Erectile dysfunction: Difference between revisions
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| prevention = Adequate [[exercise]]<ref name="EuroGuideline" /> | | prevention = Adequate [[exercise]]<ref name="EuroGuideline" /> | ||
| treatment = [[Penis pump]],<ref name="lecturioerect" /> [[counseling]] (psychological treatment)<ref name=":0" /> | | treatment = [[Penis pump]],<ref name="lecturioerect" /> [[counseling]] (psychological treatment)<ref name=":0" /> | ||
| medication = [[Sildenafil]], [[Tadalafil]], [[Vardenafil]]<ref name="Vardi">{{cite journal | vauthors = Vardi M, Nini A | title = Phosphodiesterase inhibitors for erectile dysfunction in patients with diabetes mellitus | journal = The Cochrane Database of Systematic Reviews | issue = 1 | | | medication = [[Sildenafil]], [[Tadalafil]], [[Vardenafil]]<ref name="Vardi">{{cite journal | vauthors = Vardi M, Nini A | title = Phosphodiesterase inhibitors for erectile dysfunction in patients with diabetes mellitus | journal = The Cochrane Database of Systematic Reviews | issue = 1 | article-number = CD002187 | date = January 2007 | volume = 2009 | pmid = 17253475 | pmc = 6718223 | doi = 10.1002/14651858.CD002187.pub3 }}</ref> | ||
| prognosis = | | prognosis = | ||
| frequency = | | frequency = | ||
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}} | }} | ||
'''Erectile dysfunction''' ('''ED'''), also referred to as '''impotence''', is a form of [[sexual dysfunction]] in males characterized by the persistent or recurring inability to achieve or maintain a [[Human penis|penile]] [[erection]] with sufficient rigidity and duration for satisfactory [[sexual activity]]. It is the most common sexual problem in males and can cause [[psychological distress]] due to its impact on [[self-image]] and sexual relationships. | '''Erectile dysfunction''' ('''ED'''), also referred to as '''impotence''', is a form of [[sexual dysfunction]] in males characterized by the persistent or recurring inability to achieve or maintain a [[Human penis|penile]] [[erection]] with sufficient rigidity and duration for satisfactory [[sexual activity]]. It is the most common sexual problem in males and can cause [[psychological distress]] due to its impact on [[self-image]] and sexual relationships. The term ''erectile dysfunction'' does not encompass other erection-related disorders, such as [[priapism]]. | ||
The majority of ED cases are attributed to physical risk factors and predictive factors. These factors can be categorized as vascular, neurological, local penile, hormonal, and drug-induced. Notable predictors of ED include aging, [[cardiovascular disease]], [[diabetes mellitus]], [[Hypertension|high blood pressure]], obesity, [[Dyslipidemia|abnormal lipid levels in the blood]], [[hypogonadism]], smoking, [[Depression (mood)|depression]], and [[Adverse drug reactions|medication use]]. Approximately 10% of cases are linked to psychosocial factors, encompassing conditions such as depression, stress, and problems within relationships.<ref name=":1">{{Cite book |last1=Rosen |first1=RC |title=UpToDate |last2=Khera |first2=M |publisher=[[UpToDate]] |others=Post, TW |year=2023 |editor-last=O'Leary |editor-first=MP |location=Waltham, MA |chapter=Epidemiology and etiologies of male sexual dysfunction |editor-last2=Cummingham |editor-first2=GR}}</ref> | The majority of ED cases are attributed to physical risk factors and predictive factors. These factors can be categorized as vascular, neurological, local penile, hormonal, and drug-induced. Notable predictors of ED include aging, [[cardiovascular disease]], [[diabetes mellitus]], [[Hypertension|high blood pressure]], obesity, [[Dyslipidemia|abnormal lipid levels in the blood]], [[hypogonadism]], smoking, [[Depression (mood)|depression]], and [[Adverse drug reactions|medication use]]. Approximately 10% of cases are linked to psychosocial factors, encompassing conditions such as depression, stress, and problems within relationships.<ref name=":1">{{Cite book |last1=Rosen |first1=RC |title=UpToDate |last2=Khera |first2=M |publisher=[[UpToDate]] |others=Post, TW |year=2023 |editor-last=O'Leary |editor-first=MP |location=Waltham, MA |chapter=Epidemiology and etiologies of male sexual dysfunction |editor-last2=Cummingham |editor-first2=GR}}</ref> ED is reported in 18% of males aged 50 to 59 years, and 37% in males aged 70 to 75.<ref name=":1" /> | ||
Treatment of ED encompasses addressing the underlying causes, lifestyle modification, and addressing psychosocial issues.<ref name="LMCC" /> In many instances, medication-based therapies are used, specifically [[PDE5 inhibitor|PDE5 inhibitors]] such as [[sildenafil]].<ref name="Vardi" /> These drugs function by dilating blood vessels, facilitating increased blood flow into the spongy tissue of the penis, analogous to opening a valve wider to enhance water flow in a fire hose. Less frequently employed treatments encompass [[prostaglandin]] pellets inserted into the [[urethra]], the injection of smooth-muscle relaxants and vasodilators directly into the penis, [[Penile implant|penile implants]], the use of [[Penis pump|penis pumps]], and [[vascular surgery]].<ref name="LMCC" /><ref name="pmid15947645">{{cite journal |vauthors=Montague DK, Jarow JP, Broderick GA, Dmochowski RR, Heaton JP, Lue TF, Milbank AJ, Nehra A, Sharlip ID |date=July 2005 |title=Chapter 1: The management of erectile dysfunction: an AUA update |editor-last=Smith |editor-first=JA Jr. |editor-link=Joseph A. Smith Jr. |journal=[[The Journal of Urology]] |publisher=[[Elsevier]] |volume=174 |issue=1 |pages=230–39 |doi=10.1097/01.ju.0000164463.19239.19 |issn=1527-3792 |pmid=15947645 |s2cid=1761196}}</ref> | Treatment of ED encompasses addressing the underlying causes, lifestyle modification, and addressing psychosocial issues.<ref name="LMCC" /> In many instances, medication-based therapies are used, specifically [[PDE5 inhibitor|PDE5 inhibitors]] such as [[sildenafil]].<ref name="Vardi" /> These drugs function by dilating blood vessels, facilitating increased blood flow into the spongy tissue of the penis, analogous to opening a valve wider to enhance water flow in a fire hose. Less frequently employed treatments encompass [[prostaglandin]] pellets inserted into the [[urethra]], the injection of smooth-muscle relaxants and vasodilators directly into the penis, [[Penile implant|penile implants]], the use of [[Penis pump|penis pumps]], and [[vascular surgery]].<ref name="LMCC" /><ref name="pmid15947645">{{cite journal |vauthors=Montague DK, Jarow JP, Broderick GA, Dmochowski RR, Heaton JP, Lue TF, Milbank AJ, Nehra A, Sharlip ID |date=July 2005 |title=Chapter 1: The management of erectile dysfunction: an AUA update |editor-last=Smith |editor-first=JA Jr. |editor-link=Joseph A. Smith Jr. |journal=[[The Journal of Urology]] |publisher=[[Elsevier]] |volume=174 |issue=1 |pages=230–39 |doi=10.1097/01.ju.0000164463.19239.19 |issn=1527-3792 |pmid=15947645 |s2cid=1761196}}</ref> | ||
==Signs and symptoms== | ==Signs and symptoms== | ||
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==Causes== | ==Causes== | ||
Causes of or contributors to ED include the following: | Causes of or contributors to ED include the following: | ||
* Diets high in [[saturated fat]] are linked to [[heart diseases]], and males with heart diseases are more likely to experience ED.<ref name="dietcauseerectiledysfunction">{{cite web |author=<!--Staff writer(s); no by-line.--> |title=Can Your Diet Cause Erectile Dysfunction? |url=https://health.clevelandclinic.org/can-your-diet-cause-erectile-dysfunction/ |date=20 January 2021 |website=www.clevelandclinic.org |location=[[Cleveland, Ohio]] |publisher=[[Cleveland Clinic]] |access-date=4 January 2022 |archive-date=4 January 2022 |archive-url=https://web.archive.org/web/20220104083111/https://health.clevelandclinic.org/can-your-diet-cause-erectile-dysfunction/ |url-status=live }}</ref><ref name="erectandheartdisease">{{cite web |author=<!--Staff writer(s); no by-line.--> |date=17 July 2019 |title=Erectile Dysfunction & Heart Disease |url=https://my.clevelandclinic.org/health/diseases/15029-heart-disease--erectile-dysfunction |website=www.clevelandclinic.org |location=[[Cleveland, Ohio]] |publisher=[[Cleveland Clinic]] |access-date=4 January 2022 |archive-date=4 January 2022 |archive-url=https://web.archive.org/web/20220104083110/https://my.clevelandclinic.org/health/diseases/15029-heart-disease--erectile-dysfunction | * Diets high in [[saturated fat]] are linked to [[heart diseases]], and males with heart diseases are more likely to experience ED.<ref name="dietcauseerectiledysfunction">{{cite web |author=<!--Staff writer(s); no by-line.--> |title=Can Your Diet Cause Erectile Dysfunction? |url=https://health.clevelandclinic.org/can-your-diet-cause-erectile-dysfunction/ |date=20 January 2021 |website=www.clevelandclinic.org |location=[[Cleveland, Ohio]] |publisher=[[Cleveland Clinic]] |access-date=4 January 2022 |archive-date=4 January 2022 |archive-url=https://web.archive.org/web/20220104083111/https://health.clevelandclinic.org/can-your-diet-cause-erectile-dysfunction/ |url-status=live }}</ref><ref name="erectandheartdisease">{{cite web |author=<!--Staff writer(s); no by-line.--> |date=17 July 2019 |title=Erectile Dysfunction & Heart Disease |url=https://my.clevelandclinic.org/health/diseases/15029-heart-disease--erectile-dysfunction |website=www.clevelandclinic.org |location=[[Cleveland, Ohio]] |publisher=[[Cleveland Clinic]] |access-date=4 January 2022 |archive-date=4 January 2022 |archive-url=https://web.archive.org/web/20220104083110/https://my.clevelandclinic.org/health/diseases/15029-heart-disease--erectile-dysfunction }}</ref> By contrast, [[plant-based diet]]s show a lower risk for ED.