2025, Vol. 5, Issue 1, Part C

Sildenafil citrate (Viagra), a phosphodiesterase-5 (PDE5) inhibitor, is a cornerstone treatment for erectile dysfunction (ED), affecting over 322 million men globally. While effective for organic ED, its recreational and long-term use has raised concerns about psychological dependency and performance anxiety, particularly in men with psychogenic ED. This study employs a secondary data analysis methodology, synthesizing data from clinical trials, cross-sectional surveys, and qualitative studies (1998-2025) to evaluate the prevalence, risk factors, and psychological outcomes of long-term sildenafil use. Findings indicate that 20-30% of recreational users develop psychological dependency, relying on sildenafil for sexual confidence rather than physiological necessity. Performance anxiety is exacerbated in younger men (18-39 years), driven by societal pressures and unrealistic sexual expectations from media and pornography.

Graphical representations, including bar graphs and pie charts, illustrate prevalence rates and risk factors, while a diagram elucidates sildenafil’s mechanism of action via the nitric oxide (NO)-cyclic guanosine monophosphate (cGMP) pathway. Tabulations summarize dependency prevalence across studies. The study highlights the need for integrated medical and psychological interventions, such as brief psychodynamic psychotherapy (BPP), to address dependency and anxiety. Limitations include reliance on heterogeneous secondary data and limited longitudinal studies. Future research should explore long-term psychological outcomes and psychotherapy’s efficacy in reducing dependency. This paper underscores the importance of balanced prescribing practices and public health education to mitigate sildenafil misuse.