Impotence or, more clinically, erectile dysfunction is the inability to develop or maintain an erection of the penis for satisfactory sexual intercourse regardless of the capability of ejaculation. There are various underlying causes, many of which are medically reversible. An uncircumcised penis in both flaccid and fully erect states. ... The penis (plural penises or penes) or phallus is the external male copulatory organ, and, in mammals, the external male organ of urination. ... SUCK MY PENIS BITCH!!! ... This article is about male ejaculation. ...

Due to its personal nature, the subject has been taboo for a long period of time, and is the stuff of many urban legends. Since the 1930s, folk remedies have been advertised widely for the condition. The introduction of sildenafil (Viagra®) in the 1990s caused a second wave of public attention, propelled in part by heavy advertising. A taboo is a strong social prohibition (or ban) relating to any area of human activity or social custom declared as sacred and forbidden; breaking of the taboo is usually considered objectionable or abhorrent by society. ... Urban legends are a kind of folklore consisting of stories often thought to be factual by those circulating them. ... Events and trends Technology Jet engine invented First atom was split with a particle accelerator Golden Age of radio begins in U.S. Science Nuclear fission discovered by Otto Hahn, Lise Meitner and Fritz Strassmann Pluto, the ninth planet from the Sun, is discovered by Clyde Tombaugh British biologist Arthur... Sildenafil citrate, sold under the name Viagra, is a drug used to treat male erectile dysfunction (impotence), developed by the pharmaceutical company Pfizer. ... Events and trends Technology Explosive growth of the Internet; decrease in the cost of computers and other technology Reduction in size and cost of mobile phones leads to a massive surge in their popularity Year 2000 problem (commonly known as Y2K) Microsoft Windows operating system becomes virtually ubiquitous on IBM...

The Latin term impotentia coeundi describes simple inability to insert the penis into the vagina. It is now mostly replaced by more precise terms.

Medical symptoms

Erectile dysfunction is characterised by the inability to maintain erection. Normal erections during sleep and in the early morning suggest a psychogenic cause, while loss of these erections may signify underlying disease, often cardiovascular in origin. Other things leading to erectile dysfunction are diabetes mellitus (causing neuropathy) or hypogonadism (decreased testosterone levels due to disease affecting the testicles or the pituitary gland). An uncircumcised penis in both flaccid and fully erect states. ... The circulatory system or cardiovascular system is the organ system which circulates blood around the body of most animals. ... Diabetes mellitus is a medical disorder characterized by varying or persistent hyperglycemia (elevated blood sugar levels), especially after eating. ... Neuropathy is a disease of the peripheral nervous system. ... Hypogonadism is a medical term for a defect of the reproductive system which results in lack of function of the gonads (ovaries or testes). ... Testosterone is a steroid hormone from the androgen group. ... Human male anatomy The testicles, known medically as testes (singular testis), are the male generative glands in animals. ... Located at the base of the skull, the pituitary gland is protected by a bony structure called the sella turcica. ...

Medical diagnosis

There are no formal tests to diagnose erectile dysfunction. Some blood tests are generally done to exclude underlying disease, such as diabetes, hypogonadism and prolactinoma. Blood tests are laboratory tests done on blood to gain an appreciation of disease states and the function of organs. ... This article is about the disease that features high blood sugar. ... Hypogonadism is a medical term for a defect of the reproductive system which results in lack of function of the gonads (ovaries or testes). ... A prolactinoma is a benign tumor (adenoma) of the pituitary gland that produces a hormone called prolactin. ...