<ref>{{cite journal |last1=Bauer |first1=SR |last2=Breyer |first2=BN |last3=Stampfer |first3=MJ |last4=Rimm |first4=EB |last5=Giovannucci |first5=EL |last6=Kenfield |first6=SA |date=November 2020 |title=Association of Diet With Erectile Dysfunction Among Men in the Health Professionals Follow-up Study |editor-last=Rivara |editor-first=FP |editor-link=Fred Rivara |journal=[[JAMA Network Open]] |publisher=[[American Medical Association]] |volume=3 |issue=11 |pages=e2021701 |doi=10.1001/jamanetworkopen.2020.21701 |issn=2574-3805 |pmc=7666422 |pmid=33185675 |s2cid=226850997}}</ref><ref>{{cite journal |last1=Lu |first1=Y |last2=Kang |first2=J |last3=Li |first3=Z |last4=Wang |first4=X |last5=Liu |first5=K |last6=Zhou |first6=K |last7=Wang |first7=W |last8=Shen |first8=C |date=May 2021 |title=The association between plant-based diet and erectile dysfunction in Chinese men |journal=Basic and Clinical Andrology |publisher=[[BioMed Central]] |volume=31 |issue=1 |page=11 |doi=10.1186/s12610-021-00129-5 |doi-access=free |issn=2051-4190 |pmc=8117588 |pmid=33980148 |s2cid=234476038}}</ref><ref>{{cite journal |last1=Russo |first1=GI |last2=Broggi |first2=G |last3=Cocci |first3=A |last4=Capogrosso |first4=P |last5=Falcone |first5=M |last6=Sokolakis |first6=I |last7=Gül |first7=M |last8=Caltabiano |first8=R |last9=Di Mauro |first9=M |date=November 2021 |title=Relationship between Dietary Patterns with Benign Prostatic Hyperplasia and Erectile Dysfunction: A Collaborative Review |journal=[[Nutrients (journal)|Nutrients]] |publisher=[[MDPI]] on behalf of the EAU-YAU Sexual and Reproductive Health Group |volume=13 |issue=11 |page=4148 |doi=10.3390/nu13114148 |doi-access=free |issn=2072-6643 |pmc=8618879 |pmid=34836403 |s2cid=244453931}}</ref> | ||
*[[Prescription drugs]] (e.g., [[SSRI]]s,<ref>{{cite journal |vauthors=Delgado PL, Brannan SK, Mallinckrodt CH, Tran PV, McNamara RK, Wang F, Watkin JG, Detke MJ |date=June 2005 |title=Sexual functioning assessed in 4 double-blind placebo- and paroxetine-controlled trials of duloxetine for major depressive disorder |editor-last=Freeman |editor-first=MP |journal=[[The Journal of Clinical Psychiatry]] |publisher=Physicians Postgraduate Press |volume=66 |issue=6 |pages=686–92 |doi=10.4088/JCP.v66n0603 |issn=1555-2101 |pmid=15960560 |s2cid=39581439}}</ref> [[beta blockers]], [[antihistamines]],<ref>{{cite journal | pmid=7850330 | year=1995 | last1=Cará | first1=A. M. | last2=Lopes-Martins | first2=R. A. | last3=Antunes | first3=E. | last4=Nahoum | first4=C. R. | last5=De Nucci | first5=G. | title=The role of histamine in human penile erection | journal=British Journal of Urology | volume=75 | issue=2 | pages=220–224 | doi=10.1111/j.1464-410x.1995.tb07315.x }}</ref><ref>{{cite web | url=https://www.webmd.com/erectile-dysfunction/guide/drugs-linked-erectile-dysfunction | title=Drugs That Can Cause Erectile Dysfunction }}</ref><ref>{{cite web | url=https://www.yahoo.com/lifestyle/8-substances-that-may-be-killing-your-erection-127187355828.html | title=8 Substances That May be Killing Your Erection | date=26 August 2015 | access-date=9 December 2022 | archive-date=9 December 2022 | archive-url=https://web.archive.org/web/20221209211146/https://www.yahoo.com/lifestyle/8-substances-that-may-be-killing-your-erection-127187355828.html | url-status=live }}</ref> alpha-2 adrenergic receptor agonists, [[thiazides]], hormone modulators, and [[5α-reductase inhibitors]])<ref name="uptodate">Cunningham GR, Rosen RC. Overview of male sexual dysfunction. In: UpToDate, Martin KA (Ed), UpToDate, Waltham, MA, 2018.</ref><ref name="LMCC" /> | *[[Prescription drugs]] (e.g., [[SSRI]]s,<ref>{{cite journal |vauthors=Delgado PL, Brannan SK, Mallinckrodt CH, Tran PV, McNamara RK, Wang F, Watkin JG, Detke MJ |date=June 2005 |title=Sexual functioning assessed in 4 double-blind placebo- and paroxetine-controlled trials of duloxetine for major depressive disorder |editor-last=Freeman |editor-first=MP |journal=[[The Journal of Clinical Psychiatry]] |publisher=Physicians Postgraduate Press |volume=66 |issue=6 |pages=686–92 |doi=10.4088/JCP.v66n0603 |issn=1555-2101 |pmid=15960560 |s2cid=39581439}}</ref> [[beta blockers]], [[antihistamines]],<ref>{{cite journal | pmid=7850330 | year=1995 | last1=Cará | first1=A. M. | last2=Lopes-Martins | first2=R. A. | last3=Antunes | first3=E. | last4=Nahoum | first4=C. R. | last5=De Nucci | first5=G. | title=The role of histamine in human penile erection | journal=British Journal of Urology | volume=75 | issue=2 | pages=220–224 | doi=10.1111/j.1464-410x.1995.tb07315.x }}</ref><ref>{{cite web | url=https://www.webmd.com/erectile-dysfunction/guide/drugs-linked-erectile-dysfunction | title=Drugs That Can Cause Erectile Dysfunction }}</ref><ref>{{cite web | url=https://www.yahoo.com/lifestyle/8-substances-that-may-be-killing-your-erection-127187355828.html | title=8 Substances That May be Killing Your Erection | date=26 August 2015 | access-date=9 December 2022 | archive-date=9 December 2022 | archive-url=https://web.archive.org/web/20221209211146/https://www.yahoo.com/lifestyle/8-substances-that-may-be-killing-your-erection-127187355828.html | url-status=live }}</ref> alpha-2 adrenergic receptor agonists, [[thiazides]], hormone modulators, and [[5α-reductase inhibitors]])<ref name="uptodate">Cunningham GR, Rosen RC. Overview of male sexual dysfunction. In: UpToDate, Martin KA (Ed), UpToDate, Waltham, MA, 2018.</ref><ref name="LMCC" /> | ||
* Neurogenic disorders (e.g., [[diabetic neuropathy]], [[temporal lobe epilepsy]], [[multiple sclerosis]], [[Parkinson's disease]], [[multiple system atrophy]])<ref name="uptodate"/><ref name="LMCC"/><ref name="booksexualdisfunction">{{cite book |last1=Azadzoi |first1=Kazem M. |last2=Siroky |first2=Mike B. |title=Male Sexual Function |year=2006 |chapter=Neurogenic Sexual Dysfunction in and |location=[[Cham, Switzerland]] |publisher=[[Springer Nature]] |series=Current Clinical Urology |doi=10.1007/978-1-59745-155-0_9 |isbn=978-1-59745-155-0 |pages=195–226 |s2cid=67897138}}</ref> | * Neurogenic disorders (e.g., [[diabetic neuropathy]], [[temporal lobe epilepsy]], [[multiple sclerosis]], [[Parkinson's disease]], [[multiple system atrophy]])<ref name="uptodate"/><ref name="LMCC"/><ref name="booksexualdisfunction">{{cite book |last1=Azadzoi |first1=Kazem M. |last2=Siroky |first2=Mike B. |title=Male Sexual Function |year=2006 |chapter=Neurogenic Sexual Dysfunction in and |location=[[Cham, Switzerland]] |publisher=[[Springer Nature]] |series=Current Clinical Urology |doi=10.1007/978-1-59745-155-0_9 |isbn=978-1-59745-155-0 |pages=195–226 |s2cid=67897138}}</ref> | ||
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* [[Hyperprolactinemia]] (e.g., due to a [[prolactinoma]])<ref name="uptodate"/> | * [[Hyperprolactinemia]] (e.g., due to a [[prolactinoma]])<ref name="uptodate"/> | ||
* Psychological causes: [[Stage fright|performance anxiety]], [[stress (biology)|stress]], and [[mental disorders]]<ref name=health.am>{{cite web |vauthors=Lue TF |year=2006 |title=Causes of Erectile Dysfunction |url=http://www.health.am/sex/more/causes_of_erectile_dysfunction/ |work=Erectile dysfunction |publisher=Armenian Health Network, Health.am |access-date=2007-10-07 |archive-date=2021-02-22 |archive-url=https://web.archive.org/web/20210222234416/http://www.health.am/sex/more/causes_of_erectile_dysfunction/ |url-status=live }}</ref> | * Psychological causes: [[Stage fright|performance anxiety]], [[stress (biology)|stress]], and [[mental disorders]]<ref name=health.am>{{cite web |vauthors=Lue TF |year=2006 |title=Causes of Erectile Dysfunction |url=http://www.health.am/sex/more/causes_of_erectile_dysfunction/ |work=Erectile dysfunction |publisher=Armenian Health Network, Health.am |access-date=2007-10-07 |archive-date=2021-02-22 |archive-url=https://web.archive.org/web/20210222234416/http://www.health.am/sex/more/causes_of_erectile_dysfunction/ |url-status=live }}</ref> | ||
* Surgery (e.g., radical [[prostatectomy]])<ref name=healthcommunities>{{cite web | title =Erectile Dysfunction Causes | publisher =Healthcommunities.com | work =Erectile Dysfunction | url =http://www.urologychannel.com/erectiledysfunction/causes.shtml | year =1998 | access-date =2007-10-07 | archive-date =2007-10-09 | archive-url =https://web.archive.org/web/20071009220836/http://www.urologychannel.com/erectiledysfunction/causes.shtml | * Surgery (e.g., radical [[prostatectomy]])<ref name=healthcommunities>{{cite web | title =Erectile Dysfunction Causes | publisher =Healthcommunities.com | work =Erectile Dysfunction | url =http://www.urologychannel.com/erectiledysfunction/causes.shtml | year =1998 | access-date =2007-10-07 | archive-date =2007-10-09 | archive-url =https://web.archive.org/web/20071009220836/http://www.urologychannel.com/erectiledysfunction/causes.shtml }}</ref> | ||
