On March 27,1998, Viagra became the first oral medication to be approved by the United States Food and Drug Administration to treat erectile dysfunction. A flood of books, articles and online stores, which shows no sign of abating, has subsequently been devoted to analyzing the pill's impact. Among the more insightful is Meika Loe's The Rise of Viagra: How the Little Blue Pill Changed Sex in America (2004). Her title encapsulates the popular argument. Supporters of the medicalization of sexuality certainly claim as much. Many have suggested that just as the contraceptive pill in the 1960s made possible a new age of relaxed sexual mores, Viagra is having an equally revolutionary impact in the first decade of the twenty-first century on buyers. Dr. Irwin Goldstein, a leading researcher in male sexuality, asserts that Viagra has begun a "second sexual revolution." The diamond shaped pill, agrees sex therapist Bernie Zilbergeld, has changed the way we think about sex, yet contradictorily he concedes that it has not changed men. That the fans of cheap Viagra should tout its powers is to be expected. More surprising is the enormous impact attributed to the pill by its critics. Though feminist sociologist Meika Loe provides a trenchant analysis of Pfizer's marketing ploys, she also argues that the Viagra phenomenon "has changed our understanding of sex in America and, increasingly, is changing it around the world as well... Normal sex now means sex on demand, sex for everyone, and sex for life.

The historian has to be skeptical of such extravagant claims because buying VIAGRA may not be as cheap as it sounds. As we have seen, each age has reconfigured the notion of male sexual failure. Foucault reminds us that sexuality is always controlled, what changes is the nature of the control. An analysis of Viagra's selling success is the central subject of this concluding chapter of our study, but the arrival of the little blue pill certainly did not end male sexual anxieties. Indeed there is a good deal of evidence that it actually heightened them. Specific social and cultural conditions were responsible for the appearance and profitability of a new generation of sexual pharmaceuticals in the 1990s. These buying conditions have to be understood. Some critics of cheap Viagra have been so preoccupied by the ways in which it has purportedly overturned our views of aging or gender that they have slighted the more important point that Viagra was itself a product of the interactions of science, medicine, the media, and popular culture. We know a lot about the "supply" and little of the "demand" side of the story. The appearance of Viagra and the other erectile drugs of the late 1990s was clearly the culmination of developments that began decades earlier. To appreciate the generic Viagra phenomenon we need to trace the emergence of the new pharmacological agents that arose in the 1990s but then situate them in the context of changing cultural attitudes toward masculinity, medicine, and the enhancement technologies that lead to cheaper prices.