Pathophysiology

Penile erection is managed by two different mechanisms. The first one is the reflex erection, which is achieved by directly touching the penile shaft. The second is the psychogenic erection, which is achieved by erotic stimuli. The former uses the peripheral nerves and the lower parts of the spinal cord, whereas the latter uses the limbic system of the brain. In both conditions an intact neural system is required for a successful and complete erection. Stimulation of penile shaft by the nervous system leads to the secretion of nitric oxide (NO), which causes the relaxation of smooth muscles of corpora cavernosa (the main erectile tissue of penis), and subsequently penile erection. Additionally, adequate levels of testosterone (produced by the testes) and an intact pituitary gland are required for the development of a healthy male erectile system. As can be understood from the mechanisms of a normal erection, impotence may develop due to hormonal deficiency, disorders of the neural system, lack of adequate penile blood supply or psychological problems. The limbic system is a group of brain structures that are involved in various emotions such as aggression, fear, pleasure and also in the formation of memory. ... In the anatomy of animals, the brain, or encephalon, is the supervisory center of the nervous system. ... The nervous system of an animal coordinates the activity of the muscles, monitors the organs, constructs and processes input from the senses, and initiates actions. ... The chemical compound nitric oxide is a gas with chemical formula NO. It is an important signaling molecule in the body of mammals including humans, one of the few gaseous signaling molecules known. ... Testosterone is a steroid hormone from the androgen group. ... Human male anatomy The testicles, known medically as testes (singular testis), are the male generative glands in animals. ... Located at the base of the skull, the pituitary gland is protected by a bony structure called the sella turcica. ...

A few causes of impotence may be iatrogenic (medically caused). Various antihypertensives (medications intended to control high blood pressure) and some drugs that modify central nervous system response may inhibit erection by denying blood supply or by altering nerve activity. Surgical intervention for a number of different conditions may remove anatomical structures necessary to erection, damage nerves, or impair blood supply. An iatrogenic (pronounced [aI%{.tr@UdZE.nIk], SAMPA) condition is a state of ill health or adverse effect caused by medical treatment, usually due to mistakes made in treatment. ... Antihypertensives are a class of drugs that are used In medicine and pharmacology to treat hypertension. ... Arterial hypertension, or high blood pressure is a medical condition where the blood pressure is chronically elevated. ... The vertebrate central nervous system consists of the brain and spinal cord. ...

Treatment

Treatment depends on the cause. Testosterone supplements may be used for cases with hormonal deficiency. However, usually the cause is lack of adequate penile blood supply as a result of age-dependent damage of inner walls of blood vessels. Previously, medical substances (e.g. apomorphine) were directly injected into the erectile tissue of penile shaft to treat impotence. In some cases refractory to the medical treatment, a penile implant (penile prosthesis) could be advised. After the discovery of orally active agents that increase the efficacy of NO, which dilates the blood vessels of corpora cavernosa, more conservative methods started to be used.

PDE5 Inhibitors

The prescription PDE5 inhibitors sildenafil (Viagra®), vardenafil (Levitra®) and tadalafil (Cialis®) are prescription drugs which are taken orally. They work by blocking the action of PDE5, which causes cGMP to degrade. cGMP causes the smooth muscle of the arteries in the penis to relax, allowing the corpus cavernosum to fill with blood. Diagram of phosphodiester bonds between nucleotides A phosphodiester bond is a group of strong covalent bonds between the phosphorus atom in a phosphate group and two other molecules over two ester bonds. ... Sildenafil citrate, sold under the name Viagra, is a drug used to treat male erectile dysfunction (impotence), developed by the pharmaceutical company Pfizer. ... Categories: Pages needing attention | Medicine stubs | Sexology | PDE5 inhibitors ... Cialis® (generic name, tadalafil) is the brand name of a drug used to treat male erectile dysfunction (impotence), developed by the biotech firm ICOS and marketed worldwide by Eli Lilly. ... Cyclic guanosine monophosphate (cGMP) is a second messenger derived from GTP. Cyclic guanosine monophosphate (cGMP) is a cyclic nucleotide derived from guanosine triphosphate (GTP). ... A corpus cavernosum is one of a pair of a sponge-like regions of erectile tissue which contain most of the blood in the male penis during erection. ...

