Erectile dysfunction

From The Art and Popular Culture Encyclopedia

"... parapathy, although we all know what is meant by parapathy. The introduction of "repression" and a consideration of the "unconscious" by Freud, however, brought us a bit nearer to this goal."--Impotence in the Male (1927) by Wilhelm Stekel

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Rhombicuboctahedron by Leonardo da Vinci

Erectile dysfunction (ED) or (male) impotence is a sexual dysfunction characterized by the inability to develop or maintain an erection of the penis.

The causes of erectile dysfunction may be physiological or psychological. Psychological impotence is where erection or penetration fails due to thoughts or feelings (psychological reasons) rather than physical impossibility.

Erectile dysfunction, tied closely as it is to cultural notions of potency, success and masculinity, can have devastating psychological consequences including feelings of shame, loss or inadequacy. There is a strong culture of silence and inability to discuss the matter.

Folk remedies have long been advocated, with some being advertised widely since the 1930s. The introduction of the first pharmacologically approved remedy for impotence, sildenafil (trade name Viagra), in the 1990s caused a wave of public attention, propelled in part by heavy advertising.

The Latin term impotentia coeundi describes simple inability to insert the penis into the vagina. It is now mostly replaced by more precise terms. The study of erectile dysfunction within medicine is covered by andrology, a sub-field within urology.

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History

Dr. John R. Brinkley initiated a boom in male impotence cures in the US in the 1920s and 1930s. His radio programs recommended expensive goat gland implants and "mercurochrome" injections as the path to restored male virility, including operations by surgeon Serge Voronoff.

Modern drug therapy for ED made a significant advance in 1983, when British physiologist Giles Brindley, Ph.D. dropped his trousers and demonstrated to a shocked Urodynamics Society audience his papaverine-induced erection. The drug Brindley injected into his penis was a non-specific vasodilator, an alpha-blocking agent, and the mechanism of action was clearly corporal smooth muscle relaxation. The effect that Brindley discovered established the fundamentals for the later development of specific, safe, orally effective drug therapies.

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