Approximately 50% of men over the age of 60 suffer from erectile dysfunction, and the percentage continues to rise with older age. The current story begins 40 years ago, when there was no treatment for erectile dysfunction, and this is where Dr. Giles Brindley (58 years old) comes in. He was a British researcher who wanted to test the effect of different substances on treating erectile dysfunction. He chose to try these substances on himself (!) and injected them into his own personal penis. That was personal commitment! The effort paid off, one substance was effective. It worked without sexual stimulation, unlike Viagra that was developed about 20 years later and needs a sexual trigger. He presented the results at an unforgettable scientific conference in 1983 (unforgettable for reasons that will be clarified shortly). Not only he tested the drugs on himself, his personal commitment to research was demonstrated again when he presented personal photos during the lecture, which testify to the success of the treatment, yup.
Dr. Brindley knew his peers were critical, he was concerned that they would claim that the non-refutable evidence of his anti-impotence drug (which they clearly viewed in the photos) was due to sexual stimulation and not by merely the injection of the substance. Therefore, before the lecture he had injected himself again the substance and he lectured dressed in training wear instead of a suit. The reason for the unconventional attire became clear when, to the audience's surprise, he stepped off the podium, pulled up his pants to reveal the results of the experiment. The audience did confirm that under these non-erotic conditions, indeed, Dr. Brindley did not suffer from impotence. However, Dr. Brindley felt that the evidence was not convincing enough, so he removed his pants (!) and underwear(!?) to provide the audience with a clearer view and dispel any doubts! As if that wasn't enough, he even walked with his pants off down from the stage so that the front row could judge the success of the experiment. Spontaneous screams from the front row brought him back to the stage, and he finished the unforgettable lecture. According to Dr. Brindley's claim, it was the chairman of the conference who asked him to show his organ and not settle for a visual demonstration through slides. He only did so after being assured that there were no journalists present in the audience. Since it was a urology conference, he assumed that they were accustomed to seeing exposed genital organs. Indeed, Dr. Brindley was the first to demonstrate that erection can be separated from sexual stimulation and is not dependent on psychological intervention: it is possible to create an erection without any stimulation through the use of chemical substance that increase blood flow into the penis. But Viagra, which was introduced to the world about 15 years later, succeeded because it causes erections only in the presence of sexual stimulation.
Dr. Giles Brindley from VIAGRA KNIGHTS It should be noted that for many years, the prevailing belief was that erectile dysfunction was caused by psychological factors such as performance anxiety. Men with erectile dysfunction were sent to work on their relationship with their mother, which (perhaps) helped them in their relationship with their mother but had less effect on their erectile dysfunction. Dr. Brindley was a physician, professor, inventor, athlete, musician, and esteemed researcher in the field of physiology. In the 1960s, he invented the electric Bassoon (a musical instrument), conducted research on star twinkling, as well as on the visual system, and made important discoveries. Additionally, he developed devices that interface with the nervous system (!) to restore vision for the blind, alleviate pain, and enable ejaculation for individuals with lower body paralysis. This last device was most successful and is still in use today and allows paralyzed individuals to empty their bladder. As of 2023, Dr. Brindley is already 97 years old, and for about 30 years, he has been carrying within his scrotum a device that, with the press of a button, injects the substance into the penis and causes an erection!. Undoubtedly, he is an inventor extraordinaire.
He became famous because of his unforgettable performance at that conference in 1983, and it should be noted that the norms were different back then. At that time, before the era of Me Too, the story was received as a crazy and amusing tale of a brilliant and extraordinary scientist, and it did not have negative implications on his career. In fact, three years after that conference, in 1986, Dr. Brindley was knighted for his research in the field of biomedical engineering and became Sir Dr. Brindley. Beyond the bizarre story, the story was scientifically significant: it demonstrated that erectile dysfunction could be solved with local treatment to the penis. Thus, even if the source of the problem is in the brain (i.e., psychological) or due to insufficient blood flow to the penis, it would still be possible to restore erections. The blood vessels in the penis are particularly sensitive to vascular issues (hence, erectile dysfunction can be an early sign of future vascular problems and aid in early diagnosis). Although the treatment involved injecting the penis, which was not cheered by the public, men would go to great lengths to regain their erections. In fact, there have been reports since at least the 17th century of physicians injecting various substances into their patients' penises to treat erectile problems, including extracts from monkey testicles or the installation of implants. Perhaps, after all, it is preferable to work on the relationship with one's mother? In any case, nowadays, fortunately for those who suffer from the problem, there are pills available, with the most well-known being the first one to enter the market: Viagra. Not only is it not an injection, but an erection occurs only when there is sexual stimulation. To briefly explain how this magic happens, I will explain how an erection actually occurs. How an erection occurs
