How Was ED Treated Before Viagra Invention?

Viagra, without exaggeration, caused a revolution in the treatment of erectile dysfunction (ED) in men. Since 1998, everyone suffering from ED has received a quick and effective way to deal with this unpleasant disease.

But how was ED treated before Viagra invention?

The old approaches were sometimes very strange. Ancient Hindus boiled oil with alligator testes; physicians of the late 19th century tried to treat ED with radioactive cocktails, etc.

ED Treatment in Ancient Times

The first mention of the phenomenon of erection and the analysis of the causes of ED date back to the 8th century BC and belong to the peoples of ancient India. Hindus paid particular attention to the psychological aspects of libido disorders as the causes of ED. In particular, they believed that erectile dysfunction could be observed against the background of “having sex with an ugly woman.” At the same time, there were also various medicines for the treatment of ED. So, in the Indian treatise Sushruta, ancient authors suggested cooking eggs of the alligator, frog and sparrow in oil and lubricating the man’s soles with that oil (J. Shah, 2002).

In ancient China, it was believed that when a man reached the age of 60, the life force of Yin was reduced to such an extent that a man inevitably became unable to have sex. Ancient Chinese priests advised drinking one’s own urine for treating impotence. Urine contains a small amount of testosterone (W. Futterweit, 1964), but this amount is clearly not sufficient to eliminate erectile problems.

There are references to ED as a divine punishment in the Bible (about King David) and in the Old Testament, when God punished Abimelech, making him impotent, for adultery with the wife of Abraham. Hippocrates believed that any disease or imbalance in four bodily fluids could lead to impotence. According to Hippocrates, excess sex weakened the potency; the testicles were connected to the penile organ through erectile threads, and damage to those threads also led to impotence. He wrote that ED could not be cured and at the same time advised to practice bracing procedures, and also make sacrifices to the gods.

Generally speaking, ancient people used primarily natural (herbal and animal) methods. Herbal options included truffles, ginger, and some other herbs, while animal-based remedies were strange, such as vulture lung, the tongue of goose and the horn of a rhinoceros. These “medicines” were so popular that they are common even now. Many animals, such as rhinoceroses and tigers that were hunted for the sake of obtaining miracle substances, appeared on the verge of extinction.

Beliefs about ED in the Middle Ages & Modern Age

In the Middle Ages in Europe, the occurrence of ED was usually associated with witches’ intrigues. It was believed that if a witch tied a knot on a leather cord, then the devil would make a man impotent. There were written large tracts containing descriptions of sexual impotence because of intrigues of witches and methods of combating witches. One of them was “Malleus Maleficarum” (“The Hammer of the Witches”). Check PFD version of this tracts. For a long time, erection problems were the basis for a divorce.

“Malleus Maleficarum” (adapted version)

In medicine, a new era began with the Renaissance, when the classical model of Hippocrates was perfected by Leonardo da Vinci, who first described the anatomy of the prostate and penis. The great scientist noticed that often men who had been executed through hanging had a reflex erection. He concluded that the cavernous bodies were filled with blood, not air, as many had believed before. Ambroise Paré, a French barber surgeon made a more detailed description of the anatomy of the penile organ & the physiology of erection.

In the 19th century, three basic concepts of erectile dysfunction and three scientific schools were formed.

1. Scientists of the first group believed that erectile dysfunction was caused by pathological changes in the genital organs (vascular, neurological). For example, in 1873, one Italian surgeon discovered a venous dilation of the dorsal vein of the penis and suggested that the disease was the cause of ED.
2. Scientists from the second group believed that the basis of erectile dysfunction was solely hormonal disorder. The beginning of the hormonal theory was associated with the following event. In 1889, the French scientist Brown-Sequard at the age of 72 administered an extract from the testicles of the dog and guinea pig and noted the improvement in his physical & mental strength.
3. The third group claimed that the main cause of erectile dysfunction lay in a person’s mind. This theory became especially popular in the first half of the 20th century, as we will discuss further.

Now we can say that the scientists from each group had something of a point. All of the above reasons could relate to the development of ED. But we cannot say that only one theory is correct. Along with the development of progressive views in medicine, in the second half of the 19th century, the ingenious and unscientific methods of "treating" ED were popular. People used such strange things as poisons and even electric shocks. But the most dangerous way was radioactive drink. Radium was discovered in 1898 and it was immediately used to treat various diseases. It was used as an aqueous solution, a suppository and a metal mesh with radium (Radi-Endocrinator) that men wore in bags near their genitals. It is difficult to even imagine how many cases of cancer and birth defects were caused by such an appallingly stupid approach to ED treatment.

