Created at great expense and delivered with feverish hype, it may be the most remarkable thing ever to happen to romance. No, not Titanic; we're talking about Viagra, the sky-blue, diamond-shaped pill for men that treats sexual impotence. Since its introduction by pharmaceutical giant Pfizer last month, the FDA-approved drug—which retails for around $10 a pill and is taken one hour before intercourse—has kicked off a national craze and been used almost nightly by David Letterman (in his monologue). "It has turned the world of sexual medicine on its head," says Dr. Harin Padma-Nathan, 41, director of the Male Clinic in Santa Monica, Calif., who notes that impotence affects some 52 percent of men between the ages of 40 and 70. "Interest is phenomenal."

But as glowing testimonials from giddy users pour in, questions about Viagra abound. Dr. Padma-Nathan, a clinical professor at the University of Southern California's Department of Urology, conducted many of Pfizer's clinical Viagra trials and now independently champions its use. He invited PEOPLE correspondent Ron Arias to his clinic to discuss what could become the most popular drug in history.

How was Viagra discovered?

It was more by chance than planning. A drug was being studied for its effect on angina, or chest pain. Some of the tested male patients reported that their erections were better. The angina study was shelved, but some 4,500 patients have since been examined in Viagra studies.

How effective is Viagra?

Even men who had their prostate removed, who normally would be 100 percent impotent, have responded dramatically. Diabetic men who haven't had erections for years now have normal erections. It also helps most men who can't perform for psychological reasons. About 70 percent of men taking it say it allowed them to have normal sexual relations.

Does Viagra increase sexual desire?

No. It's not an aphrodisiac. If you take this pill and there is no physical or other erotic stimulation, nothing will happen. Nor can it enhance the performance of men who suffer no sexual dysfunctions.

How safe is Viagra?

Very safe. It can lower blood pressure, but not significantly. It can also cause mild headaches, indigestion and muscle aches. And some patients say it temporarily gives their vision a blue tinge. But we have seen no severe heart or vascular side effects.

How has Viagra changed patients' lives?

It can diminish depression and improve self-esteem and confidence, sometimes dramatically. One patient of mine, a 60-year-old man, had his prostate removed. He and his wife became like brother and sister. After he took Viagra, they became sexually intimate and positive about life. They bought a boat and plan to sail the world.

Because it increases blood flow to the pelvis, can Viagra improve sexual response in women?

I'm opposed to its use for women until it has been studied in women in clinical trials. We may start such studies this summer.

Why is the drug so expensive?

I think $10 is reasonable, considering the cost of other impotence treatments, such as penile injections, at $25 each, and penile implants, which cost $5,000.

How will Viagra affect relations between men and women?

The birth control pill liberated women, but Viagra won't liberate men, except from the fear of failure. It will not alter sexual behavior nor cause men to be more aggressive.

Might we see even better impotence drugs in a few years?

Pfizer is working on a Viagra wafer that can be absorbed quickly in the mouth rather than slowly in the stomach, but that's years away. Competing companies are trying to develop other drugs too.

What's your reaction to all the Viagra jokes?

I don't think they're funny. Impotence is not a joke if you suffer from it. The hysteria will die down, but Viagra will live on to do its job.

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