Younger men drawn to sex-enhancing drugs

Hawkers in popular bars sell anti-impotence drugs, whispering that they have "blues" available for 5 bucks a pop, less than the pharmacy price.

Friends pass their pills along to others, often drug users who use them to counter the effects of drugs such as methamphetamines or Ecstasy, which can leave them unable to get an erection.

Web sites sell the drugs - or counterfeits - to nearly anyone who requests them.

And many healthy young men with normal sexual functioning are asking their general physicians for Viagra, Levitra or Cialis to help them conquer anxiety or offset the effects of smoking and partying.

At the same time, the makers of the erectile-dysfunction drugs are running racier-than-ever campaigns targeting younger men and straying from the depictions of the drugs as medicine. "Get back to mischief," woos the latest Viagra slogan, with devil's horns seeming to emerge from behind a middle-age man's ears.

These are all part of the new and rapidly changing face of erectile-dysfunction drugs. Since the first impotence drug, Viagra, debuted in 1998 to address a physical problem for some men, it and newer sister drugs Levitra and Cialis have been used increasingly by healthy younger men for perceived performance-enhancement purposes or as psychological life-preservers to alleviate performance anxiety.

"When Viagra first came out, the whole emphasis was on older men, with Bob Dole doing the marketing and the age group being around 70," says Dr. Abraham Morgentaler, a urologist and associate professor at Harvard University. "Now we're seeing the bar lowered, not just for men wanting it but for physicians giving it out to those who are younger and less severely affected."

One concern is that the drugs may be psychologically addictive, says Morgentaler, author of "The Viagra Myth," a book about the common misperceptions surrounding the drug. Healthy men may begin to feel inadequate without the pill, he says.

"For younger men to feel the need to take a pill to be deemed adequate is a lost opportunity to find out that who they are is enough and that they can be loved for who they are."

Many seem to have gotten the wrong idea about what the drugs can do. One cardiologist tells of a healthy man in his 20s with no apparent functional problems who asked for a prescription to help him celebrate his anniversary in Las Vegas. And a sex therapist says that men as young as 16 have sought her help, thinking they need Viagra to have sex or that it might compensate for having a smaller penis.

In fact, the pills enable some men who have hypertension, diabetes or prostate problems to get an erection by increasing blood flow to the penis, provided the brain kicks in with some sexual stimulation. They don't make people better lovers, instantly mend broken relationships or enlarge penises.