* [[Ageing]]: after age 40 years, ageing itself is a [[Risk factor (epidemiology)|risk factor]] for ED, although numerous other pathologies that may occur with ageing, such as [[testosterone deficiency]], [[cardiovascular diseases]], or [[diabetes]], among others, appear to have interacting effects<ref name="Gokce">{{cite journal | vauthors = Gökçe Mİ, Yaman Ö | title = Erectile dysfunction in the elderly male | journal = Turkish Journal of Urology | volume = 43 | issue = 3 | pages = 247–251 | date = September 2017 | pmid = 28861293 | pmc = 5562240 | doi = 10.5152/tud.2017.70482 | doi-broken-date = 1 July 2025 }}</ref><ref name="Meldrum">{{cite journal | vauthors = Meldrum DR, Morris MA, Gambone JC, Esposito K | title = Aging and erectile function | journal = The Aging Male | volume = 23 | issue = 5 | pages = 1115–1124 | date = December 2020 | pmid = 31724458 | doi = 10.1080/13685538.2019.1686756 | s2cid = 208018226 }}</ref> | * [[Ageing]]: after age 40 years, ageing itself is a [[Risk factor (epidemiology)|risk factor]] for ED, although numerous other pathologies that may occur with ageing, such as [[testosterone deficiency]], [[cardiovascular diseases]], or [[diabetes]], among others, appear to have interacting effects<ref name="Gokce">{{cite journal | vauthors = Gökçe Mİ, Yaman Ö | title = Erectile dysfunction in the elderly male | journal = Turkish Journal of Urology | volume = 43 | issue = 3 | pages = 247–251 | date = September 2017 | pmid = 28861293 | pmc = 5562240 | doi = 10.5152/tud.2017.70482 | doi-broken-date = 1 July 2025 }}</ref><ref name="Meldrum">{{cite journal | vauthors = Meldrum DR, Morris MA, Gambone JC, Esposito K | title = Aging and erectile function | journal = The Aging Male | volume = 23 | issue = 5 | pages = 1115–1124 | date = December 2020 | pmid = 31724458 | doi = 10.1080/13685538.2019.1686756 | s2cid = 208018226 }}</ref> | ||
* [[Kidney disease]]: ED and chronic kidney disease have pathological mechanisms in common, including vascular and hormonal dysfunction, and may share other comorbidities, such as hypertension and diabetes mellitus that can contribute to ED<ref name="Papa">{{cite journal | vauthors = Papadopoulou E, Varouktsi A, Lazaridis A, Boutari C, Doumas M | title = Erectile dysfunction in chronic kidney disease: From pathophysiology to management | journal = World Journal of Nephrology | volume = 4 | issue = 3 | pages = 379–387 | date = July 2015 | pmid = 26167462 | pmc = 4491929 | doi = 10.5527/wjn.v4.i3.379 | doi-access = free }}</ref> | * [[Kidney disease]]: ED and chronic kidney disease have pathological mechanisms in common, including vascular and hormonal dysfunction, and may share other comorbidities, such as hypertension and diabetes mellitus that can contribute to ED<ref name="Papa">{{cite journal | vauthors = Papadopoulou E, Varouktsi A, Lazaridis A, Boutari C, Doumas M | title = Erectile dysfunction in chronic kidney disease: From pathophysiology to management | journal = World Journal of Nephrology | volume = 4 | issue = 3 | pages = 379–387 | date = July 2015 | pmid = 26167462 | pmc = 4491929 | doi = 10.5527/wjn.v4.i3.379 | doi-access = free }}</ref> | ||
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ED can also be associated with bicycling due to both neurological and vascular problems due to compression.<ref>{{cite journal |vauthors=Sommer F, Goldstein I, Korda JB | s2cid = 34409059 | title = Bicycle riding and erectile dysfunction: a review. | journal = The Journal of Sexual Medicine | volume = 7 | issue = 7 | pages = 2346–58 | date = July 2010 | pmid = 20102446 | doi = 10.1111/j.1743-6109.2009.01664.x }}</ref> The increased risk appears to be about 1.7-fold.<ref>{{cite journal |vauthors=Huang V, Munarriz R, Goldstein I | title = Bicycle riding and erectile dysfunction: an increase in interest (and concern). | journal = The Journal of Sexual Medicine | volume = 2 | issue = 5 | pages = 596–604 | date = September 2005 | pmid = 16422816 | doi = 10.1111/j.1743-6109.2005.00099.x }}</ref> | ED can also be associated with bicycling due to both neurological and vascular problems due to compression.<ref>{{cite journal |vauthors=Sommer F, Goldstein I, Korda JB | s2cid = 34409059 | title = Bicycle riding and erectile dysfunction: a review. | journal = The Journal of Sexual Medicine | volume = 7 | issue = 7 | pages = 2346–58 | date = July 2010 | pmid = 20102446 | doi = 10.1111/j.1743-6109.2009.01664.x }}</ref> The increased risk appears to be about 1.7-fold.<ref>{{cite journal |vauthors=Huang V, Munarriz R, Goldstein I | title = Bicycle riding and erectile dysfunction: an increase in interest (and concern). | journal = The Journal of Sexual Medicine | volume = 2 | issue = 5 | pages = 596–604 | date = September 2005 | pmid = 16422816 | doi = 10.1111/j.1743-6109.2005.00099.x }}</ref> | ||
Concerns that use of pornography can cause ED<ref>{{cite journal | vauthors = Robinson M, Wilson G | title=Porn-Induced Sexual Dysfunction: A Growing Problem | journal=Psychology Today | date = July 11, 2011}}</ref> have little support<ref>{{cite journal |last1=Whelan |first1=Georgina |last2=Brown |first2=Jac |title=Pornography Addiction: An Exploration of the Association Between Use, Perceived Addiction, Erectile Dysfunction, Premature (Early) Ejaculation, and Sexual Satisfaction in Males Aged 18-44 Years |journal=The Journal of Sexual Medicine |date=September 2021 |volume=18 |issue=9 |pages=1582–1591 |doi=10.1016/j.jsxm.2021.06.014 |pmid=34400111 |issn=1743-6109 |quote=There was no evidence for an association between internet pornography use with erectile dysfunction, premature ejaculation, or sexual satisfaction. However, there were small to moderate positive correlations between self-perceived internet pornography addiction and erectile dysfunction, premature ejaculation or sexual dissatisfaction.|doi-access=free }}</ref><ref>{{cite journal |last1=Grubbs |first1=Joshua B. |last2=Gola |first2=Mateusz |title=Is Pornography Use Related to Erectile Functioning? Results From Cross-Sectional and Latent Growth Curve Analyses |journal=The Journal of Sexual Medicine |date=January 2019 |volume=16 |issue=1 |pages=111–125 |doi=10.1016/j.jsxm.2018.11.004 |pmid=30621919 |s2cid=58592884 |issn=1743-6109 |quote=there was evidence of a positive, cross-sectional association between self-reported problematic use and ED, but no consistent association between mere use itself and ED.|doi-access=free }}</ref> in epidemiological studies, according to a 2015 literature review.<ref>{{cite journal | vauthors = Landripet I, Štulhofer A | title = Is Pornography Use Associated with Sexual Difficulties and Dysfunctions among Younger Heterosexual Men? | journal = The Journal of Sexual Medicine | volume = 12 | issue = 5 | pages = 1136–1139 | date = May 2015 | pmid = 25816904 | doi = 10.1111/jsm.12853 | doi-access = free }}</ref> According to [[Gunter de Win]], a Belgian professor and sex researcher, "Put simply, respondents who watch 60 minutes a week and think they're addicted were more likely to report sexual dysfunction than those who watch a care-free 160 minutes weekly."<ref name="Boom 2020">{{cite web | vauthors=Van Boom D | title=Porn addiction is ruining lives, but scientists aren't convinced it's real | website=CNET | date=1 December 2020 | url=https://www.cnet.com/features/porn-addiction-is-ruining-lives-but-scientists-arent-convinced-its-real/ | access-date=2 October 2021 | archive-date=3 November 2021 | archive-url=https://web.archive.org/web/20211103032850/https://www.cnet.com/features/porn-addiction-is-ruining-lives-but-scientists-arent-convinced-its-real/ | url-status=live }}</ref><ref name="Jacobs Geysemans Van Hal Glazemakers p. ">{{cite journal | vauthors = Jacobs T, Geysemans B, Van Hal G, Glazemakers I, Fog-Poulsen K, Vermandel A, De Wachter S, De Win G | title = Is online pornography consumption linked to offline sexual dysfunction in young men? A multivariate analysis based on an international web-based survey | journal = JMIR Public Health and Surveillance | date = September 2021 | volume = 7 | issue = 10 | | Concerns that use of pornography can cause ED<ref>{{cite journal | vauthors = Robinson M, Wilson G | title=Porn-Induced Sexual Dysfunction: A Growing Problem | journal=Psychology Today | date = July 11, 2011}}</ref> have little support<ref>{{cite journal |last1=Whelan |first1=Georgina |last2=Brown |first2=Jac |title=Pornography Addiction: An Exploration of the Association Between Use, Perceived Addiction, Erectile Dysfunction, Premature (Early) Ejaculation, and Sexual Satisfaction in Males Aged 18-44 Years |journal=The Journal of Sexual Medicine |date=September 2021 |volume=18 |issue=9 |pages=1582–1591 |doi=10.1016/j.jsxm.2021.06.014 |pmid=34400111 |issn=1743-6109 |quote=There was no evidence for an association between internet pornography use with erectile dysfunction, premature ejaculation, or sexual satisfaction. However, there were small to moderate positive correlations between self-perceived internet pornography addiction and erectile dysfunction, premature ejaculation or sexual dissatisfaction.|doi-access=free }}</ref><ref>{{cite journal |last1=Grubbs |first1=Joshua B. |last2=Gola |first2=Mateusz |title=Is Pornography Use Related to Erectile Functioning? Results From Cross-Sectional and Latent Growth Curve Analyses |journal=The Journal of Sexual Medicine |date=January 2019 |volume=16 |issue=1 |pages=111–125 |doi=10.1016/j.jsxm.2018.11.004 |pmid=30621919 |s2cid=58592884 |issn=1743-6109 |quote=there was evidence of a positive, cross-sectional association between self-reported problematic use and ED, but no consistent association between mere use itself and ED.|doi-access=free }}</ref> in epidemiological studies, according to a 2015 literature review.