Viagra abuse can be a real downer
Your article Viagravation (Magazine, last week) highlights the abuse of a drug which was never intended by the Federal Drug Administration for sexual enhancement but for bona fide erectile dysfunction (ED). As an endocrinologist I see more than 300 men with ED a year and some can become psychologically dependent on these drugs. If given for psychogenic ED, treatment must include sex therapy with a counsellor.
If 30%-40% of men have ED as they age, the figure of 27m men worldwide using Viagra is conservative, as estimates put ED worldwide at 150m. In one example quoted, the man used Viagra obtained from a friend who had a valid reason for using it. However if doctors prescribe it for enhancement or men use it to “shag all night”, shame on them. There certainly are psychological and relationship downsides to this sort of abuse.
Dr Andre Guay Peabody, Massachusetts, USA
STOP TAKING THE PILLS: What an excellent article about Viagra, which reflected both male and female points of view and the growing drug dependency culture. There is neverending pressure to live up to someone else’s dream and that, combined with the propensity for instant pleasure, will push our society further towards the drug culture. Slim pills, happy pills, sex pills. It’s time to think seriously about where this is going.
Simon Husain, Southampton
MORE HELP FOR WOMEN: Women can also get physical arousal disorder, the difficulty that causes erection problems in men. However, until the research is carried out in women, this drug is not available to them except from unlicensed practitioners.
Secondly the more common disorder in women, “lack of desire”, can be due to a hormonal problem, as it often is in men. There is now a physical treatment for surgically menopausal women, which is of great value to this group.
Sexual problems are often secret, embarrassing and relationship damaging in many couples.
Just because there is some misuse of this useful medication (which also occurs with other drugs) does not in any way decrease the value of it for those who suffer and are currently excluded.
Ruth Hallam-Jones Psychotherapist, Sheffield
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COUPLES MUST DECIDE: If you decide to take Viagra you have two choices: either, you don’t tell your partner and allow her to enjoy the experience (but she may well find out in due course), or you tell her but then run the risk she may feel it is “the Viagra doing the loving” and not you.
You could lose out either way. So it’s best to discuss it first and not make the decision alone.
Michael Parsons, London NW6
LACK OF DESIRE: As a woman, I’m just happy to know that my lack of interest in sex is not abnormal. The pressure to “enjoy” sex is unbelievable; we’re hit from all angles about sex. So now I know that half of women couldn’t care less about sex either, I can relax. Sadly, it’s a man’s world. Thanks for a humorous, informative piece on this annoying “wonder drug” - for men.
Name withheld, Winston-Salem, North Carolina, USA
FLAWED INTELLIGENCE: My view of the British as subtly understated was jarred when John Carey labelled me “violently prejudiced” in a review of my book, IQ: The Brilliant Idea that Failed (Books, Culture, July 
. The phrase brings to mind cross-burning and Ku Klux Klan members, c 1951. I promise, I’ve never lynched a psychologist.
Worse were Carey’s misstatements of my beliefs. “[Murdoch] hates intelligence tests and abominates psychologists for inventing them.” On the contrary, I think IQ tests were a brilliant invention that can still be useful today. They beat nepotism, can be useful screening devices for employers and are a vast improvement over previous - if pleasingly wacky - Victorian methods. The problem is, IQ tests don’t measure intelligence, as psychology has claimed for the past century. This puffery has enabled terrible eugenic practices, such as coerced sexual sterilisation and murder, and damaging education policy, by barring perfectly capable students from learning at the highest levels.
A little humility on psychology’s part about what its exams can and can’t do is in order, as well as recognition that overselling IQ tests can rationalise disastrous policy.