Building New Therapies for Impotence

Stephen M. Stahl, M.D., Ph.D

Issue: Impotence is a common and distressful condition in men. Physicians are uniquely positioned to treat male sexual dysfunction of both functional and organic etiologies by combining traditional psychological approaches with a variety of new therapeutic agents. (J Clin Psychiatry 1998;59:47-48)
Impotence, the inability to maintain an erection sufficient for intercourse, is more properly called erectile dysfunction.1 Up to 20 million men in the United States have this problem to some degree.2 The multiple causes of erectile dysfunction include vascular insufficiency, neurologic causes, endocrine pathology (reproductive hormones, thyroid, diabetes), drugs, local pathology in the penis, and psychological/psychiatric problems.1

Plumbing and Listening Are the
Traditional Treatment Strategies

Until recently, effective treatment of organic causes of erectile dysfunction was often elusive and usually involved a urologic approach, such as prostheses and implants to compensate for faulty wires and leaky plumbing. This surgical strategy bypasses diseased peripheral nerves and inadequate vascular supply to create erections mechanically and on demand, but has serious limitations in terms of patient and partner acceptability.1,3

Brainstorms aims to provide updates of novel concepts that have relevance to practitioners.

From the Clinical Neuroscience Research Center in San Diego and the University of California San Diego.