AB006. Erectile dysfunction (ED) as a marker for cardiovascular diseases (CVD)

The word “serendipity” is considered very difficult to define; it may be considered “A talent for making fortunate discoveries while searching for other things”. The history of sexual medicine teaches us the importance of serendipity along with research. Serendipity in the year 1988 was initiated by a slow elevator. Dr. Jacob Rajfer, Professor of Urology, had attended a meeting on the 2 floor of the Univ. California LA and was waiting for an elevator to take him to his office on the 6 floor. The elevator was very slow to arrive, so Dr. Rajfer began looking around. There was a sign on a door across from the elevator that read: “Vascular smooth muscle lab”. Dr. Rajfer knew that an unknown substance, Endothelium-derived Relaxing Factor (EDRF) dilated blood vessels by relaxing smooth muscles. A penile erection resulted from vasodilation and the penis was full of vascular smooth muscle. The head of the vascular smooth muscle lab was Dr. Louis Ignarro who had just published that EDRF might be Nitric Oxide (NO). Drs. Rajfer and Ignarro began collaborating, and in 1990 published that ‘NO’ mediates erections: a discovery started by a slow elevator and leading to Dr. Ignarro receiving a Nobel Prize in 1998 and Pfizer scientists developing Viagra! Viagra, which was able to dilate smooth muscle, was being developed by Pfizer researchers to treat angina when increased nocturnal and spontaneous erections were noted. The FDA approved Viagra as the first oral treatment for erectile dysfunction in 1998. Serendipity, research and Viagra impacted how we look at aging and intimacy. The language of sexual medicine changed as well: the old term, ‘impotence’ (lacking in power) was changed to ‘erectile dysfunction’ or ED. Serendipity has played a role in the discovery of more than 24% of all drugs on the market. We would all do well to heed the wise words of Louis Pasteur: “Chance Favors the Prepared Mind”.