Acclaimed American filmmaker Spike Lee is currently working on an all-singing all-dancing movie musical about the discovery of the erectile dysfunction (ED) drug Viagra, based on a 2018 Esquire article that traced the discovery and marketing of the medicine. Also known as sildenafil, the drug was approved for use in the US and Europe in 1998 and became available in generic form in 2017 after patents by Pfizer expired – in the UK, it’s even available over the counter.
Although Viagra is no longer the only pharmaceutical treatment available for people with ED, it’s by far the most well-known. However, it also comes with a number of side effects and contraindications, some of which are rather bizarre. It can cause several adverse events, from headaches to heart attacks, and some users have even complained about seeing the world around them tinted blue, or experienced sudden hearing loss. The drug can also interfere with protease inhibitors taken for the treatment of HIV and can’t be taken in conjunction with certain nitric oxide donors, organic nitrites and nitrates.
For those who find the side effects of pharmacological treatment too unpleasant, or aren’t viable to take them, physical interventions are an alternative option. Devices such as such as pumps and rings can help wearers maintain erections, or eligible candidates may also choose to undergo penile implant surgery and have an inflatable or semirigid device implanted into their penis.
Medtech start-up Giddy has now developed a novel ED device called Eddie that aims to rethink the way physical interventions can help manage erectile dysfunction. Now registered as a Class II medical device with the US Food and Drug Administration (FDA), the inventors hope Eddie can help more people with ED experience enjoyable sex lives.
Giddy CEO Brett Jacobson says: “You’ve got roughly 50 million men suffering from ED in the US alone and yet 70% to 80% of these men don’t utilise an ED treatment, not because they’re not willing to spend the money and not because they’re not willing to put in the effort, but because they have tried everything in the past and nothing has worked for them.”
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How do other ED devices work?
ED rings work best for patients who can achieve an erection but cannot maintain it. They apply pressure to the area surrounding the penis, and sometimes to the penis and testicles themselves, causing the blood vessels in the area to constrict and let blood out of the penis more slowly. This helps the wearer maintain their erection for longer.
Meanwhile, pumps can help both achieve and maintain an erection by drawing blood into the penis via air suction – simply place the penis in an airtight tube and pump the air out slowly, causing the organ to fill with blood. However, this can interfere somewhat with spontaneity and some men find it too uncomfortable to use, as the suction can lead to pain and bruising.
On the surface, Eddie resembles a traditional ring device, which ED patients might choose to use, but Giddy says it improves upon the other solutions that currently exist on the market in a number of ways.
“The inventor of Eddie was an 88-year-old machinist who had erectile dysfunction as a result of prostate cancer,” says Jacobson. “He realised that all the products on the market tried to do one of two things. They either tried to increase blood flow to the penis or reduce blood flow out. The problem is in an effort to do one of those two things every product on the market inadvertently does the other as well, so every product on the market is essentially defective in its very design because it works against the normal physiology of an erection.”
What makes Eddie different?
To understand how Eddie improves upon other ED rings, it’s important to understand the anatomy of the penis.
Giddy’s consultant urologist Dr Christopher Kyle says: “There are three tubes—two that fill with blood for erections, known as the corpora cavernosa and one that surrounds the urethra, called the corpus spongiosum. The corpus spongiosum also provides the blood supply to the head of the penis.”
During a normal erection, the arteries inside the penis dilate and push blood into the corpus cavernosa. This process also causes the deep dorsal vein at the top of the penis to compress.
ED rings attempt to mimic the pressure that occurs during this process by stopping blood from leaving the penis, but their circular form can often force the flesh of the penis to bend unnaturally. This also compresses the arteries, stunting the body’s natural blood flow and producing uncomfortable feeling erections. They can also constrict the urethra, leading to discomfort during ejaculation and a numbing sensation in the head of the penis.
“Eddie, due to its unique shape, compresses the corpora cavernosa, but not the corpus spongiosum, allowing for a more natural ejaculation and no uncomfortable sensations in the head of the penis,” says Kyle.
Rather being circular in design like many other ED rings on the market, Eddie is more of a horseshoe-shaped ovular loop, factoring in the natural anatomy of the penis. This shape is used to recreate the natural physiology of an erection, by applying pressure to the deep dorsal vein through two apexes inside the top inner ring while leaving the arteries below unencumbered. The open bottom, which is held taut by one of two different tension bands, is specially designed to as to not block the urethra during use, meaning ejaculation remains pleasurable.
Eddie also comes with four sizes, based on the girth of the penis and frequency of ED symptoms, meaning potential users can make an informed decision about which model best suits them.
Is Eddie appropriate for everyone?
Kyle says: “Erectile dysfunction can occur for a number of reasons, which are often overlapping. It was previously believed to be primarily psychogenic, but now it’s understood that ED is generally a mixed condition and is primarily functional/physical.
“The classification recommended by the International Society of Impotence Research divides ED as follows: anatomic; vasculogenic, relating to the blood vessels; neurogenic, relating to the nervous system including brain, spinal cord, and nerves; endocrinologic, relating to hormones such as testosterone; and psychogenic, which can be generalised or situational.”
Whatever the cause of a patient’s ED, Jacobson says Eddie should be able to work for the majority of people. The device may not be appropriate for those with certain physical deformities, who are on certain erection-supressing medications or who have psychological problems that are impacting their sexual function, for example.
“Nothing is 100% in this space,” says Jacobson. “It’s a spectrum disorder and you’ve got a multitude of problems that affect it.”
While pharmaceutical treatment continues to overshadow devices when it comes to ED – the ED drug market is expected to reach $4.25bn by 2023, compared to a predicted $2.3bn for the device market – Eddie has several clear advantages over its competitors.
It doesn’t have the systemic side effects or counterindications associated with medication or require a doctor’s appointment to prescribed. Its ergonomic design is a clear improvement on rings and pumps and does not require the major surgery of an implantable penile prosthesis.
Plus, Giddy encourages Eddie users to take a holistic approach to their ED, with numerous resources on their website about why ED happens, its impact on relationships and intimacy and how lifestyle factors like diet and exercise can impact a patient’s prognosis. It’s hard to say whether Eddie will become a definitive device in the treatment of ED, but it’s definitely a step in the right direction.