In 1998, Viagra was first introduced to the world, and it is fair to say that the world has not been the same since. The impact of this medication has been enormous, not just in the narrow area of treating erectile dysfunction (ED) for which it was approved, but also in the way we think of sex and sexuality, and even in the realm of relationships between men and women.

Millions of men in the United States have tried Pfizers wonder drug, sildenafil, better known as Viagra, and there are thus millions of women who have also seen its effects on their husbands, boyfriends, and lovers. Many other millions of men and women wonder about whether Viagra can offer a solution for their own sexual and emotional problems or for the problems of their partners. We human beings are sexual animals, after all. And unfortunately, our sex lives are not always the way we want them to be. So its no surprise that when sex goes sour, relationships suffer in other ways as well.

Everyone wants to know about Viagra, and many are interested in trying it, whether or not they think they have an erection problem. There are always a good number of Viagra questions, such as, What happens when a young, healthy man with normal sexual function takes Viagra? Or Can a woman tell during sex that her partner has taken Viagra? Or Is it true that Viagra increases a mans sex drive?

Viagra quickly tapped into a set of wishful fantasies that mirrored our cultures hunger for certainty and the quick fix. Supported by stories that described elderly men restored to such sexual vitality by Viagra that they abandoned their wives in favor of younger women, a conventional wisdom arose that Viagra was a fountain of youth, a sure cure, the real deal. Baby boomers could now look forward to fabulous sex well into their nineties. Men shared Viagra stories with each other at cocktail parties or around the office water cooler.

All we can say is Wow! says one man, and other men listening in wonder how their lives might be different if they also took the magic blue pill.

Women too have been targeted to confirm Viagras ability to create satisfaction and serenity within a relationship where frustration and friction had once been the rule. One of the most successful early Pfizer ads showed a series of couples happily dancing together after Viagra apparently cured the loss of rhythm in their relationship.

Viagra jokes became a staple of comedy acts on late-night television (Have you heard the one about the man who swallowed Viagra, but it stuck in his throat? He wound up with a very stiff neck!), thus ensuring its place in our cultural lexicon. Viagra tapped into both our fantasies and our embarrassment about sexuality in a way that no other drug had ever done. When, for example, was the last time you heard a joke about a new cholesterol-lowering medication?

Skillful marketing contributed to our perception of Viagra as the pill that put the man in manly. Star professional athletes-vigorous men such as baseballs Most Valuable Player Rafael Palmeiro of the Texas Rangers and NASCAR driver Mark Martin-endorse the medication in widely seen advertisements. Other kinds of athletes use Viagra as well. Hugh Hefner, the aging head of the Playboy empire who is known for his bevy of beautiful blondes, gives Viagra credit for maintaining his pleasure quotient. Rumor has it that he provides bowls of Viagra tablets at his famous parties.

Yes, the drug is enormously powerful, and it can be a lifesaver for many men, but it has also turned a bright spotlight on previously hidden areas of sexuality and relationships. In particular, it forces couples to decide what is real in their relationships and what is not. I have come to see Viagra as providing a window into the psyche of men, and perhaps indirectly into the psyche of women as well, since women are not immune from unduly high expectations regarding the benefits of Viagra and its potential to provide sexual healing.