There are now three big competitors for the wang dang doodle dollar:

Viagra vs. Levitra vs. Cialis. It is a Madison Avenue dream. And nightmare.

It is a dream because the three rivals are flush with cash and eager to compete aggressively in a market that is already big and is forecast to grow fast. Ad agencies have been panting like lovesick suitors over the idea of clients willing to spend more than $300 million this year when many other clients are pinching pennies.

The problem is that the products in question treat erectile dysfunction, a condition, like adult incontinence or hemorrhoids, that is hard to discuss without being too vague or too vulgar. So the advertisers have to figure out how to build customer demand and loyalty without offending people and without providing additional fodder for endless gags by late-night talk-show hosts.

Even worse, the products are prescription drugs, so they come freighted with federal restrictions and requirements about advertising content. For instance, if an ad mentions the product name and what it treats, side effects must also be disclosed - in this case eyebrow-lifters like "erections that last for more than four hours."

"My 6-year-old daughter turned to me and said, 'What's a four-hour erection?' " said Kelly Simmons, executive vice president and chief creative officer at Tierney Communications in Philadelphia, who studies sex issues in marketing. "How do you explain it?"

The whole endeavor is mined with awkward moments, beginning with those faced by the 30 million American men who the drug companies estimate have trouble getting and keeping erections. Only 13 percent of those men are being treated, drug makers reckon, so analysts at Lehman Brothers figure that the market for Viagra, Levitra and Cialis should more than triple by 2010, to $6 billion a year.

That is, if the ad agencies can help destigmatize seeking treatment for erectile dysfunction, said Nancy Bryan, vice president for men's health marketing at Bayer Pharmaceuticals in West Haven, Conn. It sells Levitra in a joint venture with GlaxoSmithKline.

In recent weeks, Levitra has slipped to third place in sales, having been overtaken by Cialis, which is marketed by Lilly Icos, a joint venture of Eli Lilly & Company and the Icos Corporation. But together they have already grabbed 15 percent of the market from the leader, Viagra, which created the category when Pfizer introduced it in 1998. Levitra was introduced last August; Cialis, in November.

As the rivalry heats up, the ads are flooding television, radio, magazines, newspapers, the Internet and even mailboxes. The drug makers are sponsoring sports like golf and auto racing; Pfizer has initiated a frequent-user "value card," offering a free seventh prescription for each six a customer fills. Levitra and Cialis have even tried the Super Bowl of advertising: the Super Bowl itself. Their makers paid more than $4 million each for 60-second spots during the game in February.

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