In early 2012, the world was abuzz over the new drug Viagra. People were rushing to their doctors’ offices and pharmacy counters to get their hands on the popular drug, which was at that time selling for $25 a pill—more than double what it usually goes for. But what was happening and why did it happen?

As it turns out, Viagra was introduced to the world at large as a “female sexual enhancement drug” to help people with erectile dysfunction. However, its history actually dates back more than a century, to the early 1900s, when scientists began researching it as a possible treatment for high blood pressure.

The first place you might have heard of Viagra was in connection with one of the most recognizable men in history: Bill Clinton. In 1975, Clinton was diagnosed with erectile dysfunction and began taking Viagra. In fact, he credited the medication with helping him to overcome his impotence issues and win the Presidency.

Viagra was originally developed and tested on animals—primates, to be specific—before being prescribed to humans. Despite its relatively recent introduction to the world at large, it has been around for more than a century.

The active ingredient in Viagra is sildenafil citrate, which is a powerful inhibitor of phosphodiesterase type 5 (PDE5), an enzyme that degrades cyclic guanosine monophosphate (cGMP) in the body. When this enzyme is inhibited, more cGMP is available to stimulate blood vessel dilation and increase blood flow to the penis.

Sildenafil citrate is a structural analogue of viobasic, which is the chemical compound that makes up vitamin C. What this means is that it has similar properties but is more stable and potent than what is commonly found in nature. The chemical structure of sildenafil citrate allows it to interact more effectively with proteins and other molecules in the body and allows it to be more effective at overcoming erectile dysfunction than previous compounds.

A Drug to Treat Impotence More Effectively

The FDA initially approved Viagra for the treatment of erectile dysfunction, but it was quickly discovered that the medication actually worked even better for some patients than for others. The typical patient reaction to Viagra was one of incredible joy and relief, with many people reporting improvements in their sexual performance as soon as they started taking the drug. However, for others, the effects were much more subtle and took longer to appear.

It wasn’t until the 1980s that researchers started discovering the true potential of Viagra and other PDE5 inhibitors. During this decade, research demonstrated that these drugs could treat a variety of disorders and conditions, from hypertension to pulmonary hypertension and eye disease. As a result, the scope of potential patients who might benefit from PDE5 inhibition increased dramatically, and it became a common prescription drug not just for men with erectile dysfunction but for men and women with a variety of health issues.

One problem, as it turned out, was that Viagra and other PDE5 inhibitors weren’t designed to treat all patients. In fact, they were developed to specifically target conditions that affect nearly half of all men at some point in their lives. These include hypertension, atherosclerosis (a type of heart disease), and diabetes. Because of this, a significant number of patients didn’t respond well to the drug or had adverse effects when taking it. In a few rare cases, people even died from an overuse of Viagra. (Taken from Harvard Health Publishing)

The Revival of Viagra

Despite these risks, the FDA still gave Viagra the green light for use in treating erectile dysfunction. This was partly due to the fact that even without proper oversight, drugs like Viagra don’t necessarily need to be safe to be effective. The effectiveness of a drug is sometimes more important than its safety, particularly when the potential benefits are so great.

That all changed, however, when the economic crisis of 2008 hit. The world was suddenly faced with a huge wave of demand for treatments, including prescription pills, and the price dropped to an all-time low. What this meant for Viagra was a significant increase in the number of people who could benefit from it. Since then, the popularity of the drug has continued to rise as more and more people seek out treatments to help with their sexual health issues. In early 2017, the drug reached an all-time high in sales when it exceeded the $25 billion mark for the first time ever.

While the drug may have started out as a treatment for erectile dysfunction, it has evolved into so much more. Today, Viagra is used to treat a variety of disorders and conditions, spanning from pulmonary hypertension and heart disease to dementia and prostate cancer. As a result of this increased understanding of its uses and benefits, more and more people are turning to the drug as a viable option for addressing their sexual health issues.

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