Sildenafil is not allowed to be prescribed by every doctor in modern medicine, except for a few in specialised practice. People expect to receive some kind of magic pill/ treatment for their sexual problems and individual or couple counselling is not very much an accepted form of treatment. Though the governmental regulation stipulates that most medicines should be dispensed only against physicians’ prescriptions, this is not always followed. The regulatory authorities are lax and many drugs are sold over-the-counter. Self medication by the patients is also rampant. These and other factors make things difficult for the clinicians who want to practice ethically.