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England's Round of 16 clash with Mexico at the 2026 FIFA World Cup has prompted discussion not only about tactics and team selection, but how players might cope with the unique demands of Mexico City's high altitude.
Among the more unusual talking points is Viagra. The medication, designed to combat male impotence, has previously been linked to elite sport because of its potential effects on blood flow and oxygen delivery at altitude.
While the idea may sound surprising, it has been studied by sports scientists and discussed by national teams in the past.
Could England actually use Viagra against Mexico? How is it thought to help athletes competing at altitude? And is it permitted under anti-doping rules? The Sporting News takes a closer look.
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Will England players take Viagra vs. Mexico?
England head coach Thomas Tuchel dismissed suggestions that his players could take Viagra before facing Mexico at the Azteca Stadium.
Asked about the reports ahead of the Round of 16 tie, Tuchel replied: "The information and the support didn't reach me. That is not true."
Jordan Henderson also made light of the reports during his pre-match press conference, and there has been no indication that Viagra forms part of England's preparation for the game.
MORE: How high up the Azteca is — and why it matters
How does Viagra help athletes at high altitude?
Viagra, whose active ingredient is sildenafil, was originally developed to treat high blood pressure in the lungs before becoming widely known as a treatment for erectile dysfunction.
At high altitude, the drug relaxes blood vessels and can improve blood flow through the lungs. Researchers have investigated whether that could help athletes absorb oxygen more efficiently in environments where the air contains less of the gas than at sea level.
The evidence, however, is mixed. Some studies have suggested sildenafil may benefit certain individuals at high altitude, while others have found little or no improvement in endurance or overall athletic performance. As a result, it is not regarded as a proven performance-enhancer for healthy athletes.
Even so, the medication has periodically become a talking point before sporting events held at high-altitude venues, particularly in soccer, where matches in cities such as Mexico City, La Paz and Quito have prompted discussion about ways to reduce the physiological effects of elevation.
MORE: Mexico's incredible record at their fortress Azteca venue
Is Viagra allowed under WADA rules?
Yes. Viagra is not included on the World Anti-Doping Agency (WADA) Prohibited List, meaning athletes are permitted to use it in competition.
WADA has previously reviewed sildenafil because of questions over whether it could provide a performance advantage at high altitude. However, the available scientific evidence has not been considered strong enough for the drug to be prohibited.
Although permitted under anti-doping regulations, there is no evidence that the medication is used routinely in professional soccer.
Have soccer teams used Viagra for altitude before?
There are no confirmed cases of a national soccer team publicly acknowledging that it has used Viagra to prepare for a high-altitude match.
However, the medication has been discussed in the sport for many years because of research into its potential effects at altitude. Ahead of the 2010 FIFA World Cup in South Africa, reports suggested England had considered sildenafil as part of their preparations, although the Football Association denied those claims.
The topic continues to resurface whenever major matches are played in high-altitude cities, but there is no public evidence that Viagra has become a routine or widely adopted part of elite soccer preparation.
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