Inside the penis, there is tissue that contains small chambers surrounded by muscle. Each chamber receives blood from an artery. Subsequently, the blood exits the chamber through a vein. During an erection, the muscles surrounding the main artery expand, allowing more blood to flow into the chambers. Simultaneously, the muscles surrounding the chambers also expand, effectively "sucking" the blood from the arteries due to their enlargement. In contrast, the rate of blood outflow from the chambers remains unchanged, resulting in the chambers becoming filled. At a certain point, the chambers expand so much that they press against the veins (which drain the chambers), making it difficult for the blood to exit. This leads to further engorgement of the penis. It is worth noting that this process also occurs in the clitoris. The substance that Dr. Brindley discovered relaxes the muscles surrounding the chambers and arteries, allowing for an erection until the substance dissipates from the body. How does an erection occur naturally, without injecting an external substance like Dr. Brindley did? The command for an erection is sent from the spinal cord to the muscles surrounding the arteries and chambers, causing them to relax. This allows the chambers to fill up, resulting in an erection. In other words, the nerve command reaches the muscle cells, and within these muscle cells, a substance called cGMP (cyclic guanosine monophosphate) is produced, which causes relaxation and leads to an erection. However, to prevent men from constantly having an erection, there is also a reverse process within the muscle cells that breaks down cGMP. Viagra inhibits this reverse process, the breakdown of cGMP. Therefore, in the presence of Viagra, when there is nerve stimulation to the muscle, cGMP is produced in the muscle cells and accumulates to a greater amount than usual because its breakdown is much slower. This accumulation of cGMP successfully causes relaxation in the muscle cells, allowing for increased blood flow, filling of the chambers, and achieving an erection. When the sexual stimulation ceases, the nerve command stops, the production of cGMP ceases, the cGMP that was already formed gradually breaks down. Although the breakdown is slower due to the influence of Viagra, in a man with erectile dysfunction, the processes that decrease the erection are already enhanced. Therefore, a person without erectile dysfunction who takes a high dosage of Viagra may find themselves with a prolonged erection even after the sexually arousing stimulus is over. For those who like it deeper: The breakdown of cGMP occurs with an enzyme called phosphodiesterase type 5, abbreviated as PDE5. Therefore, the inhibitors of this breakdown are called PDE5 inhibitors. Nowadays, besides Viagra, there are other medications (such as Cialis, Levitra, and Stendra) that also inhibit the breakdown of cGMP, but they do so with different active ingredients. This results in differences in the duration of action and side effects, but the principle remains the same. The main advantage of Viagra, Cialis, Levitra, and Stendra is that they reduce the decline of an erection, so when there is no sexual stimulation, they have no effect. The active ingredient in Viagra is called Sildenafil. By the way, Caffeine is another substance that delays the breakdown of this cGMP. Caffeine affects other cell groups, meaning its influence is less specific to muscle cells in the penis compared to medications, and it affects other cells in the body as well. Indeed, in rats with diabetes, a daily intake of 10 mg (per kg of body weight) of caffeine for two months improved erection. The discovery of Viagra
In fact, Pfizer stumbled upon Viagra by chance. The company had developed the active substance to dilate blood vessels as a treatment for high blood pressure and angina. The development team assumed that the substance would work on all blood vessels in the body and did not expect it to be specifically effective on the muscles surrounding the blood vessels in the genital organ. To their surprise, some of the patients in the clinical trial returned with overwhelmingly positive feedback, refusing to stop the trial, and the side effect became apparent.
The field of sexuality was considered - unjustly - less respectable, and Pfizer needed some persuasion to enter this domain. Eventually, they entered, and on March 27, 1998, they launched Viagra. Sales spoke for themselves: $400 million in the first three months.
The word "Viagra" is indeed a tiger in Sanskrit but is also derived from the name of one of the researchers who had a significant contribution in persuading Pfizer to turn the bag into a feature: Dr. Virag. Dr. Virag, a French cardiologist, accidentally discovered that injecting a substance that relaxes muscle cells into the penis causes an erection, similar to the experiments Dr. Brindley conducted on himself during the same period. He published his discovery in a less dramatic way than Dr. Brindley: a letter to the prestigious medical journal Lancet's editor. After several years, as a cardiologist, Dr. Virag was involved in Pfizer's original experiment aimed at solving a cardiovascular problem. When the failure of the experiment became apparent, with its unexpected side effect, he was central in convincing Pfzier to make lemonade out of the lemons, so to speak.
What about Viagra for women?
Indeed, Viagra also works for women by enhancing blood flow to the genital area and causing arousal of the clitoris. However, the idea that Viagra would ignite a burst of desire in women has failed. In 2004, Pfizer discontinued the attempt to use Viagra for enhancing desire in women who suffer from low sexual desire. This is not surprising because Viagra does not affect sexual desire but rather influences muscle cells. Therefore, attempts to treat the most common sexual problem in women, low sexual desire, with Viagra have not been successful.
But read my post on the pink pill!
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Read more:
2. Dr. Brindely's music skills and personality. 3. Biographical sketch: Giles Brindley, FRS Jacob Kan, Tipu Z. Aziz, Alexander L. Green & Erlick A. C. Pereira (2014) British Journal of Neurosurgery 4. VIAGRA KNIGHTS
6. Effect of caffeine on erectile function via up-regulating cavernous cyclic guanosine monophosphate in diabetic rats
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