PT-141

The experimental drug PT-141 does not act on the vascular system like the former compounds but increases sexual desire and drive in male as well as female. It is apllied as a nasal spray PT-141 and works by activation of melanocortin receptors in the brain. It is awaiting FDA approval. Chemical structure of PT-141 PT-141 is a new medication for use in treating sexual dysfunction in men (erectile dysfunction or impotence) as well as in women (sexual arousal disorder). ... In biochemistry, a receptor is a protein on the cell membrane or within the cytoplasm that binds to a specific factor (a ligand), such as a neurotransmitter, hormone, or other substance, and initiates the cellular response to the ligand. ...

Ginseng

A double-blind study appears to show evidence that ginseng is better than placebo: see the ginseng article for links and more details. Double-blind describes an especially stringent way of conducting an experiment, usually on living, conscious, human subjects. ... Species Panax ginseng - Chinese Ginseng Panax japonicus - Japanese Ginseng Panax pseudoginseng - Himalayan Ginseng Panax quinquefolius - American Ginseng Panax trifolius - Dwarf Ginseng Panax vietnamensis - Vietnamese Ginseng Ginseng (Panax) is a genus of about five or six species of slow-growing perennial plants with fleshy roots, in the family Araliaceae. ... Species Panax ginseng - Chinese Ginseng Panax japonicus - Japanese Ginseng Panax pseudoginseng - Himalayan Ginseng Panax quinquefolius - American Ginseng Panax trifolius - Dwarf Ginseng Panax vietnamensis - Vietnamese Ginseng Ginseng (Panax) is a genus of about five or six species of slow-growing perennial plants with fleshy roots, in the family Araliaceae. ...

Enzyte

Enzyte is a product that has been advertised by saturation coverage on television channels such as Court-TV. However, the Center for Science in the Public Interest (CSPI) has filed a complaint with the Federal Trade Commission (FTC) about Enzyte for deceptive advertising. It is manufactured by Berkeley Nutritionals, which is alleged to be the subject of an investigation by the Attorney General of Ohio and the defendant in class-action lawsuits. Categories: United States federal agencies | Stub ... State nickname: The Buckeye State Other U.S. States Capital Columbus Largest city Columbus Governor Bob Taft Official languages None Area 116,096 km² (34th)  - Land 106,154 km²  - Water 10,044 km² (8. ...

Enzyte is a supplement that claims to increase the frequency of erections of the male penis or libido. Commercials for Enzyte are shown regularly on television. These commercials feature a man named Bob who never stops smiling, apparently because he had taken Enzyte and improved the size of his sex organs. The commercials are riddled with symbolic phallic imagery, e.g. golf clubs, remarkably tall glasses of iced tea, and a hose spraying barely a trickle of water (carried by someone who doesn't use Enzyte). The penis (plural penises or penes) or phallus is the external male copulatory organ, and, in mammals, the external male organ of urination. ... For the Peruvian rock group, see Libido (band). ... Phallic symbols are forms or concepts considered to be representations of the penis (or phallus) and the fertility and cultural implications that are associated with the male sexual organ. ... Golfer teeing off at the start of a hole Golf is an outdoor game where individual players or teams play a small ball into a hole using various clubs. ...

The effectiveness of Enzyte is in dispute. Some medical professionals in fact advise against taking Enzyte, saying that it can lead to damage. The Center for Science in the Public Interest have urged the Federal Trade Commission to disallow further television advertising for Enzyte due to a lack of proper studies supporting claims. Enzyte maker Berkeley Premium Nutraceuticals, Inc., is currently under a class action lawsuit for false advertising. The Center for Science in the Public Interest is a non-profit organization that focuses on issues relating to foods and the foodservices industry. ... Categories: United States federal agencies | Stub ... Generally speaking, advertising is the paid promotion of goods, services, companies and ideas by an identified sponsor. ... In law, a class action is an equitable procedural device used in litigation for determining the rights of and remedies, if any, for large numbers of people whose cases involve common questions of law and fact. ... False advertising is an act of deliberately misleading a potential client about a product, service or a company in general by reporting false or misrepresenting information or data in advertising or other promotional materials. ...

