Sildenafil Use, Body Image Concerns, and Performance Anxiety among Gym-Going Men: A Psychiatric Perspective

Abstract Background: Recreational use of sildenafil (Viagra) has been rising among young men, particularly fitness enthusiasts. While it is prescribed for erectile dysfunction, its nonmedical use is associated with psychological factors such as body image concerns and sexual performance anxiety. Objective: This study aimed to explore the association between sildenafil use, body image concerns, and sexual performance anxiety in gym-going men. Methods: A cross-sectional and comparative study was conducted among 120 male fitness enthusiasts aged 20–40 years. Participants were divided into two groups: sildenafil users ( n = 60) and nonusers ( n = 60). The Body Image Concern Inventory (BICI) and the Sexual Performance Anxiety Scale (SPAS) were administered. Data were analyzed using independent t -tests, Chi-square tests, and regression analysis. Results: Sildenafil users reported significantly higher body image concern scores ( M = 42.5 ± 8.1) compared to nonusers ( M = 36.2 ± 7.6; P < 0.01). Similarly, sexual performance anxiety was greater among sildenafil users ( M = 24.8 ± 5.9) compared to nonusers ( M = 18.7 ± 6.2; P < 0.001). Regression analysis indicated that body image concerns significantly predicted sildenafil use (b = 0.41, P < 0.01), and sexual performance anxiety mediated this relationship. Conclusion: Recreational sildenafil use among gym-going men is associated with heightened body image dissatisfaction and sexual performance anxiety. Preventive interventions should address the psychological underpinnings of misuse, promoting healthier coping mechanisms for body image and performance pressures.