<ref>{{cite journal | vauthors = Landripet I, Štulhofer A | title = Is Pornography Use Associated with Sexual Difficulties and Dysfunctions among Younger Heterosexual Men? | journal = The Journal of Sexual Medicine | volume = 12 | issue = 5 | pages = 1136–1139 | date = May 2015 | pmid = 25816904 | doi = 10.1111/jsm.12853 | doi-access = free }}</ref> According to [[Gunter de Win]], a Belgian professor and sex researcher, "Put simply, respondents who watch 60 minutes a week and think they're addicted were more likely to report sexual dysfunction than those who watch a care-free 160 minutes weekly."<ref name="Boom 2020">{{cite web | vauthors=Van Boom D | title=Porn addiction is ruining lives, but scientists aren't convinced it's real | website=CNET | date=1 December 2020 | url=https://www.cnet.com/features/porn-addiction-is-ruining-lives-but-scientists-arent-convinced-its-real/ | access-date=2 October 2021 | archive-date=3 November 2021 | archive-url=https://web.archive.org/web/20211103032850/https://www.cnet.com/features/porn-addiction-is-ruining-lives-but-scientists-arent-convinced-its-real/ | url-status=live }}</ref><ref name="Jacobs Geysemans Van Hal Glazemakers p. ">{{cite journal | vauthors = Jacobs T, Geysemans B, Van Hal G, Glazemakers I, Fog-Poulsen K, Vermandel A, De Wachter S, De Win G | title = Is online pornography consumption linked to offline sexual dysfunction in young men? A multivariate analysis based on an international web-based survey | journal = JMIR Public Health and Surveillance | date = September 2021 | volume = 7 | issue = 10 | article-number = e32542 | pmid = 34534092 | doi = 10.2196/32542 | publisher = JMIR Publications Inc. | pmc = 8569536 | quote = '''Conclusions:''' This prevalence of ED in young men is alarmingly high and the results of presented study suggest a significant association with PPC. | doi-access = free }}</ref> A 2026 review shows that simple pornography consumption does not cause erectile dysfunction, the relationship between pornography and ED being much more complex.<ref name="k266">{{cite book | last1=Zacharopoulos | first1=Zisimos | last2=Georgiou | first2=Christos | last3=Critselis | first3=Elena | last4=Tigani | first4=Xanthi | last5=Kanaka-Gantenbein | first5=Christina | last6=Bacopoulou | first6=Flora | title=GeNeDIS 2024 | chapter=Pornography Consumption and Male Sexual Dysfunction: A Systematic Review | series=Advances in Experimental Medicine and Biology | volume=1487 | date=2026 | issn=0065-2598 | pmid=41273571 | doi=10.1007/978-3-032-03398-7_29 | pages=297–304 | isbn=978-3-032-03397-0 }}</ref> | ||
In seemingly rare cases, medications such as SSRIs, [[isotretinoin]] (Accutane) and [[finasteride]] (Propecia) are reported to induce long-lasting [[Iatrogenesis|iatrogenic]] disorders characterized by sexual dysfunction symptoms, including erectile dysfunction in males; these disorders are known as [[Selective serotonin reuptake inhibitor#Sexual dysfunction|post-SSRI sexual dysfunction]] (PSSD), post-retinoid sexual dysfunction/post-Accutane syndrome (PRSD/PAS), and | In seemingly rare cases, medications such as SSRIs, [[isotretinoin]] (Accutane) and [[finasteride]] (Propecia) are reported to induce long-lasting [[Iatrogenesis|iatrogenic]] disorders characterized by sexual dysfunction symptoms, including erectile dysfunction in males; these disorders are known as [[Selective serotonin reuptake inhibitor#Sexual dysfunction|post-SSRI sexual dysfunction]] (PSSD), post-retinoid sexual dysfunction/post-Accutane syndrome (PRSD/PAS), and post-finasteride syndrome (PFS). These conditions remain poorly understood and lack effective treatments, although they have been suggested to share a common etiology.<ref>{{Cite journal |last1=Giatti |first1=Silvia |last2=Diviccaro |first2=Silv.ia |last3=Panzica |first3=Giancarlo |last4=Melcangi |first4=Roberto Cosimo |date=August 2018 |title=Post-finasteride syndrome and post-SSRI sexual dysfunction: two sides of the same coin? |journal=Endocrine |volume=61 |issue=2 |pages=180–193 |doi=10.1007/s12020-018-1593-5 |issn=1559-0100 |pmid=29675596 |s2cid=4974636 }}</ref> | ||
* Rarely impotence can be caused by [[aromatase]] being active. See [[Androgen replacement therapy]]. | * Rarely impotence can be caused by [[aromatase]] being active. See [[Androgen replacement therapy]]. | ||
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In some cases, the simple search for a previously undetected [[groin hernia (disambiguation)|groin hernia]]<!--intentional link to DAB page--> can prove useful since it can affect sexual functions in males and is relatively easily curable.<ref name="groin-cause"/> | In some cases, the simple search for a previously undetected [[groin hernia (disambiguation)|groin hernia]]<!--intentional link to DAB page--> can prove useful since it can affect sexual functions in males and is relatively easily curable.<ref name="groin-cause"/> | ||
The current{{Dash}}{{As of|2025|April|lc=y}}<ref>{{Cite web |title=DSM |url=https://www.psychiatry.org/psychiatrists/practice/dsm |url-status=live |archive-url=https://web.archive.org/web/20250425142756/https://www.psychiatry.org/psychiatrists/practice/dsm |archive-date=25 April 2025 |access-date=2025-04-25 |website=www.psychiatry.org |publisher=[[American Psychiatric Association]] |language=en |quote=The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) features the most current text updates based on scientific literature with contributions from more than 200 subject matter experts.}}</ref>{{Dash}}edition of the ''[[Diagnostic and Statistical Manual of Mental Disorders]]'' ([[DSM-5-TR]]) lists ''Erectile Disorder'' ([[ICD-10-CM]] code: F52.21) as a diagnosis.<ref name=":2">{{Cite book |title=Diagnostic and statistical manual of mental disorders: DSM-5-TR™ |title-link=DSM-5-TR |date=2022 |publisher=American Psychiatric Association Publishing |isbn=978-0-89042-575-6 |editor-last=American Psychiatric Association |edition=Fifth edition, text revision |location=Washington, DC |pages=481–483}}</ref> According to the DSM, it "is the more specific DSM-5 diagnostic category in which erectile dysfunction persists for at least 6 months and causes distress in the individual."<ref name=":2" /> The [[ICD-10]], to which the DSM refers regarding ''Erectile dysfunction'',<ref name=":2" /> lists it under ''Failure of genital response'' (F52.2).<ref>{{Cite web |title=ICD-10 Version:2019 |url=https://icd.who.int/browse10/2019/en#/F52.2 |url-status=live |archive-url=https://web.archive.org/web/20250422021426/https://icd.who.int/browse10/2019/en#/F52.2 |archive-date=2025-04-22 |access-date=2025-04-25 |website=icd.who.int |language=en }}</ref> The latest edition of the [[International Classification of Diseases|ICD]]{{Dash}}namely, the [[ICD-11]]{{Dash}}lists the condition as ''Male erectile dysfunction'' ( | The current{{Dash}}{{As of|2025|April|lc=y}}<ref>{{Cite web |title=DSM |url=https://www.psychiatry.org/psychiatrists/practice/dsm |url-status=live |archive-url=https://web.archive.org/web/20250425142756/https://www.psychiatry.org/psychiatrists/practice/dsm |archive-date=25 April 2025 |access-date=2025-04-25 |website=www.psychiatry.org |publisher=[[American Psychiatric Association]] |language=en |quote=The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) features the most current text updates based on scientific literature with contributions from more than 200 subject matter experts.}}</ref>{{Dash}}edition of the ''[[Diagnostic and Statistical Manual of Mental Disorders]]'' ([[DSM-5-TR]]) lists ''Erectile Disorder'' ([[ICD-10-CM]] code: F52.21) as a diagnosis.<ref name=":2">{{Cite book |title=Diagnostic and statistical manual of mental disorders: DSM-5-TR™ |title-link=DSM-5-TR |date=2022 |publisher=American Psychiatric Association Publishing |isbn=978-0-89042-575-6 |editor-last=American Psychiatric Association |edition=Fifth edition, text revision |location=Washington, DC |pages=481–483}}</ref> According to the DSM, it "is the more specific DSM-5 diagnostic category in which erectile dysfunction persists for at least 6 months and causes distress in the individual."<ref name=":2" /> The [[ICD-10]], to which the DSM refers regarding ''Erectile dysfunction'',<ref name=":2" /> lists it under ''Failure of genital response'' (F52.2).<ref>{{Cite web |title=ICD-10 Version:2019 |url=https://icd.who.int/browse10/2019/en#/F52.2 |url-status=live |archive-url=https://web.archive.org/web/20250422021426/https://icd.who.int/browse10/2019/en#/F52.2 |archive-date=2025-04-22 |access-date=2025-04-25 |website=icd.who.int |language=en }}</ref> The latest edition of the [[International Classification of Diseases|ICD]]{{Dash}}namely, the [[ICD-11]]{{Dash}}lists the condition as ''Male erectile dysfunction'' (HA01.1). | ||
===Ultrasonography=== | ===Ultrasonography=== | ||
[[File:Ultrasonography of dilated penile sinusoids during erection.jpg|thumb|Transverse ultrasound image, ventral view of the penis. Image obtained after induction of an erection, 15 min after injection of prostaglandin E1, showing dilated sinusoids (arrows).<ref name="FernandesSouza2018"/>]] | [[File:Ultrasonography of dilated penile sinusoids during erection.jpg|thumb|Transverse ultrasound image, ventral view of the penis. Image obtained after induction of an erection, 15 min after injection of prostaglandin E1, showing dilated sinusoids (arrows).<ref name="FernandesSouza2018"/>]] | ||
