VITUG: Will Viagra change the sexual landscape in the Philippines? HOLMES: One thing they always say here is that Viagra needs stimulation–not only physical but emotional. This, I think, is to gain acceptance from the Catholic Church, because it implies a relationship. Yet stories have come out in newspapers about Viagra sex tours from Japan. Men who could not go on sex tours before can do so now. It crystallizes the role of the Philippines as a supplier of women, and the rich men can have what they want.

You’re upset about Viagra? Viagra also perpetuates the wide discrepancy between rich and poor in this country. Who can afford $7 or $13 [per pill] for [an erection]? Believe me, you ask the women: it’s more important that their husbands are faithful to them and care for them. A woman can still have terrific orgasms with her husband or boyfriend or lover even if he doesn’t have an erection. In my clinical practice, there are women who like their husbands to remain either premature ejaculators or with erectile dysfunction because in a very sad, indirect way, it guarantees their husband’s fidelity. With the onset of Viagra–if it is really as good as they say–this might change the landscape for men who were unfaithful in their hearts.

Is there anything positive about Viagra? The good thing is, doctors make erectile dysfunction something that people can talk about. It’s become legitimate. Second, sometimes men have erectile difficulties because it’s a self-fulfilling prophecy. They had a lot to drink that night. Nothing’s physically wrong. It’s mental. So Viagra can help men bypass the emotional obsession.

Will Viagra catch on in the Philippines? I would like to think that people are much more sensitive and humane than we think. For sensitive men and women, unless Viagra is taken within the context of the relationship, it’s nothing. It’s just like other things needed to get an erection–which are all good and need not be comical as long as it’s done with respect and love. If not, Viagra will be just like any ploy. Let’s face it. There are men in this country who treat women like merchandise. So I’m sure Viagra will thrive–for the macho men who can afford it, as well as for men who care for their women. It can thrive for both.

Even with the Catholic Church opposing its use for unmarried men? First of all, there are men and women who do not blindly follow the Catholic Church in this country. The ones who do, believe me, if it’s convenient for them, they’ll forget what the Catholic Church says.

Have people written to you about Viagra? Constantly.

What are their most common questions? They ask about side effects. I tell them to be very careful. The fact that Viagra is a pill, something you take orally, is both its boon and its bane. You don’t need to inject it or insert it. It’s easy. But because you take it orally, it’s systemic. It goes through the entire blood system. That is why there [could be] problems.

Many Filipinos write to you about their sexual problems. If you were to summarize, what are their most pressing problems? It’s different for men and women. Women consistently seem more concerned about relationships. It’s always infidelity on the part of their husbands or boyfriends. Very seldom would Filipino women come to me with a physiological problem concerning themselves, like “I don’t get an orgasm.” Men, in my experience, usually come to me for a performance problem.

What about Bill Clinton and his ordeals? Some Americans place far too much importance on what one or several unfaithful incidents may do. The other thing is, there are gradations of morality. A man who has been unfaithful to his wife is not necessarily more immoral than a man who has been faithful to his wife. I would think that a man who promulgated laws against the working class is far more immoral than a man who may have done something with Monica Lewinsky, who, by the way, wanted it.

Back to Viagra. Will it be a fad here? Definitely. Because of our economic realities, not everyone can buy this product. You pop a pill, you get an erection. How satisfactory can that be? I hope, though, that it hits men at a deeper level, that they really realize that there are other things men can do to please their women and to be sexually alive. After all, the most important sex organ is the one between your ears, not the one between your legs.