‘Fear of failure is now pathological’: Why more and more young people are self-medicating with Viagra

“I have to make sure it’s going to work.” “I can hold out longer this way.” “I have to rise to the occasion.” With such thoughts in mind, more and more Spanish men under 30 are turning to the strongest solution available: carrying a Viagra in their pocket just in case they have sex. But that is not necessarily what worries most of the urologists, psychologists and sexologists who see the phenomenon. Even worse is the fact that most of these young men take the pill in the context of parties, where alcohol increases the chances of erectile dysfunction. Many take a sildenafil pill to feel safe, but experts warn that the biggest danger is getting hooked on it. Addiction can lead to anxiety, depression and, in very extreme cases, even suicide: dependence on this drug can destroy one’s sex life.

The following story is emblematic of the problem: “I go out partying, drink alcohol or do something and then I’m afraid I won’t perform at my best if I end up hooking up. Once, in a nightclub having a few drinks, I was with a girl, and I couldn’t get it up. I had a terrible time. I felt embarrassed and insecure.” This anecdote echoes countless stories told to the professionals who participated in this report like Ricardo Fandiño, a psychologist at ASEIA and Vanessa R. Pousada, the vice president of the Sociedade Galega de Sexoloxía (Galician Association of Sexology). Among the most common refrains: “I don’t like to fail when I am with a girl”; “I always take a couple of viagras just in case”; “I have used them to last longer”; “you look like a champion” and “even if I don’t have sex, it makes me feel more confident.”

Viagra cannot be purchased without a prescription, but these experts point out that it is being bought on the black market or with fake prescriptions. The low price helps. At pharmacies, a generic 50 mg pill (it goes up to 200 mg) usually costs about €4 ($4.30) for blister packs of 10 units, or at less than 50 cents per tablet for packs of 360. On the street, each tablet costs between €5 ($5.38) and €10 ($10.76). Speaking with ICON, Enrique Granda, the director of the Medicines Observatory of the Spanish Pharmacists’ Business Federation (FEFE), put the number of units of erectile dysfunction products sold in Spain as a whole in 2022 at four million, 7% more than in 2021 (the data has not yet been published). According to various studies and market data, about one in four Viagra pills is consumed by men between 16 and 30 years of age.

The experts we consulted indicate that an increase in erectile dysfunction among young people cannot be ruled out, but data points to an increase in recreational use of Viagra. And they are concerned about the growing number of young people who come to the clinic with problems arising from abuse or even addiction. We are talking about a drug that has been associated with older people since its launch in 1998. “Taking Viagra does not depend on age. The problem is self-medication, especially when it can cause you to get sick,” says Nayara Malnero, a psychologist and sexologist. With the increase in pill use, she says, young people “end up becoming mentally conditioned and feel they need it more and more. It is a distortion of how the body works and of our sexuality in general.” The author of Sexperimentando (Sexperimenting) and social media educator with over 100,000 followers says that “it’s already pathological.” Of the consequences of consuming the drug at parties, she cautions that when “Monday comes, there’s no pill, and you can’t have sex because the body gets used to it. It’s more mental than physical.”

On a night when drug use stimulates sexual desire, but hinders its consummation, sildenafil and other drugs give a certain boost. “Viagra makes it easier to have an erection and to have several sexual encounters with penetration. It is used as performance insurance,” urologist François Peinado Ibarra, who is also a surgeon and andrologist, explains by telephone. Thus, experts say, Viagra is dangerously becoming another recreational drug, a stimulant. “They trivialize consumption. They’re looking for sexual performance and believe that it will help them,” says Ricardo Fandiño, a psychologist at ASEIA, Spanish organization specializing in child and adolescent emotional health. But “they are far from guaranteeing that it will be a pleasurable encounter.”

These perceptions refer to penetration-centered sex. But caresses, kisses, massages... are also sex. The conception of practicing intercourse under the penis-vagina or penis-anus binary is misleading, the interviewees remind us. “It is a perception of sexuality that is openly phallocentric and geared to a [specific] performance ideal,” notes Fandiño. “There is a fear of failure that goes so far as to call masculinity into question.”

“It’s not the young people’s fault; it’s the educational system, families and politics,” says Malnero. “Nobody explains anything to them about sex and, in a few seconds, with the click of a button, they have all the porn they want. In the absence of contrasting information, how can you not believe that porn fiction is a lie?” he asks. In 2023, the Pornhub and Xvideos websites were among the 20 most visited in Spain, behind giants like Google, YouTube and Facebook.

The problem doesn’t just stem from pornography. Fandiño points to “shows, movies, books and even songs.” He asserts that “young people aspire to an ideal that determines success or failure in relationships. They are inexperienced, they are full of doubt, but they have to succeed in sex [and] always through penetration. That’s why they think that using Viagra can help them in that effort.” Dr. François Peinado observes that “many even compete with each other.” He sees a generational aspect in the assumed increase in spontaneous sporadic sexual relations. “Now, as [sexual encounters] are more random, people want them to be more intense and to give maximum [effort]. It is a self-imposed demand that increases the possibility of erectile dysfunction,” he argues. Peinado calls for greater empathy: “We have to normalize [the fact] that nothing happens if you don’t always have an erect penis and generate a pleasant, pressure-free environment of trust. It’s about enjoying oneself, not being successful”.

If conceiving sex in terms of penetration is a mistake, how should young people approach their sexual relationships? “By deconstructing the social concept and exploring other avenues of arousal,” Nayara Malnero says, adding that “nothing will happen” if one doesn’t have sex one day or if penetration does not occur. “We are missing out on many other aspects of pleasure by focusing on a single model.”

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