[[Penile ultrasonography]] with [[doppler ultrasound|doppler]] can be used to examine the erect penis. Most cases of ED of organic causes are related to changes in blood flow in the corpora cavernosa, represented by occlusive artery disease (in which less blood is allowed to enter the penis), most often of atherosclerotic origin, or due to failure of the veno-occlusive mechanism (in which too much blood circulates back out of the penis). Before the Doppler sonogram, the penis should be examined in B mode, in order to identify possible tumors, fibrotic plaques, calcifications, or hematomas, and to evaluate the appearance of the cavernous arteries, which can be tortuous or atheromatous.<ref name="FernandesSouza2018">Originally copied from:<br>{{cite journal | vauthors = Fernandes MA, de Souza LR, Cartafina LP | title = Ultrasound evaluation of the penis | journal = Radiologia Brasileira | volume = 51 | issue = 4 | pages = 257–261 | year = 2018 | pmid = 30202130 | pmc = 6124582 | doi = 10.1590/0100-3984.2016.0152 }}<br>[[Creative Commons|CC BY]] 4.0 license</ref> | [[Penile ultrasonography]] with [[doppler ultrasound|doppler]] can be used to examine the erect penis. Most cases of ED of organic causes are related to changes in blood flow in the corpora cavernosa, represented by occlusive artery disease (in which less blood is allowed to enter the penis), most often of atherosclerotic origin, or due to failure of the veno-occlusive mechanism (in which too much blood circulates back out of the penis). Before the Doppler sonogram, the penis should be examined in B mode, in order to identify possible tumors, fibrotic plaques, calcifications, or hematomas, and to evaluate the appearance of the cavernous arteries, which can be tortuous or atheromatous.<ref name="FernandesSouza2018">Originally copied from:<br />{{cite journal | vauthors = Fernandes MA, de Souza LR, Cartafina LP | title = Ultrasound evaluation of the penis | journal = Radiologia Brasileira | volume = 51 | issue = 4 | pages = 257–261 | year = 2018 | pmid = 30202130 | pmc = 6124582 | doi = 10.1590/0100-3984.2016.0152 }}<br />[[Creative Commons|CC BY]] 4.0 license</ref> | ||
Erection can be induced by injecting 10–20 μg of prostaglandin E1, with evaluations of the arterial flow every five minutes for 25–30 min (see image). The use of prostaglandin E1 is contraindicated in patients with predisposition to priapism (e.g., those with sickle cell anemia), anatomical deformity of the penis, or penile implants. Phentolamine (2 mg) is often added. Visual and tactile stimulation produces better results. Some authors recommend the use of sildenafil by mouth to replace the injectable drugs in cases of contraindications, although the efficacy of such medication is controversial.<ref name="FernandesSouza2018"/> | Erection can be induced by injecting 10–20 μg of prostaglandin E1, with evaluations of the arterial flow every five minutes for 25–30 min (see image). The use of prostaglandin E1 is contraindicated in patients with predisposition to priapism (e.g., those with sickle cell anemia), anatomical deformity of the penis, or penile implants. Phentolamine (2 mg) is often added. Visual and tactile stimulation produces better results. Some authors recommend the use of sildenafil by mouth to replace the injectable drugs in cases of contraindications, although the efficacy of such medication is controversial.<ref name="FernandesSouza2018"/> | ||
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===Medications=== | ===Medications=== | ||
The [[PDE5 inhibitor]]s [[sildenafil]] (Viagra), [[vardenafil]] (Levitra) and [[tadalafil]] (Cialis) are prescription drugs which are taken by mouth.<ref name=EuroGuideline/>{{rp|20–21}} As of 2018, sildenafil is available in the UK without a prescription.<ref>{{cite news |url=https://www.bbc.com/news/health-42155489 |title=Viagra can be sold over the counter |date=28 November 2017 |work=BBC News |access-date=5 April 2018 |archive-date=22 February 2021 |archive-url=https://web.archive.org/web/20210222234502/https://www.bbc.com/news/health-42155489 |url-status=live }}</ref> Additionally, a cream combining [[alprostadil]] with the permeation enhancer [[DDAIP]] has been approved in Canada as a [[First-line treatment|first line treatment]] for ED.<ref>{{cite web|vauthors=Bujdos B|title=New Topical Erectile Dysfunction Drug Vitaros Approved in Canada; Approved Topical Drug Testim Proves Helpful for Erectile Dysfunction|date=16 November 2010|url=http://www.accessrx.com/blog/current-health-news/vitaros-testim-topical-drugs-treat-erectile-dysfunction-a1115|access-date=15 April 2011|archive-date=13 May 2011|archive-url=https://web.archive.org/web/20110513011529/http://www.accessrx.com/blog/current-health-news/vitaros-testim-topical-drugs-treat-erectile-dysfunction-a1115|url-status=live}}</ref> Penile injections, on the other hand, can involve one of the following medications: [[papaverine]], [[phentolamine]], and [[prostaglandin E1]], also known as | {{See also|List of investigational sexual dysfunction drugs}} | ||
The [[PDE5 inhibitor]]s [[sildenafil]] (Viagra), [[vardenafil]] (Levitra) and [[tadalafil]] (Cialis) are prescription drugs which are taken by mouth.<ref name=EuroGuideline/>{{rp|20–21}} As of 2018, sildenafil is available in the UK without a prescription.<ref>{{cite news |url=https://www.bbc.com/news/health-42155489 |title=Viagra can be sold over the counter |date=28 November 2017 |work=BBC News |access-date=5 April 2018 |archive-date=22 February 2021 |archive-url=https://web.archive.org/web/20210222234502/https://www.bbc.com/news/health-42155489 |url-status=live }}</ref> Additionally, a cream combining [[alprostadil]] with the permeation enhancer [[DDAIP]] has been approved in Canada as a [[First-line treatment|first line treatment]] for ED.<ref>{{cite web|vauthors=Bujdos B|title=New Topical Erectile Dysfunction Drug Vitaros Approved in Canada; Approved Topical Drug Testim Proves Helpful for Erectile Dysfunction|date=16 November 2010|url=http://www.accessrx.com/blog/current-health-news/vitaros-testim-topical-drugs-treat-erectile-dysfunction-a1115|access-date=15 April 2011|archive-date=13 May 2011|archive-url=https://web.archive.org/web/20110513011529/http://www.accessrx.com/blog/current-health-news/vitaros-testim-topical-drugs-treat-erectile-dysfunction-a1115|url-status=live}}</ref> Penile injections, on the other hand, can involve one of the following medications: [[papaverine]], [[phentolamine]], and [[prostaglandin E1]], also known as alprostadil.<ref name=EuroGuideline/> In addition to injections, there is an alprostadil [[suppository]] that can be inserted into the urethra. Once inserted, an erection can begin within 10 minutes and last up to an hour.<ref name=":0">{{Cite web|url=https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/treatment|title=Treatment for erectile dysfunction {{!}}|website=US National Institute of Diabetes and Digestive and Kidney Diseases|language=en-US|access-date=2019-08-04|archive-date=2021-02-22|archive-url=https://web.archive.org/web/20210222234446/https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/treatment|url-status=live}}</ref> Medications to treat ED may cause a side effect called [[priapism]].<ref name=":0" /> | |||
====Prevalence of medical diagnosis==== | ====Prevalence of medical diagnosis==== | ||
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[[Extracorporeal shockwave therapy|Focused shockwave therapy]] involves passing short, high frequency acoustic pulses through the skin and into the penis. These waves break down any plaques within the blood vessels, encourage the formation of new vessels, and stimulate repair and tissue regeneration.<ref>{{cite journal | vauthors = Vardi Y, Appel B, Jacob G, Massarwi O, Gruenwald I | title = Can low-intensity extracorporeal shockwave therapy improve erectile function? A 6-month follow-up pilot study in patients with organic erectile dysfunction | journal = European Urology | volume = 58 | issue = 2 | pages = 243–8 | date = August 2010 | pmid = 20451317 | doi = 10.1016/j.eururo.2010.04.004 }}</ref><ref>{{Cite web|url=https://edclinics.co.uk/shockwave-therapy/|title=Shockwave Therapy for Erectile Dysfunction | ED Clinics|date=27 July 2020|access-date=22 September 2021|archive-date=23 September 2021|archive-url=https://web.archive.org/web/20210923151918/https://edclinics.co.uk/shockwave-therapy/|url-status=live}}</ref> | [[Extracorporeal shockwave therapy|Focused shockwave therapy]] involves passing short, high frequency acoustic pulses through the skin and into the penis. These waves break down any plaques within the blood vessels, encourage the formation of new vessels, and stimulate repair and tissue regeneration.<ref>{{cite journal | vauthors = Vardi Y, Appel B, Jacob G, Massarwi O, Gruenwald I | title = Can low-intensity extracorporeal shockwave therapy improve erectile function? A 6-month follow-up pilot study in patients with organic erectile dysfunction | journal = European Urology | volume = 58 | issue = 2 | pages = 243–8 | date = August 2010 | pmid = 20451317 | doi = 10.1016/j.eururo.2010.04.004 }}</ref><ref>{{Cite web|url=https://edclinics.co.uk/shockwave-therapy/|title=Shockwave Therapy for Erectile Dysfunction | ED Clinics|date=27 July 2020|access-date=22 September 2021|archive-date=23 September 2021|archive-url=https://web.archive.org/web/20210923151918/https://edclinics.co.uk/shockwave-therapy/|url-status=live}}</ref> | ||
