Healthsystem

The Serendipitous Story of Sildenafil: An Unexpected Oral Therapy for Erectile Dysfunction

Irwin Goldstein 1 , Arthur L Burnett 2 , Raymond C Rosen 3 , Peter W Park 4 , Vera J Stecher 4
Affiliations expand
PMID: 30301707 DOI: 10.1016/j.sxmr.2018.06.005
Abstract

Introduction: The serendipitous discovery of sildenafil (Vi**ra [sildenafil citrate]) as a treatment for erectile dysfunction (ED) is one of the most fascinating drug development stories of our time. When sildenafil was approved by the U.S. Food and Drug Administration in 1998, it revolutionized the treatment protocol for men with ED, once considered a psychological issue or an inevitable part of aging.

Aim: To review the discovery of sildenafil and its role in changing the field of s*xual medicine in the context of the epidemiology and history of treatment for ED.

Methods: For this narrative review, a literature search was conducted to identify essential articles and was supplemented by author observations from a historical perspective.

Main outcome measure: A broad overview of ED and its past, current, and future treatments.

Results: ED is a prevalent condition for which medical treatment had been limited to genitally localized interventions, including surgery, vacuum pumps, injectable therapies, and intraurethral suppositories. The discovery of sildenafil provided a safe, oral pharmacotherapy for the treatment of ED, sparking greater understanding of the science behind ED and its role in men's overall health.

Conclusion: The approval of sildenafil initiated a global conversation about ED that had profound implications for patients, methods of clinical practice, and academic s*xual medicine. These changes will catalyze continued advances in ED treatment. Goldstein I, Burnett AL, Rosen RC, et al. The serendipitous story of sildenafil: an unexpected oral therapy for erectile dysfunction. S*x Med Rev 2019;7:115-128.

Keywords: Clinical Trials; Erectile Dysfunction; Impotence; Nitric Oxide; Sildenafil.

Copyright © 2018 International Society for S*xual Medicine. Published by Elsevier Inc. All rights reserved.

Cutting through the Paleo hype: The evidence for the Palaeolithic diet

Christopher E Pitt
PMID: 27051985
Free article
Abstract

Background: General practitioners (GPs) are commonly asked about popular diets. The Palaeolithic diet is both highly popular and controversial.

Objective: This article reviews the published literature to establish the evidence for and against the Palaeolithic diet.

Discussion: The Palaeolithic diet remains controversial because of exaggerated claims for it by wellness bloggers and celebrity chefs, and the contentious evolutionary discordance hypothesis on which it is based. However, a number of underpowered trials have suggested there may be some benefit to the Palaeolithic diet, especially in weight loss and the correction of metabolic dysfunction. Further research is warranted to test these early findings. GPs should caution patients who are on the Palaeolithic diet about adequate calcium intake, especially those at higher risk of osteoporosis.