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John Brinkley initiated a boom in male impotence cures in the U.S. Impotence can be treated — sometimes even without drugs. If never, the problem is likely to be physiological; if sometimes (however rarely), it could be physiological or psychological. Additionally, adequate levels of testosterone (produced by the testes) and an intact pituitary gland are required for the development of a healthy erectile system. Modern drug therapy for ED made a significant advance in 1983, when British physiologist Giles Brindley dropped his trousers and demonstrated to a shocked Urodynamics Society audience his papaverine-induced erection.[30] The drug Brindley injected into his penis was a non-specific vasodilator, an alpha-blocking agent, and the mechanism of action was clearly corporal smooth muscle relaxation. More than nine clinical studies performed by six universities and academic hospitals on this purified extract have confirmed the herb's beneficial effect. Their absence may indicate a problem with nerve function or blood supply in the penis. Stimulation of the 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. Duplex ultrasound is used to evaluate blood flow, venous leak, signs of atherosclerosis, and scarring or calcification of erectile tissue. Secondary impotence, defined as the loss of erectile function after a period of normal function, is more common.

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The effect that Brindley discovered established the fundamentals for the later development of specific, safe, orally effective drug therapies. It is estimated that about 10% to 20% of impotence cases are the direct result of various psychological factors, such as low self-esteem, depression, and — especially — stress and anxiety (general and performance anxieties). Although they are generally safe and free of side effects (unlike chemical drugs), it is important to know that the quality of their extraction and preparation processes varies widely. This device works quite well, although some men complain about the discomfort of the elastic ring in addition to the hassle of, well, pumping up.

-Mr.Robinson, Ohio