Enzyte is said to contain: Tribulus terrestris; Yohimbe Extract; Niacin; Epimedium; Avena sativa; Zinc Oxide; Maca; Muira Pauma; Ginkgo biloba; L-Arginine; Saw Palmetto. Other ingredients: gelatin, rice bran, oat fiber, magnesium stearate, silicon dioxide. Binomial name Tribulus terrestris Linnaeus Goathead fruit Puncture Vine (Tribulus terrestris), also known as Caltrop, Yellow Vine, and Goathead, is an herb used for its virilizing effects. ... Niacin, also known as nicotinic acid or vitamin B3, is a water-soluble vitamin whose derivatives such as NADH play essential roles in energy metabolism in the living cell. ... Epimedium, also known as Horny Goat Weed, is an herbal extract with reported aphrodisiac qualities. ... Species References ITIS 41455 2002-09-22 Oats are the seeds of any of several cereal grains in the genus Avena. ... Binomial name Ginkgo biloba L. The Ginkgo (Ginkgo biloba), sometimes also known as the Maidenhair tree, is a unique tree with no living relatives. ... Arginine Arginine is one of the 20 most common natural amino acids. ... Binomial name Serenoa repens Hooker The Saw Palmetto is the sole species currently classified in the genus Serenoa. ...

History

Dr. John R. Brinkley began a fad for finding cures for male impotence during the 1930s. He used the medium of radio to achieve the same kind of advertising boom to treat the same kind of symptoms. This article is about the medical doctor known for his Mexican border blaster broadcasts, for the first Astronomer Royal of Ireland (1763 – September 14, 1835), see John Brinkley. ... Events and trends Technology Jet engine invented First atom was split with a particle accelerator Golden Age of radio begins in U.S. Science Nuclear fission discovered by Otto Hahn, Lise Meitner and Fritz Strassmann Pluto, the ninth planet from the Sun, is discovered by Clyde Tombaugh British biologist Arthur...

In the 1930s the American radio airwaves were bombarded with such advertising, first from domestic stations and then upon action by the American Medical Association the media blitz was shifted to superpower Mexican border-blasters. Events and trends Technology Jet engine invented First atom was split with a particle accelerator Golden Age of radio begins in U.S. Science Nuclear fission discovered by Otto Hahn, Lise Meitner and Fritz Strassmann Pluto, the ninth planet from the Sun, is discovered by Clyde Tombaugh British biologist Arthur... The American Medical Association (AMA) is the largest association of medical doctors in the United States. ... A border blaster, unlike an international broadcasting station, is a term that has been specifically used to describe licensed commercial radio stations that have transmited at very high power to the United States of America from various points along the Mexican side of the border. ...

References

• Cheitlin MD, Hutter AM Jr, Brindis RG, Ganz P, Kaul S, Russell RO Jr, Zusman RM. ACC/AHA expert consensus document. Use of sildenafil (Viagra) in patients with cardiovascular disease. American College of Cardiology/American Heart Association. J Am Coll Cardiol. 1999 Jan;33(1):273-82. Fulltext (http://www.acc.org/clinical/consensus/viagra.htm). PMID 9935041.

External sources

• PDE5 inhibitors:
  • Home Page for Viagra (http://www.viagra.com/) and prescribing information (http://www.pfizer.com/download/uspi_viagra.pdf) (PDF)
  • Official Levitra website (http://www.levitra.com/)
  • Pfizer Pharmaceutical (Company website) (http://www.pfizer.com/) - manufacturer of Viagra;
  • FDA Web Site for Viagra Consumer Information (http://www.fda.gov/cder/consumerinfo/viagra/)
  • Viagra Misunderstood (http://www.usrf.org/breakingnews/bn_111202_viagra/bn_111202_viagra.html) Article describing what Viagra feels like
• FDA's Consumer Information (http://www.fda.gov/cder/consumerinfo/druginfo/levitra.htm)
• Enzyte Company website (http://www.mgsglaw.com/enzyte.html)
• Enzyte investigation reported on CBS-TV news site (http://www.cbsnews.com/stories/2004/09/23/health/webmd/main645232.shtml)