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Reference

Glossary

Erectile dysfunction medicine runs on terminology that nobody explains to you in a ten-minute appointment. These are the words you will meet, in plain English, each linked to the page that covers it in full.

Terms defined
66
Categories
5
Cross-linked
Yes
Jargon tolerated
None

Anatomy & physiology

Cavernosal arteries
The arteries supplying blood to the erectile tissue. At roughly 1–2 mm across they are much narrower than the coronary arteries, which is why they show vascular disease first.More →
Cavernous nervesneurovascular bundles
The parasympathetic nerves that trigger an erection. They run alongside the prostate, which is why prostate surgery so often affects erectile function.More →
Corpora cavernosacorpus cavernosum
The two cylinders of spongy erectile tissue running the length of the penis. They do essentially all the work of an erection.More →
Corpus spongiosum
The third, smaller cylinder on the underside of the penis carrying the urethra. It stays softer during an erection so ejaculation is not obstructed.More →
Cyclic GMPcGMP
The signalling molecule that relaxes smooth muscle in the penis and allows blood in. PDE5 inhibitors work by preventing its breakdown.More →
Detumescence
The return to a flaccid state, driven by noradrenaline from the sympathetic nervous system contracting the smooth muscle.More →
Endothelium
The single-cell lining of blood vessels, which produces nitric oxide. Endothelial dysfunction is the shared mechanism linking ED with cardiovascular disease.More →
Ischiocavernosus
A pelvic floor muscle at the base of the penis that raises internal pressure beyond what blood flow alone achieves. It is trainable.More →
Nitric oxideNO
The messenger released by nerve endings and blood vessel lining during arousal. It triggers the cascade that produces an erection.More →
Nocturnal penile tumescenceNPT · morning wood · morning erections
Erections occurring during REM sleep, typically three to five a night. Their presence indicates the physical mechanism is intact.More →
Psychogenic erection
An erection triggered by thought, sight or arousal in the brain rather than by touch.More →
Reflexogenic erection
An erection triggered by direct physical stimulation through a spinal reflex, without needing a signal from the brain. Often preserved after spinal cord injury.More →
Tunica albuginea
The tough fibrous sheath around each corpus cavernosum. It is what makes an erection rigid rather than merely swollen, and the structure that scars in Peyronie's disease.More →
Veno-occlusive mechanismvenous occlusion
The process by which expanding erectile tissue compresses the outflow veins against the tunica albuginea, trapping blood and producing rigidity. Its failure is venous leak.More →

Conditions & causes

Atherosclerosis
Plaque build-up narrowing arteries. Because penile arteries are narrow, it causes symptoms there before the heart or brain.More →
Autonomic dysreflexia
A dangerous blood pressure surge triggered by stimulation below a spinal cord injury at or above T6, including sexual activity. Needs a plan agreed in advance.More →
Autonomic neuropathy
Damage to the involuntary nerves, commonly from diabetes. It interrupts the signal that starts an erection, which is why tablets work less well.More →
Benign prostatic hyperplasiaBPH · enlarged prostate
Non-cancerous prostate enlargement causing urinary symptoms. Daily tadalafil is licensed to treat both BPH and ED.More →
Erectile dysfunctionED · impotence
The persistent inability to get or keep an erection firm enough for satisfactory sex. The usual clinical threshold is difficulty on most attempts over about three months.More →
Hyperprolactinaemiahigh prolactin
Raised prolactin, which suppresses testosterone production. Causes include medication, underactive thyroid and a benign pituitary tumour.More →
Hypogonadismlow testosterone · low T
Deficient testosterone production. Diagnosis requires two low morning blood tests plus matching symptoms.More →
Metabolic syndrome
The cluster of central obesity, raised blood pressure, raised glucose and abnormal lipids. Strongly associated with erectile dysfunction.More →
NAIONnon-arteritic anterior ischaemic optic neuropathy
Sudden painless vision loss in one eye. A very rare adverse effect associated with PDE5 inhibitors; previous episodes are a contraindication.More →
Neuropraxia
Temporary loss of nerve function from stretching or bruising rather than division. It explains why erectile function can recover over 12–24 months after nerve-sparing prostate surgery.More →
Obstructive sleep apnoeaOSA · sleep apnea
Repeated airway collapse during sleep. It fragments REM, suppresses testosterone and damages blood vessels — a commonly missed cause of ED.More →
Performance anxietyspectatoring
Anxiety about sexual performance that activates the sympathetic nervous system — the exact chemical signal that ends an erection.More →
Peyronie's disease
Fibrous scar tissue in the tunica albuginea causing penile curvature, pain and often erectile dysfunction.More →
Priapism
An erection lasting more than four hours. A medical emergency — go to an emergency department, as delay risks permanent tissue damage.More →
Prolactinoma
A benign pituitary tumour that secretes prolactin. Usually treated with dopamine agonists rather than surgery.More →
Retrograde ejaculation
Semen passing backwards into the bladder rather than out. Common after prostate surgery and often mistaken for erectile dysfunction.More →
Venous leakveno-occlusive dysfunction
Failure to trap blood in the penis, producing an erection that starts well then fades within a minute or two.More →

