Is There a Space to Improve the Treatment of Erectile Dysfunction in the Next Years? Opinion: No. Ten reasons that there will be no new pharmacologic therapies for erectile dysfunctionin the foreseeable future

Abstract

BAcKgROunDFrom the 1960s to the 1990s, breakthrough developments in sexual medicine occurred about once every ten years. In the decade of the 1960s, there was the launch of birth control pills for women and the resulting sexual revolution. This was followed by penile implant surgery in the 1970s, intracavernous injection therapy in the 1980s and oral therapy with phosphodiesterase type 5 (PDE5) inhibitors in the late 1990s. Landmark developments since then have been the approval in 2013 of collagenase clostridium histolyticum for intralesional treatment of Peyronie's disease and the very recent approval in 2015 of flibanserin for the treatment of hypoactive sexual desire in pre-menopausal women. However, no landmark development has occurred for the treatment of erectile dysfunction since the introduction of PDE5 inhibitors starting in 1998. Moreover, there are no clinically relevant innovations on the horizon for erectile dysfunction. It is likely that current PDE5 inhibitors and intracavernous agents will be the last pharmacologic therapies for erectile dysfunction in the foreseeable future. There are ten reasons for this.