MR A. YASSER always keeps a Viagra pill in his wallet.

'You never know when you're going to get lucky,' he says.

Mind you, the training executive is no ageing playboy whose ability to perform has not quite kept pace with his desire.

So why use Viagra?

'To impress the girls. You can really go on for a long time,' says Mr Yasser, who first started using the pill five years ago after being persuaded by friends who had tried it.

It worked. He adds with a grin: 'I don't use it all the time, of course. Only for special occasions. Maybe about once or twice a month.'

There are risks when healthy young men take erectile dysfunction (ED) drugs, but Mr Yasser is not alone.

The introduction of Viagra, Cialis and Levitra has spawned a generation of young, so-called recreational users.

Advertising executive David Cheong, 35, says he uses Viagra about once a fortnight.

'It adds to the sexual pleasure and makes me perform better,' says the bachelor, who started using it two years ago. He knows many other young men who occasionally use Viagra as a performance enhancer too.

Sex therapist and psychiatrist Calvin Fones says Viagra has become more than just a medical solution for men suffering from erectile dysfunction.

'It can actually enhance erectile functions for more men than those defined under the rubric of ED sufferers,' he says.

Urologist Peter Lim agrees: 'These are young men with the need for adventure; they want sexual stamina to perform better and longer.'

Finance manager Johnson Lau, 36, uses it when he's had too much to drink.

'When you've had one drink too many or when you feel tired, you can't perform. It's very embarrassing when that happens. Popping half a pill takes care of the problem,' says the bachelor, who admits to paying for sex on his business trips to cities like Bangkok. He started using the pills about two years ago.

In Singapore, Viagra and other ED pills are available only on prescription from general practitioners and specialists.

Polyclinics under the SingHealth group do not carry ED drugs, while those under the National Healthcare Group carry only Viagra, but not Cialis and Levitra.

Doctors tell The Straits Times that most of their patients with ED problems are aged 40 and above. One says he rarely gets patients in their 20s or 30s.

All say they screen their patients, asking about their medical history and marital status.

Do they say no to single young men?

Dr Gan Tek Kah from the Singapore Men's Health Clinic says: 'It's very hard to moralise. If it's a young man who is single, I'll try and determine if the problem is organic and if he requires pyschosexual counselling.'

But the men interviewed by The Straits Times say the drugs are easily available over the Internet, or from friends and dealers.

A few, like Mr Lau, buy them in Bangkok, where many pharmacies sell them without a prescription.

All say they stick to the genuine products or the generic equivalents legally manufactured in countries like Thailand.

In the United States, 'Viagra-holism' support groups have already sprung up for abusers of the drug.

The warning signs of abuse include escalating use of the drug, to suffering from exhaustion and sore genitals from sexual overactivity.

Doctors interviewed say that prescription drugs should never be used without proper medical advice.

Dr Gan says: 'If you overdose, you may end up with priapism, which is prolonged and painful erections. It can also cause hypotension, or very low blood pressure, which can be very dangerous.'

Priapism, which can last up to several days, occurs when the male sexual organ is unable to drain blood after an erection. Treatment may involve needling it to drain the blood, or taking drugs to reduce the blood flow.

Doctors also warn of the risk of a stroke or heart attack if Viagra is used with other drugs such as nitrates, which are used to treat heart problems, or amyl nitrates, a recreational drug commonly known as 'poppers'.

There are also overseas reports which suggest that prolonged recreational use of ED drugs may affect a man's fertility.

Dr Gan says that Viagra and other ED drugs are not addictive in the physiological or chemical sense, but he cautions about psychological dependence.

'You may not feel secure without it any more. And that can become a real issue.'

BEWARE THE DANGER

'If you overdose, you may end up with priapism, which is prolonged and painful erections. It can also cause hypotension, or very low blood pressure, which can be very dangerous.'
DR GAN TEK KAH from the Singapore Men's Health Clinic, about overusing performance-enhancing sex drugs

This article was first published in The Straits Times on May 3, 2008.