This story first appeared on our sister site, Shape.com
When I worked at GNC in my early 20s, I had a regular Friday night crowd of customers: guys looking for what we called “boner pills.” These weren’t middle-aged men with erectile issues—these were usually young, in-their-sexual prime guys, eager to enhance the perfectly normal erections they already had.
Now, men like this may have to look no further than the pharmacy aisle at any big-box store for a boost: The drug manufacturer Eli Lilly is vying to make Cialis, a drug presently prescribed for erectile dysfunction, available over the counter. Any man—healthy or otherwise—could soon get his hands on the stuff.
This is a good thing for the guys who really need it, whether for E.D., prostate problems, or urinary trouble, says Culley Carson III, M.D., a distinguished professor of urology at the University of North Carolina at Chapel Hill. “If Cialis goes over the counter, more men will have access to it, because, hopefully, the cost will be more affordable,” he says. “Right now, it’s very expensive.”
But there’s also an unavoidable side effect: an uptick in recreational use of the drug. A recent Archives of Sexual Behavior study found that 74% of young guys who’d ever taken an erectile dysfunction med had done so recreationally. That number is almost guaranteed to rise if Cialis becomes more readily available. “Men, especially young men, think, ‘Well, my sexual function is good, but if I had a little extra pill, it would be great.’”
The problem with this mindset? Taking Cialis just for fun may cause guys to equate awesome sex with a pill. Or as Carson says, men can become psychologically dependent on the drug—leading them to think they can’t have sex without it.
Using Cialis for a non-medical reason may also take some of the fun out of sex. If you take the pill “on demand,”—that is, only when you want to hook up—you may have to wait up to an hour to hit the sheets (so the drug can take effect), sucking the spontaneity out of your sex life, says Carson. And it may even have long-term effects on your ability to perform: A new Turkish study in young, healthy rats also suggests that taking E.D. drugs unnecessarily can cause irreversible damage in the penis by creating scar tissue (although this still needs to be examined in humans).
As for the men who really do need Cialis, over-the-counter availability may mean a missed opportunity for face time with an M.D.—and therefore, a chance to diagnose an underlying health issue causing their erectile trouble. If a guy can't get hard, “he may have low testosterone, vascular disease, some physiological issue,” says Carson. “E.D. is a really good reason to get men in the doctor’s door to look at things like cardiac disease, cholesterol, depression.” (That said, he does note that men with advanced vascular disease won’t likely respond to the over-the-counter dose of Cialis, forcing them to see their physician for something stronger.)
The takeaway: If you’re struggling to perform, your first stop should be an M.D., not a drugstore aisle. And if Cialis is, in fact, the right med for you, then easy access will only be good news for your sex life. Even though recreational use could be tempting, finding new ways to better your sex life will bring you and your partner closer in the long run. And hey, if it ain’t broke, don’t fix it.