LONDON. – It’s a booming global industry, worth billions of dollars, but for its clients, millions of men around the world, it also comes with major risks.
It’s now almost 30 years since Viagra was officially approved by the United States Food and Drug Administration (FDA) on March 27, 1998.
It was the first oral treatment for male erectile dysfunction.
But, it also comes with major risks.
A record 530 men needed hospital treatment last year for painful, long-lasting erections — some in their 80s and 90s.
The problem has risen sharply, with more than ten cases a week and a 58 per cent surge on the number seeking help a decade ago.
National Health Service figures show incidents of priapism — where blood is trapped and causes a stiffie that can last for hours — rose by 11 per cent in a year.
Five men affected were in their 80s and 90s.
Of the total 530 sufferers, doctors had to treat 441 as emergencies.
Treatment starts with ice packs and drugs to shrink the blood vessels.
But many patients need a needle inserted to drain the trapped blood, and some even require surgery.
But consultant urological surgeon Gordon Muir warned those who use them with illicit drugs such as cocaine or alcohol run a greater risk of priapism.
He said: ““There are two different types of cases that may be feeding into the numbers.
“The first is elderly men who use injectables to help get and maintain an erection. When something goes wrong these men can end up with priapism, and it needs to be treated quickly.
“The other group are men who take a variety of illegal and legal drugs with a view to having an erection for as long as possible so they have sex for three or four hours non-stop.
“The mixture of drugs – typically Viagra, cocaine and amphetamines – can leave them with an erection for many hours, and this can be very dangerous for their long-term health.”
Erectile Dysfunction is a condition where men are unable to maintain a penile erection due to physical and psychological health issues, including diabetes, high cholesterol, smoking, stress, and mental health issues.
According to a WHO report, approximately 15 percent of men are affected by ED each year.
ED is closely linked to both physical and psychological health.
Major risk factors include diabetes mellitus, heart disease, hypertension, and increased HDL levels. In addition, medications for hypertension, diabetes, depression, and cardiovascular disease can contribute to erectile difficulties.
ED is a highly prevalent condition in geriatric men. Natural decline in testosterone levels, reduced blood flow, and other age-related physiological changes contribute to the higher incidence of ED among older men.
This disease has a significant impact on a patient’s quality of life and healthcare resources.
The geriatric population is more likely to have chronic conditions such as diabetes, cardiovascular disease, and hypertension, which are major risk factors for ED.
Thus, the increasing geriatric population is a major factor in the prevalence of ED in men in the coming years.
Technological advancement in drug delivery, the high burden of disease, and strong healthcare infrastructure are some of the factors that drive market growth.
Growing demand for robust pharmaceutical medicines to address the increase in ED prevalence is one of the key contributors to the growth in the adoption of ED medicines.
Erectile dysfunction drugs market
The global erectile dysfunction drugs market size was estimated at US$3.2 billion in 2025 and is projected to grow from US$3.4 billion in 2026 to US$6.6 billion by 2033, growing at a CAGR of 9.8 percent from 2026 to 2033.
North America dominated the Erectile Dysfunction Drugs market with the largest revenue share of 50.17% in 2025.
The market is significantly influenced by several factors, including a rising geriatric population, increasing R&D efforts, and a growing prevalence of Erectile Dysfunction (ED).
Key market trends & insights
• By product: Viagra (sildenafil citrate) segment led the market with the largest revenue share of 57.18 percent in 2025.
• By mode of administration: the Oral Mode of Administration segment led the market with the largest revenue share of 83.92% in 2025.
• Largest regional market: North America (50.17 percent revenue share, 2025)
• Fastest-growing regional market: Asia Pacific (highest CAGR, 2026-2033)
• By country: The U.S. held the largest market share in 2025
Market size & forecast
• Market size in 2025: US$3.2 Billion
• Estimated market size in 2026: US$3.4 Billion
• Projected market size by 2033: US$6.6 Billion
• CAGR (2026-2033): 9.8%
Key details on hospitalisations & Risks
• Emergency Care: Of the 530 recorded cases, 441 men required emergency hospital treatment.
• Age Range: The affected individuals included men of varying age groups, with five men in their 80s and 90s needing treatment.
• Contributing Factors: Health experts and urologists point to the misuse of erectile dysfunction drugs like Viagra (sildenafil), often compounded by mixing them with recreational substances such as cocaine or amphetamines to artificially prolong performance.
• What is Priapism: Priapism is a medical emergency where blood becomes trapped in the penis, causing a rigid and often intensely painful erection that lasts for more than four hours without subsiding.
• Medical Interventions: Depending on severity, hospital treatment ranges from oral or injected medication to reverse the erection, needle aspiration to drain trapped blood under local anesthesia, or surgical intervention in severe cases. Untreated priapism can result in permanent erectile dysfunction, severe tissue damage, or scarring.
NHS Guidelines for Safety
• When to Seek Help: Anyone experiencing an erection that lasts 3 to 4 hours (or over 1 hour for individuals with sickle cell disease) should seek immediate emergency medical attention or go to the nearest emergency department.
• What to Avoid: Medical guidance advises against applying ice packs or cold water directly to the penis, attempting further sexual activity or masturbation, smoking, or drinking alcohol.
• Unsupervised and Recreational Use: Public health agencies have reported a sharp rise in young adults using Viagra recreationally without a prescription or medical supervision. This practice frequently leads to emergency room presentations due to severe side effects such as extreme migraines, sudden visual disturbances, and acute chest pain.
• Dangerous Drug Interactions: A critical cause of severe, life-threatening hospital admissions is the co-ingestion of Viagra with nitrates (often prescribed for heart conditions or used recreationally as “poppers”). This combination causes an immediate, catastrophic drop in blood pressure (severe hypotension) that can trigger heart attacks or strokes. – The Sun/grandviewresearch.com/Agencies
