Viagra, considered a huge step in understanding human sexuality, cultural attitudes, ED indicates other health issues and that blood vessels aren't working well

Viagra isn't a cure-all, some sex problems are indicative of relationship problems. Before Viagra entered the public lexicon, impotence was hush-hush.

Viagra entered the market over 10 years ago, bringing once taboo subjects like erectile dysfunction out in the open.

In-boxes are clogged daily with spam mail promising cheap and instant manliness delivered fast and in bulk. Couples exchange amorous, come-hither looks followed by a lengthy recitation of side effects on TV ads. Viagra, helped more than 25 million men get their groove back and blasted the topic of erectile dysfunction into the open.

"It's like the nuclear explosion," said Dr. Irwin Goldstein, director of Sexual Medicine at Alvarado Hospital in San Diego, California. "It created sexual medicine. It allowed the taboo to be broken."

Since Viagra debuted over 10 years ago, it has become embedded in the public psyche, late-night television jokes and urologists' offices.

"It is one of the revolutionary steps in sexual health," said Dr. Ira Sharlip, spokesman for the American Urological Association. "It ranks with the changes in cultural attitudes about sexuality that were started by [Sigmund] Freud, continued by [William] Masters and [Virginia] Johnson, the two researchers in the '60s, and the work that [Alfred] Kinsey did in the '40s. "These were the huge steps in the development of our understanding of human sexuality and cultural attitudes of sex."

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