Viagra continues to generate a torrent of Internet spam

Hard to believe since Viagra was approved by the Food and Drug Administration, Viagra might cause nerve damage to the eye or directly trigger cardiac deaths have now been laid to rest, while its status as a cultural phenomenon still growns. Viagra though has some stiff competition.

Glaxo Smith Kline and Bayer have brought drugs called vardenafil (trade name: Levitra) to the market in Europe with affects similar to Viagra. Another drug, called tadalafil (Cialis), has also being launched there.

Like Viagra, these new pills facilitate an erection by trapping more blood in the penis.

Pfizer believes both drugs infringe on its patent.

Meanwhile, the uses for Viagra seem to be growing.

A study in the Journal of the American Medical Association two weeks ago showed that Viagra successfully counteracts some of the sexual side effects experienced by men who take Prozac or similar antidepressants.

Researchers at Pfizer are also intrigued by reports that because it dilates blood vessels, Viagra may help reduce pulmonary hypertension, an often deadly and difficult-to-treat form of high blood pressure that affects the lungs.

Viagra users are only getting younger.

A typical user of Viagra was a married man in his 60s. Nowadays, he's still married but more likely to be in his 50s.

One trend that worries public-health officials, however, is the growing recreational use of Viagra in some settings.

Gay men seem to be at the vanguard of this trend. Viagra often in combination with illegal drugs like ecstasy, enables patrons of sex clubs to have sex with more partners, which increases their risk of contracting sexually transmitted diseases (STDs) like syphilis and aids.

"One out of three sexually active gay men at our STD clinics has used Viagra in the past year," says Dr. Jeffrey Klausner, director of STD Prevention and Control Services in San Francisco.

The same was true for 1 of 14 heterosexual men at the clinics. Despite the potential for abuse and the usual risks associated with any physical activity like sex, Viagra has been a boon to many men.

"Viagra is still the most patient-friendly method of treating erectile dysfunction," says Dr.

Ira Sharlip, assistant clinical professor of urology at the University of California at San Francisco. Although Viagra doesn't work for everyone, it's what most patients want to try first, before turning to such alternatives as injections, vacuum pumps and surgical implants. Perhaps all those unsolicited e-mail come-ons are a small price to pay after all.

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