ROBERT SIEGEL, HOST:
Viagra was introduced in 1998. A few years later, Cialis and Levitra hit the market. NPR's Ina Jaffe covers aging, and she has this report about how the drugs work and the impact that they've had. And we'll be hearing, of course, about the male anatomy and human sexuality.
INA JAFFE, BYLINE: OK, let's just get the giggles out of the way. So here's Jay Leno.
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JAY LENO: There's a very small risk that men who take Viagra could go blind. Oh, great. What is that - go blind? I mean, for years they tell you, oh, you satisfy yourself, you go blind. Now if you have a partner you go blind. We can't win.
JAFFE: According to the Wall Street Journal, by 2002, Jay Leno had told 944 Viagra jokes. We couldn't independently verify that number. Actually, we didn't try.
But we did confirm that Viagra has, as Leno said, been associated with sudden blindness, though that's very, very rare. Most users are like 71-year-old Mike.
JAFFE: Mike, who asked us to use just his first name is a retired Marine Corps pilot. He's been married for 47 years, and he's been using either Viagra or Cialis for the past 10.
MIKE: I was having some issues and discussed it with my son who's a physician. He thought I should try it.
JAFFE: And did you discuss it with your wife too?
MIKE: I did. And she was all for it as well.
JAFFE: Because his performance issues had become a source of tension in the marriage.
MIKE: But after using the drug, I believe my wife and I became closer.
JAFFE: Because there was a source of anxiety that was removed?
JAFFE: Before Viagra, relieving that anxiety required measures that could cause plenty of anxiety themselves.
EDWARD SCHNEIDER: They're just medieval, these things.
JAFFE: Doctor Edward Schneider is a professor of gerontology, medicine and biology at the University of Southern California. One of the devices he finds medieval is the vacuum pump.
SCHNEIDER: Where you essentially cause an erection by creating a partial vacuum around the penis, drawing blood into the penis. I've never done it, but I imagine it's awful.
JAFFE: There's also a surgically implantable palm and a Viagra-like drug you can inject directly into the penis.
SCHNEIDER: And the other way is you actually put a little bit of a pill into the tip of the penis, and that works too.
JAFFE: All of these methods are still in use because some men can't take Viagra-type drugs. But the men that can, have made Viagra, Cialis and Levitra wildly successful. The three drugs took in more than $2.5 billion last year. Doctor Jacob Rajfer, a professor of urology at UCLA medical school says there's another reason the drugs are so profitable.
JACOB RAJFER: This is what happens to all men.
JAFFE: Gradually, over time.
RAJFER: Men in their 40s have a 40 percent chance of having this problem. So for every decade after 40, there's a 10 percent increase.
JAFFE: So a man in his 70s, says Rajfer, for would have a 70 percent chance of having a problem, at least once in a while.
RAJFER: Because after our prime reproductive years, mother nature begins turning that off. And one of the ways she does that is she begins the deterioration of that smooth muscle.
JAFFE: Which is the kind of muscle in blood vessel and the penis. In fact, years before Viagra hit the market, Rajfer helped identify the chemical in the body that acts on smooth muscle and makes erections possible. Viagra-type drugs work by keeping that chemical from breaking down. But for a man named David, the drug is much more than the sum of its chemical parts.
DAVID: It's something that gives that sense that intimacy can continue, and that you can feel less alone as a result.
JAFFE: David is 66 years old, a recently retired community college professor and a widower. He's now in a new relationship.
DAVID: I was simply concerned at my age that I wasn't as capable as I wanted to be. And after I got the prescription, I told her I had done that.
JAFFE: And what did she say?
DAVID: She was fine with it. You know, women have their own concerns as they age. She was also concerned about how we were going to be as older people making love.
JAFFE: Older people making love hasn't been something that most people have wanted to think about. But David says with people living longer, he and the new woman in his life could spend another 25 years together.
DAVID: And that meant I wanted to keep that intimacy as long as possible because I love this person, and I expect to be with her for a very long time.
JAFFE: And now because of a little pill, being physically intimate with a woman he loves isn't something that will be lost to old age. Ina Jaffe, NPR News.
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