Expectations are funny things. You have them and then find yourself surprised when they prove wrong. It’s like assuming every classic diner will serve apple pie only to find some that don’t. So, browsing through the news, I was surprised to come across a news item about the latest words of wisdom to fall from the lips of the American College of Physicians (ACP). For those of you who don’t follow medical affairs, the ACP was founded in 1915 and has 120,000 internists in its organization. This makes it the largest specialty organization in the medical field. You expect this kind of body to be on top of things. With advances in medical technology stunning us every week, you look to the ACP for leadership, promoting excellence and professionalism among its members by issuing guidelines and advice based on the latest evidence. So here is their latest offering. It’s finally official. The best treatment for erectile dysfunction is a PDE5 inhibitor pill.

So, all you doctors living out there in the boondocks, you must stop prescribing and recommending those pump devices. You know those vacuum tubes that encourage a hard erection when you pump out the air. More effective but painful and less convenient were those injections. Patients always liked the words of encouragement that being injected in the penis was no worse than being slapped by an elastic band on the rebound. And no more of those suppositories. Yes, keeping regular is good for you and, with the right chemicals inside and a lot of belief, there were times when these worked. Then there were all those creams, gels and patches. You know the ones. They were stuffed full of good things like male hormones. And all those other pills offering enhancement. . . Well, you can put all those things away in a drawer, turn the key and forget about them. The ACP has spoken in its voice of thunder. Apart from psychotherapy which can be useful if the cause of the ED is mainly psychological, the best therapy is a PDE5 inhibitor. According to the evidence, about 88% of all men using viagra find their ED is cured on the first use. The well-advertized testosterone gels and creams were no better than the placebos.

The ACP did talk wisely about dosages, indicating that slightly higher dosages yielded the best results. Their advice was also balanced. Yes, there were occasional side effects. Indeed, the committee members called for more research to determine which of the PDE5 inhibitors caused the most problems. But, as it stands, most men preferred a hard erection and were prepared to tolerate the odd runny or blocked-up nose. Why, you might ask, has the ACP decided to talk now. The answer is quite revealing. The US has an ageing population and more men are reaching an age when they may expect problems of ED. In 2025, the ACP estimates there will be more than 300 million men seeking help. This makes the ED market worth billions so they decided to endorse viagra now. Significantly, only one of the authors of this report disclosed funding from the ED manufacturers so that makes this report timely, balanced and reliable.