Focused shockwave therapy appears to work best for males with vasculogenic ED, which is a blood vessel disorder that affects blood flow to tissue in the penis. The treatment is painless and has no known side effects. Treatment with shockwave therapy can lead to a significant improvement of the IIEF (International Index of Erectile Function).<ref>{{cite web | title = International Index of Erectile Function (IIEF): Guidelines on Clinical Application of IIEF patient Questionnaire | work = Department of Urology | publisher = Addenbrooke's Hospital | location = Hills Road, Cambridge, CB2 0QQ | url = https://www.camurology.org.uk/wp-content/uploads/interpretation-of-the-iief.pdf | access-date = 2021-09-22 | archive-date = 2021-10-26 | archive-url = https://web.archive.org/web/20211026022523/https://www.camurology.org.uk/wp-content/uploads/interpretation-of-the-iief.pdf | Focused shockwave therapy appears to work best for males with vasculogenic ED, which is a blood vessel disorder that affects blood flow to tissue in the penis. The treatment is painless and has no known side effects. Treatment with shockwave therapy can lead to a significant improvement of the IIEF (International Index of Erectile Function).<ref>{{cite web | title = International Index of Erectile Function (IIEF): Guidelines on Clinical Application of IIEF patient Questionnaire | work = Department of Urology | publisher = Addenbrooke's Hospital | location = Hills Road, Cambridge, CB2 0QQ | url = https://www.camurology.org.uk/wp-content/uploads/interpretation-of-the-iief.pdf | access-date = 2021-09-22 | archive-date = 2021-10-26 | archive-url = https://web.archive.org/web/20211026022523/https://www.camurology.org.uk/wp-content/uploads/interpretation-of-the-iief.pdf }}</ref><ref>{{cite journal | vauthors = Man L, Li G | title = Low-intensity Extracorporeal Shock Wave Therapy for Erectile Dysfunction: A Systematic Review and Meta-analysis | journal = Urology | volume = 119 | pages = 97–103 | date = September 2018 | pmid = 28962876 | doi = 10.1016/j.urology.2017.09.011 | s2cid = 7048621 }}</ref><ref>{{cite journal | vauthors = Clavijo RI, Kohn TP, Kohn JR, Ramasamy R | title = Effects of Low-Intensity Extracorporeal Shockwave Therapy on Erectile Dysfunction: A Systematic Review and Meta-Analysis | journal = The Journal of Sexual Medicine | volume = 14 | issue = 1 | pages = 27–35 | date = January 2017 | pmid = 27986492 | doi = 10.1016/j.jsxm.2016.11.001 }}</ref> | ||
=== Testosterone === | === Testosterone === | ||
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{{Main|Vibrator (sex toy)}} | {{Main|Vibrator (sex toy)}} | ||
The vibrator was invented in the late 19th century as a medical instrument for pain relief and the treatment of various ailments. Sometimes described as a massager, the vibrator is used on the body to produce [[sexual stimulation]]. Several clinical studies have found vibrators to be an effective solution for Erectile Dysfunction.<ref>{{Cite journal |last1=Ismail |first1=Ezzat A. |last2=El-Sakka |first2=Ahmed I. |date=2016-06-01 |title=Innovative trends and perspectives for erectile dysfunction treatment: A systematic review |journal=Arab Journal of Urology |language=en |volume=14 |issue=2 |pages=84–93 |doi=10.1016/j.aju.2016.04.002 |pmid=27493808 |issn=2090-598X|pmc=4963167 }}</ref><ref>{{Cite journal |last1=Miranda |first1=Eduardo P. |last2=Taniguchi |first2=Hisanori |last3=Cao |first3=David L. |last4=Hald |first4=Gert M. |last5=Jannini |first5=Emmanuele A. |last6=Mulhall |first6=John P. |date=2019-06-01 |title=Application of Sex Aids in Men With Sexual Dysfunction: A Review |journal=The Journal of Sexual Medicine |language=en |volume=16 |issue=6 |pages=767–780 |doi=10.1016/j.jsxm.2019.03.265 |pmid=31029536 |issn=1743-6095|pmc=8519170 }}</ref> Examples of FDA registered vibrators for erectile dysfunction include | The vibrator was invented in the late 19th century as a medical instrument for pain relief and the treatment of various ailments. Sometimes described as a massager, the vibrator is used on the body to produce [[sexual stimulation]]. Several clinical studies have found vibrators to be an effective solution for Erectile Dysfunction.<ref>{{Cite journal |last1=Ismail |first1=Ezzat A. |last2=El-Sakka |first2=Ahmed I. |date=2016-06-01 |title=Innovative trends and perspectives for erectile dysfunction treatment: A systematic review |journal=Arab Journal of Urology |language=en |volume=14 |issue=2 |pages=84–93 |doi=10.1016/j.aju.2016.04.002 |pmid=27493808 |issn=2090-598X|pmc=4963167 }}</ref><ref>{{Cite journal |last1=Miranda |first1=Eduardo P. |last2=Taniguchi |first2=Hisanori |last3=Cao |first3=David L. |last4=Hald |first4=Gert M. |last5=Jannini |first5=Emmanuele A. |last6=Mulhall |first6=John P. |date=2019-06-01 |title=Application of Sex Aids in Men With Sexual Dysfunction: A Review |journal=The Journal of Sexual Medicine |language=en |volume=16 |issue=6 |pages=767–780 |doi=10.1016/j.jsxm.2019.03.265 |pmid=31029536 |issn=1743-6095|pmc=8519170 }}</ref> Examples of FDA registered vibrators for erectile dysfunction include [[MV.Health]]'s Tenuto<ref>{{Cite journal |last1=Rodríguez Martínez |first1=Jesús E. |last2=Alcaina |first2=Leandro R. |last3=Agullo |first3=Guillermo H. |date=2022-11-01 |title=Improved erectile function after focal muscle vibrations therapy in a patient with neurogenic erectile dysfunction: a case report |url=https://www.sciencedirect.com/science/article/pii/S1743609522015867 |journal=The Journal of Sexual Medicine |language=en |volume=19 |issue=11, Supplement 4 |pages=S69 |doi=10.1016/j.jsxm.2022.08.012 |s2cid=253821604 |issn=1743-6095|url-access=subscription }}</ref> and Reflexonic's Viberect.<ref>{{Cite journal |last1=Clavell Hernandez |first1=J. |last2=Wu |first2=Q. |last3=Zhou |first3=X. |last4=Nguyen |first4=J. N. |last5=Davis |first5=J. W. |last6=Wang |first6=R. |date=2018-07-01 |title=319 Penile vibratory stimulation in penile rehabilitation after radical prostatectomy: a randomized, controlled trial |url=https://www.sciencedirect.com/science/article/pii/S1743609518305551 |journal=The Journal of Sexual Medicine |series=Proceedings of the 21st World Meeting on Sexual Medicine |language=en |volume=15 |issue=7, Supplement 3 |pages=S253–S254 |doi=10.1016/j.jsxm.2018.04.282 |s2cid=58240260 |issn=1743-6095|url-access=subscription }}</ref> | ||
=== Surgery === | === Surgery === | ||
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===Alternative medicine=== | ===Alternative medicine=== | ||
The [[United States Food and Drug Administration|Food and Drug Administration]] (FDA) does not recommend alternative therapies to treat sexual dysfunction.<ref>{{Cite web|url=http://www.medscape.com/viewarticle/562177|title=Dangers of Sexual Enhancement Supplements|website=Medscape|access-date=2009-02-10|archive-date=2021-02-22|archive-url=https://web.archive.org/web/20210222234545/https://www.medscape.com/viewarticle/562177|url-status=live}}</ref> Many products are advertised as "[[herbal viagra]]" or "natural" sexual enhancement products, but no clinical trials or scientific studies support the effectiveness of these products for the treatment of ED, and synthetic chemical compounds similar to sildenafil have been found as [[adulterant]]s in many of these products.<ref>{{cite journal |vauthors=Gryniewicz CM, Reepmeyer JC, Kauffman JF, Buhse LF | title = Detection of undeclared erectile dysfunction drugs and analogues in dietary supplements by ion mobility spectrometry | journal = Journal of Pharmaceutical and Biomedical Analysis | volume = 49 | issue = 3 | pages = 601–06 | year = 2009 | pmid = 19150190 | doi = 10.1016/j.jpba.2008.12.002 }}</ref><ref>{{cite journal |vauthors=Choi DM, Park S, Yoon TH, Jeong HK, Pyo JS, Park J, Kim D, Kwon SW | title = Determination of analogs of sildenafil and vardenafil in foods by column liquid chromatography with a photodiode array detector, mass spectrometry, and nuclear magnetic resonance spectrometry | journal = Journal of AOAC International | volume = 91 | issue = 3 | pages = 580–88 | year = 2008 | pmid = 18567304 | doi = 10.1093/jaoac/91.3.580 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Reepmeyer JC, Woodruff JT | title = Use of liquid chromatography-mass spectrometry and a chemical cleavage reaction for the structure elucidation of a new sildenafil analogue detected as an adulterant in an herbal dietary supplement | journal = Journal of Pharmaceutical and Biomedical Analysis | volume = 44 | issue = 4 | pages = 887–93 | year = 2007 | pmid = 17532168 | doi = 10.1016/j.jpba.2007.04.011 | url = https://zenodo.org/record/1259165 | access-date = 2019-07-02 | archive-date = 2020-01-28 | archive-url = https://web.archive.org/web/20200128091836/https://zenodo.org/record/1259165 | url-status = live }}</ref><ref>{{cite journal | vauthors = Reepmeyer JC, Woodruff JT, d'Avignon DA | title = Structure elucidation of a novel analogue of sildenafil detected as an adulterant in an herbal dietary supplement | journal = Journal of Pharmaceutical and Biomedical Analysis | volume = 43 | issue = 5 | pages = 1615–21 | year = 2007 | pmid = 17207601 | doi = 10.1016/j.jpba.2006.11.037 | url = https://zenodo.org/record/1259163 | access-date = 2019-07-02 | archive-date = 2021-10-09 | archive-url = https://web.archive.org/web/20211009125925/https://zenodo.org/record/1259163 | url-status = live }}</ref><ref>[https://www.fda.gov/Safety/Recalls/EnforcementReports/ucm217780.htm Enforcement Report for June 30, 2010] {{Webarchive|url=https://web.archive.org/web/20160625154458/http://www.fda.gov/Safety/Recalls/EnforcementReports/ucm217780.htm |date=June 25, 2016 }}, [[United States Food and Drug Administration]]</ref> The FDA has warned consumers that any sexual enhancement product that claims to work as well as prescription products is likely to contain such a contaminant.