Treatments & medication

Alpha-blocker
Drugs such as tamsulosin and doxazosin for prostate or blood pressure symptoms. They lower blood pressure, so PDE5 inhibitors need careful dose separation.More →
Alprostadilprostaglandin E1 · Caverject · Edex · MUSE
A vasodilator given by penile injection, as a urethral pellet or as a cream. It works directly on the erectile tissue without needing a nerve signal.More →
AvanafilStendra
The newest and most selective PDE5 inhibitor, with the fastest onset — as little as 15 minutes — and the highest price.More →
Clomipheneclomifene
Raises the body's own testosterone by blocking oestrogen feedback at the pituitary. Fertility-preserving, and used off-label in men.More →
Constriction ringtension ring · cock ring
A ring at the base of the penis that slows blood leaving it. Maximum 30 minutes of use.More →
CYP3A4 inhibitor
Drugs including ketoconazole, ritonavir and clarithromycin that slow the breakdown of PDE5 inhibitors, raising blood levels and requiring dose reduction.More →
hCGhuman chorionic gonadotropin
Stimulates the testicles to produce their own testosterone while preserving sperm production. Used off-label where fertility matters.More →
Intracavernosal injectionICI · penile injection
Injection of medication directly into the erectile tissue. Success rates of 70–90%+, including in men for whom tablets failed.More →
Li-ESWTshockwave therapy · low-intensity extracorporeal shockwave therapy
Acoustic pressure waves applied to the penis, intended to stimulate new blood vessel growth. Classed as investigational and not FDA-approved for ED.More →
Nitrates
Drugs including nitroglycerin and isosorbide, plus recreational 'poppers'. Absolutely contraindicated with any PDE5 inhibitor.More →
PDE5 inhibitorphosphodiesterase type 5 inhibitor
The drug class including sildenafil, tadalafil, vardenafil and avanafil. They block the enzyme that breaks down cyclic GMP.More →
Penile prosthesispenile implant · inflatable penile prosthesis · IPP
Surgically implanted cylinders that restore rigidity. The highest satisfaction rate of any ED treatment, and irreversible.More →
Penile rehabilitation
Using medication, a vacuum device or injections after prostate surgery to keep erectile tissue oxygenated while nerves recover.More →
Platelet-rich plasmaPRP · P-Shot
Concentrated platelets from your own blood, injected into the penis. Not FDA-approved for ED, and sham-controlled evidence has not shown clear benefit.More →
Sensate focus
A structured programme of graded touching exercises with intercourse initially off the table. Removing the goal removes the performance test.More →
SildenafilViagra
The original PDE5 inhibitor. Onset 30–60 minutes, useful window 4–6 hours, and inexpensive as a generic.More →
TadalafilCialis
A long-acting PDE5 inhibitor with a useful window up to 36 hours, and the only one with a licensed daily dose.More →
Testosterone replacement therapyTRT
Treatment for confirmed testosterone deficiency. It suppresses sperm production, so fertility must be discussed before starting.More →
Trimixbimix
A compounded injectable mixture of papaverine, phentolamine and alprostadil. Effective at lower doses of each, so less painful than alprostadil alone.More →
Vacuum erection deviceVED · penis pump
A cylinder and pump that draws blood into the penis mechanically, held by a constriction ring. Works independently of nerves and arteries.More →
VardenafilLevitra · Staxyn
A PDE5 inhibitor similar in duration to sildenafil. Carries a QT-interval caution that the others do not.More →

Tests & measurements

Haematocrit
The proportion of blood made up of red cells. Monitored during testosterone therapy because the treatment can raise it to unsafe levels.More →
HbA1c
A blood test reflecting average glucose over about three months. Used to screen for diabetes, a leading cause of ED.More →
IIEF-5SHIM · Sexual Health Inventory for Men
A five-question screening questionnaire scoring erectile function from 5 to 25. Describes severity; it is not a diagnosis.More →
LH and FSHluteinising hormone · follicle-stimulating hormone
Pituitary hormones measured alongside testosterone. A low testosterone with low or normal LH points upstream to the pituitary rather than the testicles.More →
Penile duplex Doppler ultrasound
An ultrasound measuring penile blood flow after an injected vasodilator. Used to distinguish arterial insufficiency from venous leak.More →
SHBGsex hormone binding globulin
The protein that binds testosterone in the blood. Useful when total testosterone is borderline, particularly in obesity or diabetes.More →

Commercial & regulatory

Bioequivalence
The standard a generic must meet: the same rate and extent of absorption as the original, within defined limits.More →
Compounded medication
A preparation mixed by a pharmacy to a prescription. Legal, but not FDA-approved for that formulation — which covers most chewable ED products and trimix.More →
De Novo pathway
An FDA route to market for novel low-to-moderate risk devices with no existing equivalent. Used by some newer topical ED products.More →
FDA-registered vs FDA-approved
Registration is an administrative listing by the manufacturer. Approval or clearance means the FDA has actually evaluated the product. Marketing frequently blurs the two.More →
Formulary
The list of drugs a plan or pharmacy covers or stocks. ED medication is excluded from many US formularies entirely.More →
Prior authorisation
Insurer approval required before a treatment is covered. The most common obstacle to second- and third-line ED treatment.More →
Step therapy
An insurance requirement to try cheaper treatments first. Documenting those failures is what unlocks the next step.More →

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