Psychoanalytic Approach to the Treatment of ED

At the beginning of the 20th century, psychoanalysis was very popular. The founder of this theory, Sigmund Freud believed that erection problems were rooted primarily in the mind and not in other parts of the body. According to his ideas, the Ego refused sexual pleasure, if it was regarded as associated with a great danger. He wrote that a potency disorder usually accompanied all neurotic diseases. He also attributed masturbation and early sexual excesses to ED causes.

Freud was partly right. Specifically, he was right about the so-called psychogenic (psychological) ED, the causes of which include sexual trauma in the past, fear of failure, interpersonal problems, etc. Up to the present time, patients with significant psychological problems can be treated with the help of psychosexual therapy, both in the form of monotherapy and in combination with other treatment methods.

For the first time, the technique of psychosexual therapy was suggested by well-known scientists Masters and Johnson in the 1960s.

However, according to current research data, only 10-20% of men suffer from ED due to psychological problems. In the case of organic erectile dysfunction, the psychoanalyst is unlikely to help. It is necessary to contact an ordinary health care practitioner and use traditional methods of treatment.

Methods of Treatment in the XX century – Surgeries & Intracavernous Injections

Before the 1960s, urologic therapy for ED was rare, because the disease was considered a psychiatric one. The history of modern anti-ED surgery began in the early 1970s when scientists Scott & Bradley invented an inflatable penile prosthesis. Such prostheses were used for male patients suffering from significant ED of organic nature. Now similar implants are also used if ED is very severe and drug therapy does not give necessary results.

Intracavernous therapy was discovered by Virag in the early 1980s accidentally, during a surgical procedure on the penile organ. The first intracavernosal drug for the treatment of ED was papaverine. For a long time, it was used as a monotherapy for ED with the administration of huge (up to 8 ml) doses of this drug.

Thanks to the efforts of Israeli specialists, a “cocktail” therapy was developed, which significantly reduced the dose administered and decreased the number of side effects. In addition to papaverine, intracavernous drugs include:

• prostaglandin (PGE1);
• Phentolamine;
• Rimix (prostaglandin, papaverine, and phentolamine)
• Bimix (papaverine and phentolamine), etc.

The technique of intracavernous injection is as follows. The patient needs to pull the penis towards the hip, holding its glans. The puncture is done in the lateral part of the cavernous body at the base of the penis, in a diagonal direction (90 degrees).

Systemic side effects of intracavernous injections include dizziness, fainting, and orthostatic hypotension. Doctors believe that these unwanted effects arise as a reaction to the drug in sensitive patients, and in some cases may be a manifestation of a psychological response to an injection into the penis. Local side effects include pain, bruising, infection, fibrous cavernosa and priapism. They often arise because of the negligence of the patient.

Intracavernous injections are sometimes used now. Although they are quite effective, they have given way to oral therapy because of the comfort for a man. Undoubtedly, it is better to drink a small pill than to make a penile shot.

Information about Intracavernous injections www.ncbi.nlm.nih.gov/pubmed/11525316

Viagra and Other PDE5 Inhibitors – New Era in ED Treatment

Inhibitors of PDE-5 are currently the first-line drugs for ED patients. They suppress the activity of the enzyme PDE5 in the penis, which adversely affects the cGMP levels necessary for the normal achievement and maintenance of an erection. The first PDE5 inhibitor was Viagra. It was originally invented to treat angina, but the scientists noticed that the men participating in clinical trials did not want to return the tablets. As it turned out, they had an erection. The scientists continued studies in a new area and in 1998 Viagra was officially approved.

Why did it become so popular? 

There are several reasons for that:

• convenience of use (oral tablets);
• quick effect (in 30-60 minutes after taking the pill);
• long time of action (up to 6 hours, sometimes longer);
• a small number of contraindications;
• generally mild side effects;
• the possibility of long-term use.

Following Viagra, other drugs from the class of PDE5 inhibitors began to appear. So, in August 2003, the FDA approved Levitra developed by Bayer and two other companies. Three months later (in November), American company Eli Lilly received an approval for Cialis. There are other drugs of this class (like Avanafil), but they are less well-known, despite of their advantages.

Additional information on Modern Generic PDE5 inhibitors:

• Viagra Professional Review: awcanadianpharmacy.com/viagra-pro.php
• Levitra Professional Guide: awcanadianpharmacy.com/levitra-professional.php
• New Cialis Professional Information: awcanadianpharmacy.com/cialis-professional.php

Now every man with ED has the opportunity to quickly eliminate the symptoms of the disease and have full-fledged sex thanks to Viagra and other PDE5 inhibitors.