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Men’s health, masculinity & the little blue pill

Pfizer, not just for Covid

Pfizer has been in the media a lot recently. They’re one of the giant pharmaceutical companies producing the Covid-19 vaccine. However, it is not the first time they have made headlines. In March 2018, they announced for the first time that Viagra would be available as an over the counter drug rather than on prescription. This meant any adult male in the UK could walk into a chemist, go to the counter and provided they answered basic health questions (disease history, blood pressure, history of fainting etc), they could walk out with Viagra.



Viagra, for those not familiar with it, is the name of a drug that treats Erectile Dysfunction (ED) - the inability to get and/or retain an erection firm enough for sex with another person or by oneself.


My algorithms

Roughly a year after this over-the-counter Viagra became available, I was killing time on social media, and I noticed a shift in advertising algorithms. One ad, in particular, was especially aggressive, flashing images edited together with bright, jazzy music. It featured a man holding a huge fishing rod at 45 degrees with an ecstatic facial expression. The following image was a large cactus, then a hand holding a corncob, the Shard in London, which cut to black and the words ‘Order clinically proven ED treatments online, no need to leave your home,’ more images follow, a lighthouse, a train entering a tunnel, ‘Discreetly delivered the next day’ fireman up a ladder spraying a hose…it goes on. ‘What did I google?’ I asked myself. That same week a bus drove past me. The ad said, “Is stress getting you down?” The word ‘down’ was curved downward. It was an ad for an online private company selling Viagra. Suddenly my digital and physical world wanted me to know that I could get Viagra without having to speak to another living being.

Men’s health, a snapshot

In the UK, men aged 20 - 40 go to the doctor or pharmacy half as much as women. Men across all socioeconomic groups demonstrate unhealthier smoking practices, unhealthier dietary patterns, higher alcohol consumption levels and higher rates of injuries (WHO, 2020). 88% of them will die of noncommunicable diseases* and 1 in 5 men die before collecting their pension at 65. This is not to mention mental health, where males 45 - 49 continue to have the highest suicide rate (ONS, 2020). Yet only 36% of referrals to NHS Increasing Access to Psychological Therapies (IAPT) are men.

There are complex and societal reasons men’s health is so bad. Well known contributors tend to be; low health literacy, toxic ideas of masculinity and social stigma around mental, sexual and intimate health.

But surely, buying embarrassing medication online helps men get treatment?

Making pathways to healthcare accessible and shame-free is essential. However, a significant part of healthcare is not access to drugs. It's access to a healthcare professional who can assess the cause of symptoms a patient is suffering.

There can be many reasons for ED. Some are:

  • The narrowing of blood vessels in the penis

  • High blood pressure or high cholesterol

  • Hormones may be unbalanced

  • Side effects from other medications

  • Lifestyle influenced (heavy use of drugs or alcohol)

  • Depression and anxiety

  • Parkinson’s disease

  • Multiple sclerosis

While access to Viagra online may address a symptom (the inability to get or sustain an erect penis), it also increases the potential for men to go on living with illnesses undiagnosed and untreated. By removing a medical consultation, we remove the chance for other health conditions being identified.

Beyond erections

This quickly becomes a far broader problem when we consider men’s health in a wider sense. Men are not good at seeking medical help, and the results of this are bleak! Online medication is a way for men to further isolate themselves from a health system and set a presence for men to continue ignoring their health and secretly treat symptoms in private. It de-skills a group of people who are already under-prepared to have difficult conversations about wellbeing and themselves.

Some suppliers of online Viagra throw in the odd blog on men’s mental health, suicide rates or depression, written by someone in the Comms team. This tokenistic nod barely scratches the surface of what society needs if we want men to stop dying of suicide and preventable diseases.

We need to create spaces for men that allow the development of good health literacy and conversations about awkward and stigmatized topics from mental health to sexual issues. We need accessible pathways to healthcare professionals who are socially aware and trained. We need to have conversations in our communities and families about health and wellbeing. We can’t rely on pharmaceutical companies with trendy marketing teams to offer quick fixes at the cost of further isolation.

Further reading

Love Worth Making: How to Have Ridiculously Great Sex in a Long-Lasting Relationship - Stephen Snyder (Yes the title is very sensationalist, but it is accessible, knowledgeable and recommended by lots of Psychosexual therapists)

The New Male Sexuality - Bernie Zilbergeld (This book is 20 years old and very heteronormative, however, still a good book detailing men's experiences of sex, relationships and sexual problems and how to overcome them)

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