<ref>[https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm048386.htm Hidden Risks of Erectile Dysfunction "Treatments" Sold Online] {{Webarchive|url=https://web.archive.org/web/20190423031555/https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm048386.htm |date=2019-04-23 }}, [[United States Food and Drug Administration]], February 21, 2009</ref> A 2021 review indicated that ginseng had "only trivial effects on erectile function or satisfaction with intercourse compared to placebo".<ref>{{cite journal | vauthors = Lee HW, Lee MS, Kim TH, Alraek T, Zaslawski C, Kim JW, Moon DG | title = Ginseng for erectile dysfunction | journal = The Cochrane Database of Systematic Reviews | volume = 2021 | | The [[United States Food and Drug Administration|Food and Drug Administration]] (FDA) does not recommend alternative therapies to treat sexual dysfunction.<ref>{{Cite web|url=http://www.medscape.com/viewarticle/562177|title=Dangers of Sexual Enhancement Supplements|website=Medscape|access-date=2009-02-10|archive-date=2021-02-22|archive-url=https://web.archive.org/web/20210222234545/https://www.medscape.com/viewarticle/562177|url-status=live}}</ref> Many products are advertised as "[[herbal viagra]]" or "natural" sexual enhancement products, but no clinical trials or scientific studies support the effectiveness of these products for the treatment of ED, and synthetic chemical compounds similar to sildenafil have been found as [[adulterant]]s in many of these products.<ref>{{cite journal |vauthors=Gryniewicz CM, Reepmeyer JC, Kauffman JF, Buhse LF | title = Detection of undeclared erectile dysfunction drugs and analogues in dietary supplements by ion mobility spectrometry | journal = Journal of Pharmaceutical and Biomedical Analysis | volume = 49 | issue = 3 | pages = 601–06 | year = 2009 | pmid = 19150190 | doi = 10.1016/j.jpba.2008.12.002 }}</ref><ref>{{cite journal |vauthors=Choi DM, Park S, Yoon TH, Jeong HK, Pyo JS, Park J, Kim D, Kwon SW | title = Determination of analogs of sildenafil and vardenafil in foods by column liquid chromatography with a photodiode array detector, mass spectrometry, and nuclear magnetic resonance spectrometry | journal = Journal of AOAC International | volume = 91 | issue = 3 | pages = 580–88 | year = 2008 | pmid = 18567304 | doi = 10.1093/jaoac/91.3.580 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Reepmeyer JC, Woodruff JT | title = Use of liquid chromatography-mass spectrometry and a chemical cleavage reaction for the structure elucidation of a new sildenafil analogue detected as an adulterant in an herbal dietary supplement | journal = Journal of Pharmaceutical and Biomedical Analysis | volume = 44 | issue = 4 | pages = 887–93 | year = 2007 | pmid = 17532168 | doi = 10.1016/j.jpba.2007.04.011 | url = https://zenodo.org/record/1259165 | access-date = 2019-07-02 | archive-date = 2020-01-28 | archive-url = https://web.archive.org/web/20200128091836/https://zenodo.org/record/1259165 | url-status = live }}</ref><ref>{{cite journal | vauthors = Reepmeyer JC, Woodruff JT, d'Avignon DA | title = Structure elucidation of a novel analogue of sildenafil detected as an adulterant in an herbal dietary supplement | journal = Journal of Pharmaceutical and Biomedical Analysis | volume = 43 | issue = 5 | pages = 1615–21 | year = 2007 | pmid = 17207601 | doi = 10.1016/j.jpba.2006.11.037 | url = https://zenodo.org/record/1259163 | access-date = 2019-07-02 | archive-date = 2021-10-09 | archive-url = https://web.archive.org/web/20211009125925/https://zenodo.org/record/1259163 | url-status = live }}</ref><ref>[https://www.fda.gov/Safety/Recalls/EnforcementReports/ucm217780.htm Enforcement Report for June 30, 2010] {{Webarchive|url=https://web.archive.org/web/20160625154458/http://www.fda.gov/Safety/Recalls/EnforcementReports/ucm217780.htm |date=June 25, 2016 }}, [[United States Food and Drug Administration]]</ref> The FDA has warned consumers that any sexual enhancement product that claims to work as well as prescription products is likely to contain such a contaminant.<ref>[https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm048386.htm Hidden Risks of Erectile Dysfunction "Treatments" Sold Online] {{Webarchive|url=https://web.archive.org/web/20190423031555/https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm048386.htm |date=2019-04-23 }}, [[United States Food and Drug Administration]], February 21, 2009</ref> A 2021 review indicated that ginseng had "only trivial effects on erectile function or satisfaction with intercourse compared to placebo".<ref>{{cite journal | vauthors = Lee HW, Lee MS, Kim TH, Alraek T, Zaslawski C, Kim JW, Moon DG | title = Ginseng for erectile dysfunction | journal = The Cochrane Database of Systematic Reviews | volume = 2021 | article-number = CD012654 | date = April 2021 | issue = 4 | pmid = 33871063 | pmc = 8094213 | doi = 10.1002/14651858.cd012654.pub2 }}</ref> | ||
==History== | ==History== | ||
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{{Further|Medicalisation of sexuality}} | {{Further|Medicalisation of sexuality}} | ||
[[File:Zibik.jpg|thumb|An unhappy wife is complaining to the [[qadi]] about her husband's impotence. [[Ottoman miniature]].]] | [[File:Zibik.jpg|thumb|An unhappy wife is complaining to the [[qadi]] about her husband's impotence. [[Ottoman miniature]].]] | ||
Attempts to treat the symptoms described by ED date back well over 1,000 years. In the 8th century, males of Ancient Rome and Greece wore talismans of rooster and goat genitalia, believing these talismans would serve as an aphrodisiac and promote sexual function.<ref name="MCLAREN">{{cite book | vauthors = McLaren A |title=Impotence: A Cultural History |date=2007 |publisher=University of Chicago Press |isbn=978-0-226-50076-8}}</ref> In the 13th century, [[Albertus Magnus]] recommended ingesting roasted wolf penis as a remedy for impotence.<ref name="MCLAREN" /> During the late 16th and 17th centuries in France, male impotence was considered a crime, as well as legal grounds for a divorce. The practice, which involved inspection of the complainants by court experts, was declared obscene in 1677.<ref>{{cite book| vauthors = Roach M |title=Bonk: The Curious Coupling of Science and Sex|year=2009|publisher=W.W. Norton & Co|location=New York|isbn=978-0-393-33479-1|pages=149–52|title-link=Bonk: The Curious Coupling of Science and Sex}}</ref><ref>{{cite book | vauthors = Darmon P |title=Trial by Impotence: Virility and Marriage in Pre-Revolutionary France |date=1985 |publisher=Vintage/Ebury |isbn=978-0-7011-2915-6}}</ref> | Attempts to treat the symptoms described by ED date back well over 1,000 years. In the 8th century,{{dubious|date=November 2025}} males of Ancient Rome and Greece wore talismans of rooster and goat genitalia, believing these talismans would serve as an aphrodisiac and promote sexual function.<ref name="MCLAREN">{{cite book | vauthors = McLaren A |title=Impotence: A Cultural History |date=2007 |publisher=University of Chicago Press |isbn=978-0-226-50076-8}}</ref> In the 13th century, [[Albertus Magnus]] recommended ingesting roasted wolf penis as a remedy for impotence.<ref name="MCLAREN" /> During the late 16th and 17th centuries in France, male impotence was considered a crime, as well as legal grounds for a divorce. The practice, which involved inspection of the complainants by court experts, was declared obscene in 1677.<ref>{{cite book| vauthors = Roach M |title=Bonk: The Curious Coupling of Science and Sex|year=2009|publisher=W.W. Norton & Co|location=New York|isbn=978-0-393-33479-1|pages=149–52|title-link=Bonk: The Curious Coupling of Science and Sex}}</ref><ref>{{cite book | vauthors = Darmon P |title=Trial by Impotence: Virility and Marriage in Pre-Revolutionary France |date=1985 |publisher=Vintage/Ebury |isbn=978-0-7011-2915-6}}</ref> | ||
The first major publication describing a broad medicalization of sexual disorders was the first edition of the ''[[Diagnostic and Statistical Manual of Mental Disorders]]'' in 1952.<ref name=":15">{{Cite journal |last1=Hart |first1=Graham |last2=Wellings |first2=Kaye |date=2002-04-13 |title=Sexual behaviour and its medicalisation: in sickness and in health |url=https://www.bmj.com/content/324/7342/896 |journal=BMJ |language=en |volume=324 |issue=7342 |pages=896–900 |doi=10.1136/bmj.324.7342.896 |issn=0959-8138 |pmc=1122837 |pmid=11950742 |access-date=2023-12-23 |archive-date=2023-12-23 |archive-url=https://web.archive.org/web/20231223052939/https://www.bmj.com/content/324/7342/896 |url-status=live }}</ref> In the early 20th century, medical folklore held that 90-95% of cases of ED were psychological in origin, but around the 1980s research took the opposite direction of searching for physical causes of sexual dysfunction, which also happened in the 1920s and 30s.<ref name=":9">{{Cite journal |last=Tiefer |first=Leonore |date=1996 |title=The medicalization of sexuality: Conceptual, normative, and professional issues |journal=[[Annual Review of Sex Research]] |volume=7 |issue=1 |pages=252–282 |doi=10.1080/10532528.1996.10559915 |via=EBSCO|doi-access=free }}</ref> Physical causes as explanations continue to dominate literature when compared with psychological explanations {{As of|2022|lc=y}}.