If you check your junk mail or spam folder at all, you’ll be familiar with emails selling “little blue diamond” tablets for low prices. There is a very real demand for Viagra and other medications used for the treatment of erectile dysfunction.

Some 1.8 billion of Pfizer’s blue diamond-shaped tablets have been distributed worldwide since 1998. Unsurprisingly, considering it helps men with erectile dysfunction to have an erection, it is one of the world’s most counterfeited medicines.

So, if you or your partner has erectile dysfunction, what do you do to get medication – tablets such as Viagra, Cialis, Levetria or injection techniques? The first stop should be your general practitioner (GP).

Dr Mark Walsh, a Wexford-based GP and chairman of the Irish College of General Practitioners, says that people should have a full medical assessment because these medications are not suitable for everybody and don’t mix with some other medications and medical problems. “It’s not like taking a paracetamol,” he warns.

In the past there was embarrassment amongst men requesting medication for erectile dysfunction, but this is no longer the case, says Dr Walsh.

“GPs have also learnt to initiate that question themselves. You can almost anticipate it sometimes,” he says, referring to men who are taking certain medication or have certain illnesses that create a problem with erectile dysfunction.

Frequently, he says, men will go to their GP with another problem before opening up about their erectile dysfunction. “I think it’s important that people feel comfortable when they are talking about it,” notes Dr Walsh.

A visit to the doctor’s surgery rather than buying online is vital as people need to be aware of side effects or problems before administering the medication.

He dispels, in part, the urban legend that men who take Viagra could be left with an erection for days. “Most people who use Viagra or its equivalent don’t have any problems with it. If you read down the list of side effects you will see priopism, where you get a permanent erection, if you like. But that would be way down the list. It’s such a rare side effect.”

Does having to take the tablet interfere with the spontaneity of using that side of one’s relationship? “For some of them, it might be that there is a time limit,” says Dr Walsh. “For others there’s not. There would be a 36-hour interval where it would still be acting in that period of time. It’s not a case of popping your pills, looking at your clock and saying ‘let’s go for some action’.”

For some people, going to the pharmacy is just as daunting as visiting their GP. Dr Walsh says that, on occasion, a patient will ask for Viagra to be put on a separate prescription and will go to a pharmacy in the next town.