wonders where I learned it from – and how he compares.”
Raymond says the first line in any treatment is to throw away the Viagra – which, as manufacturer Pfizer points out, should only be taken with a doctor’s prescription and is not physically addictive.
Raymond says: “The problem is that many men try and camouflage the problem with Viagra – so very often the women involved are not aware. For instance, I have one client, a professional man in his 30s, who has been married for four years and who’s started coming home late so he can tell his wife he’s too tired to have sex.
“But as soon as men start to open up and relax instead of placing such high demands on themselves – it becomes possible to get to the root of the issue.”
Sex and relationship expert Dr Pam Spurr (www.drpam.co.uk) says: “I hear from young men in this position quite a lot, and there are a few different strands to what’s behind it.
“Young men are under immense pressure to be sex gods. We always think it’s women who are under pressure to perform in bed, but whether it’s a bad thing or not, women can also fake it. Men just can’t.
“If they’re not into it, the woman will know - they won’t have an erection for a start and that’s pretty difficult to disguise – and of course they feel they’ve got to carry on until they satisfy their partner.
“Now combine that pressure with the attitude of a lot of young people towards what they see as recreational drugs.
“A lot of the guys I hear from see sex drugs as an extension of these and they can become a psychological crutch. In the old days some young men needed a lucky charm like their pulling pants to perform, now some rely on sex drugs.
“This is worrying because of the possibility it could be combined with other medication, either prescribed or so-called ‘recreational’ drugs, or a lot of alcohol.
“Because so many young people now have several sexual partners, the pressure for guys to compete is greater.
“We really must start to consider more the pressures on young men when it comes to sex.”
Viagra manufacturer Pfizer said: “As with all prescription medicines, Viagra should only be used when prescribed by an appropriately qualified healthcare professional, and always in accordance with the labelling information.
“Viagra is one of the most studied erectile dysfunction (ED) drugs and has an established safety profile of more than 10 years.”