<ref name=":14">{{Cite journal |last=Grunt-Mejer |first=Katarzyna |date=2022-07-03 |title=The history of the medicalisation of rapid ejaculation—A reflection of the rising importance of female pleasure in a phallocentric world |url=https://www.tandfonline.com/doi/full/10.1080/19419899.2021.1888312 |journal=Psychology & Sexuality |language=en |volume=13 |issue=3 |pages=565–582 |doi=10.1080/19419899.2021.1888312 |issn=1941-9899 |s2cid=233924065 |access-date=2023-12-23 |archive-date=2023-12-23 |archive-url=https://web.archive.org/web/20231223052939/https://www.tandfonline.com/doi/full/10.1080/19419899.2021.1888312 |url-status=live |url-access=subscription }}</ref> | The first major publication describing a broad medicalization of sexual disorders was the first edition of the ''[[Diagnostic and Statistical Manual of Mental Disorders]]'' in 1952.<ref name=":15">{{Cite journal |last1=Hart |first1=Graham |last2=Wellings |first2=Kaye |date=2002-04-13 |title=Sexual behaviour and its medicalisation: in sickness and in health |url=https://www.bmj.com/content/324/7342/896 |journal=BMJ |language=en |volume=324 |issue=7342 |pages=896–900 |doi=10.1136/bmj.324.7342.896 |issn=0959-8138 |pmc=1122837 |pmid=11950742 |access-date=2023-12-23 |archive-date=2023-12-23 |archive-url=https://web.archive.org/web/20231223052939/https://www.bmj.com/content/324/7342/896 |url-status=live }}</ref> In the early 20th century, medical folklore held that 90-95% of cases of ED were psychological in origin, but around the 1980s research took the opposite direction of searching for physical causes of sexual dysfunction, which also happened in the 1920s and 30s.<ref name=":9">{{Cite journal |last=Tiefer |first=Leonore |date=1996 |title=The medicalization of sexuality: Conceptual, normative, and professional issues |journal=[[Annual Review of Sex Research]] |volume=7 |issue=1 |pages=252–282 |doi=10.1080/10532528.1996.10559915 |via=EBSCO|doi-access=free }}</ref> Physical causes as explanations continue to dominate literature when compared with psychological explanations {{As of|2022|lc=y}}.<ref name=":14">{{Cite journal |last=Grunt-Mejer |first=Katarzyna |date=2022-07-03 |title=The history of the medicalisation of rapid ejaculation—A reflection of the rising importance of female pleasure in a phallocentric world |url=https://www.tandfonline.com/doi/full/10.1080/19419899.2021.1888312 |journal=Psychology & Sexuality |language=en |volume=13 |issue=3 |pages=565–582 |doi=10.1080/19419899.2021.1888312 |issn=1941-9899 |s2cid=233924065 |access-date=2023-12-23 |archive-date=2023-12-23 |archive-url=https://web.archive.org/web/20231223052939/https://www.tandfonline.com/doi/full/10.1080/19419899.2021.1888312 |url-status=live |url-access=subscription }}</ref> | ||
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Treatments in the 80s for ED included [[penile implant]]s and [[Intracavernous injection|intracavernosal injections]].<ref name=":9" /> The first successful vacuum erection device, or [[penis pump]], was developed by Vincent Marie Mondat in the early 1800s.<ref name="MCLAREN" /> A more advanced device based on a bicycle pump was developed by Geddings Osbon, a Pentecostal preacher, in the 1970s. In 1982, he received FDA approval to market the product.<ref>{{cite journal |vauthors=Hoyland K, Vasdev N, Adshead J |date=2013 |title=The use of vacuum erection devices in erectile dysfunction after radical prostatectomy |journal=Reviews in Urology |volume=15 |issue=2 |pages=67–71 |pmc=3784970 |pmid=24082845}}</ref> [[John R. Brinkley]] initiated a boom in male impotence treatments in the U.S. in the 1920s and 1930s, with radio programs that recommended expensive goat gland implants and "mercurochrome" injections as the path to restored male virility, including operations by surgeon [[Serge Voronoff]]. | Treatments in the 80s for ED included [[penile implant]]s and [[Intracavernous injection|intracavernosal injections]].<ref name=":9" /> The first successful vacuum erection device, or [[penis pump]], was developed by Vincent Marie Mondat in the early 1800s.<ref name="MCLAREN" /> A more advanced device based on a bicycle pump was developed by Geddings Osbon, a Pentecostal preacher, in the 1970s. In 1982, he received FDA approval to market the product.<ref>{{cite journal |vauthors=Hoyland K, Vasdev N, Adshead J |date=2013 |title=The use of vacuum erection devices in erectile dysfunction after radical prostatectomy |journal=Reviews in Urology |volume=15 |issue=2 |pages=67–71 |pmc=3784970 |pmid=24082845}}</ref> [[John R. Brinkley]] initiated a boom in male impotence treatments in the U.S. in the 1920s and 1930s, with radio programs that 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]] dropped his trousers and demonstrated to a shocked Urodynamics Society audience showing his [[papaverine]]-induced erection.<ref>{{cite journal | vauthors = Klotz L | title = How (not) to communicate new scientific information: a memoir of the famous Brindley lecture | journal = BJU International | volume = 96 | issue = 7 | pages = 956–7 | date = November 2005 | pmid = 16225508 | doi = 10.1111/j.1464-410X.2005.05797.x | s2cid = 38931340 | doi-access = free }}</ref> The current most common treatment for ED, the oral [[PDE5 inhibitor]] known as [[sildenafil]] (Viagra) was approved for use for [[Pfizer Inc.|Pfizer]] by the FDA in 1998, which at the time of release was the fastest selling drug in history.<ref name=":15" /><ref>{{cite journal | vauthors = Valiquette L | title = A historical review of erectile dysfunction | journal = The Canadian Journal of Urology | volume = 10 | issue = Suppl 1 | pages = 7–11 | date = February 2003 | pmid = 12625844 | url = https://www.researchgate.net/publication/10865798 | access-date = 2019-02-16 | archive-date = 2022-02-03 | archive-url = https://web.archive.org/web/20220203061457/https://www.researchgate.net/publication/10865798_A_historical_review_of_erectile_dysfunction | url-status = live }}</ref><ref name=":02">{{Cite journal |last=Pacey |first=Susan |date=2008-08-01 |title=The medicalisation of sex: a barrier to intercourse? | Modern drug therapy for ED made a significant advance in 1983, when British physiologist [[Giles Brindley]] dropped his trousers and demonstrated to a shocked Urodynamics Society audience showing his [[papaverine]]-induced erection.<ref>{{cite journal | vauthors = Klotz L | title = How (not) to communicate new scientific information: a memoir of the famous Brindley lecture | journal = BJU International | volume = 96 | issue = 7 | pages = 956–7 | date = November 2005 | pmid = 16225508 | doi = 10.1111/j.1464-410X.2005.05797.x | s2cid = 38931340 | doi-access = free }}</ref> The current most common treatment for ED, the oral [[PDE5 inhibitor]] known as [[sildenafil]] (Viagra) was approved for use for [[Pfizer Inc.|Pfizer]] by the FDA in 1998, which at the time of release was the fastest selling drug in history.<ref name=":15" /><ref>{{cite journal | vauthors = Valiquette L | title = A historical review of erectile dysfunction | journal = The Canadian Journal of Urology | volume = 10 | issue = Suppl 1 | pages = 7–11 | date = February 2003 | pmid = 12625844 | url = https://www.researchgate.net/publication/10865798 | access-date = 2019-02-16 | archive-date = 2022-02-03 | archive-url = https://web.archive.org/web/20220203061457/https://www.researchgate.net/publication/10865798_A_historical_review_of_erectile_dysfunction | url-status = live }}</ref><ref name=":02">{{Cite journal |last=Pacey |first=Susan |date=2008-08-01 |title=The medicalisation of sex: a barrier to intercourse? |journal=Sexual and Relationship Therapy |volume=23 |issue=3 |pages=183–187 |doi=10.1080/14681990802221092 |issn=1468-1994 |s2cid=144685850}}</ref> Sildenafil largely replaced [[Selective serotonin reuptake inhibitor|SSRI]] treatments for ED at the time<ref name=":42">{{Cite book |last=Štulhofer |first=Aleksandar |title=The International Encyclopedia of Human Sexuality |date=2015-04-20 |isbn=978-1-4051-9006-0 |pages=721–817 |chapter=Medicalization of sexuality |doi=10.1002/9781118896877.wbiehs297 |chapter-url=http://dx.doi.org/10.1002/9781118896877.wbiehs297}}</ref> and proliferated new types of specialised pharmaceutical marketing which emphasised social connotations of ED and Viagra rather than its physical effects.<ref name=":122">{{Cite journal |last1=Gurevich |first1=Maria |last2=Cormier |first2=Nicole |last3=Leedham |first3=Usra |last4=Brown-Bowers |first4=Amy |date=August 2018 |title=Sexual dysfunction or sexual discipline? Sexuopharmaceutical use by men as prevention and proficiency |url=http://journals.sagepub.com/doi/10.1177/0959353517750682 |journal=Feminism & Psychology |language=en |volume=28 |issue=3 |pages=309–330 |doi=10.1177/0959353517750682 |issn=0959-3535 |s2cid=149254089 |access-date=2023-12-23 |archive-date=2023-12-13 |archive-url=https://web.archive.org/web/20231213081719/https://journals.sagepub.com/doi/10.1177/0959353517750682 |url-status=live |url-access=subscription }}</ref><ref name=":17">{{Cite journal |last=Tiefer |first=Leonore |date=2001-05-01 |title=A new view of women's sexual problems: Why new? Why now? |url=https://www.tandfonline.com/doi/full/10.1080/00224490109552075 |journal=The Journal of Sex Research |language=en |volume=38 |issue=2 |pages=89–96 |doi=10.1080/00224490109552075 |issn=0022-4499 |s2cid=144377564|url-access=subscription }}</ref> | ||
==Anthropology== | ==Anthropology== | ||
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== External links == | == External links == | ||
{{Commons}} | |||
{{Medical resources | {{Medical resources | ||
| DiseasesDB = 21555 | | DiseasesDB = 21555 | ||