Dear Dr G,

I am turning 50 this year and have a confession to make. I am generally a healthy and fit man, who is a father of two.

From the start of my sexual experience, I must admit, I was not exactly a “stud” between the sheets.

My wife is my only sexual partner since university days. Despite having known her for many years, I still find myself having some degree of anxiety in the bedroom.

I am ashamed to inform you since the introduction of the blue pills in the market in the late 90s, I have started using the medication before sex.

For more than two decades, the pills have helped me tremendously. I achieve great erection with minimal arousal, and the erection definitely sustains throughout the intercourse.

Despite the hardness bringing tremendous happiness to our relationship in the last two decades, I must confess I have never told my wife I need to take the blue pills to “satisfy” her.

I would like to put Dr G on the spot about the safety of the blue diamond? Is long-term consumption of the pills harmful to my kidneys?

After 20 years of taking the pills, am I now addicted, and dependent on the tablets?

Lastly, since my wife is completely happy and oblivious to the “artificial hardness” created by the blue pills, should I tell her the truth?

Regards,

Happy Hardy

The year 1998 was the year that saw James Cameron’s film Titanic grossing US$1bil, and the blockbuster winning 11 Oscars on the 70th Academy Award ceremony. Interestingly, that same year also witnessed another blockbuster approved for medical use in the United States and Europe, for the treatment of erectile dysfunction, which turned out to be the “Pfizer Riser”. In fact, on March 27 this year, we see the blue pills celebrating 21 years of shaping “diamond moments” for couples in their bedrooms.

Pfizer actually discovered the welcoming desirable side effects of sildenafil by accident in 1989, while evaluating a treatment for cardiovascular intervention. The molecule intended for vascular dilation in the heart, acts by blocking the Phosphodiesterase 5 (PDE5), was noted to act on the regulatory control of blood flow in the penis instead. As a result, erectile function was restored for millions of “compromised” men in the bedrooms.

Since the introduction of the blue pills, emergence of other PDE5 such as tadalafil and vardenafil had also helped men with ED. Ten years after the approval, the annual sales of the blue pills and the other counterparts peaked at nearly US$2bil. In many countries, the tablets are now available over the counter and directly accessible to men online. In fact, with the expiry of sildenafil’s patent in 2018, many drug manufacturers started to market generic pills, resulting in dramatic price reduction and accessibility to more sufferers.

The success of the blue pills has generated interests in men to seek help in identifying risk factors such as diabetes, hypertension and dyslipidemia. On the other hand, there is also significant number of men with psychogenic ED also facing the obstacles of hardness.

The good news is that the blue pills are equally efficacious in organic and non-organic causes of ED. Despite the hard evidence, the myths of the pills and guilt of sex continue to trouble men struggling to accept the long-term treatment of ED. The common misconceptions of the blue pills are the worries of renal impairment, addiction and tolerance. In fact, sildenafil is a simple compound that has a very transient dilatory effect on the penile vessels, and metabolised by p450 enzymes in the liver. The possibility of addiction and renal impairment is simply non-existence.

American president Franklin Roosevelt once said: “Happiness lies in the joy of achievement and thrill of creative effort.” On the other hand, the success story of the blue pills has really brought happiness amongst ED sufferers. Hence, “hard penis lies in the joy of achievement, with minimal thrill of creative effort.”

On that note, wishing the blue pill a Happy 21st birthday and many “Hardpy” years ahead!

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