Was Erectile Dysfunction Treatment Discovered By Accident?

It has been nearly three decades since the first erectile dysfunction pills became available on prescription, and it is still astonishing how much men’s sexual and reproductive health has changed as a direct result.

Even the term erectile dysfunction is relatively new as compared to the concerns men have had about their sexual health over the years, and the complex ways in which the various causes for ED often interlink is still a fascinating topic for research.

However, the shift in perception of what was previously known as impotence into what we know now as ED might have emerged as a result of an accident that created a revolutionary treatment

for sexual health.

When Was ED First Treated?

Historically, before there was an understanding of reproductive health or mental health, impotence was heavily stigmatised. In 17th-century France, it was even considered a legal ground for divorce and potentially even a crime.

The first documented medical “treatments” for ED took place in the 1920s, but given that they were undertaken by infamous quack John R Brinkley, the medical basis for these “treatments” was dubious at best.

By the 1970s and 1980s, multiple breakthroughs in the physiological causes of ED reversed the idea that it was primarily a psychological condition (although depression, anxiety and medication that treats both can be a causal factor), with pumps and injections consistently demonstrating the potential for a medical solution.

The problem at that point stopped being the possibility of a treatment for ED but instead the plausibility of a convenient treatment. Direct, carefully controlled injections of papaverine or a penis pump were suboptimal in this regard.

The ideal solution would be a medicine that could be taken as needed and easily carried around or stored discreetly.

Pfizer found their answer through a serendipitous failure.

The Greatest Failure

The pharmaceutical conglomerate Pfizer was exploring the potential of a drug they had recently synthesised in their research facility in Sandwich, Kent.

Known as sildenafil, the medicine helps to relax smooth muscle around arteries, which improves blood flow around the body.

Because of this, Pfizer was interested in the medication as a treatment for angina, a tightness around the chest typically caused by a lack of blood flow around the heart.

Unfortunately, as an angina treatment sildenafil fell at the first hurdle, as the drug appeared to provide little effect or relief for angina. However, clinical trial director Ian Osterloh reported a side effect that would change everything.

The drug was reported to induce erections in the male candidates, something an observant nurse found out when she noticed that a lot of the men enrolled in the Phase I study were lying on their stomachs to try and hide it.

This is where the researchers figured out that the drug worked remarkably well, but relaxed smooth muscles in the penis rather than around the heart, which is why it can improve blood flow so quickly.

Ironically, it would later be approved in 2005 to treat pulmonary arterial hypertension, a different heart condition related to blood flow.

Designing Around The Accident

The first point the research team noticed was that it was causing blood to flow in a very different place than where they expected, but the second point was that the clinical trial subjects wanted to keep the supply of tablets or lied about having any leftover tablets.

This suggested that there could be a market for a discreet, effective drug to treat ED which led to one of the most famous cases of pivoting and drug repositioning in the history of the pharmaceutical industry.

This led to the development of what would become Viagra, a treatment for erectile dysfunction that would replace selective serotonin reuptake inhibitors (SSRIs) as the primary oral medication prescribed for erectile dysfunction.

SSRIs are used as antidepressants, and the change in prescribing behaviour highlights the shift from treating erectile dysfunction as a mental health condition (outside of situations where that is the diagnosed cause) and instead as a physical health condition for which is an approved treatment.

This approval arrived in the United States in 1998 with an unusually large and influential marketing campaign for a prescription medication, something that was only legally possible due to the laws surrounding marketing prescription medications directly to patients.

The campaign, which featured former United States Senator and presidential candidate Bob Dole and the footballer Pele, was incredibly successful to such an extreme degree that the only recent medication that has come close has been the weight management injection Wegovy.

To find out more about erectile dysfunction treatments, get in touch with the My Chemist Plus team today.