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Such a physical condition has undoubtedly 18 interfered with procreation and intimate relations, and as such, individuals have been seeking aids to improve sexual performance and enhance fertility for centuries. Soderling and Beavo note that although not life-threatening, the psychological and social consequences of this condition are serious as well (2000). Erectile function in men depends upon a complex interaction of psychogenic, neurologic, hormonal and vascular factors, and the management of erectile dysfunction would ideally reflect this complexity of control. Therapeutic options include psychological and non-pharmacological approaches such as counseling for interpersonal difficulties or addressing lifestyle factors that contribute to erectile dysfunction such as cigarette smoking or alcohol abuse. However, despite the frequent involvement of emotional and interpersonal factors in sexual dysfunction, medical treatments are often viewed as more efficient and effective, and as a result, preferred over other treatments (Levine, 1992). The treatment for erectile dysfunction followed this trend when the general public, notably men, began turning to the medical field for a way to combat this “side effect of socially rooted problems” through allopathic means (Carpiano, 2001). By 1994, Tiefer noted that (preferred) forms of ED treatment had indeed moved away from psychogenic causes in favor of organic ones such as penile, surgery, implants and injections, although their results were mixed. Two terms have been largely employed to label this condition in men: impotence and erectile dysfunction. Both terms denote similar, yet distinct concepts. The term impotence has traditionally been used to signify the inability of a male to attain and maintain erection of the penis sufficient to permit satisfactory sexual intercourse. This value-laden label, which means ‘without power’ in the Latin language, symbolizes a fault with the man himself for the condition and captures the tendency to blame. A man termed ‘impotent’ is devalued as one no longer able to fulfill his role as a ‘true’ man in society. It does not however, hint of reasons for the inability to attain an erection, which may be truly outside of the control of the man. Conversely, the term erectile dysfunction is used to signify an inability of the male to achieve an erect penis as part of theoverall multifaceted process of male sexual function. This process comprises a variety of physical aspects with important psychological and behavioral overtones (National Institute of Health Consensus Development Panel on Impotence, 1993). However, being labeled as having this condition, as opposed to impotence, is less likely to impinge on one’s sense of value as a man or ability to function as a ‘true’ man in society. The development of this new term of erectile dysfunction and the construction of the condition which it denotes helped to transform unacceptable erectile performance into a subject for medical analysis and treatment, and as I argue, in the process further blurred the boundary between discontentment and disease. In addition, by analyzing the events which are described below through the lens of Latour’s theory of fact-construction, it becomes evident that erectile dysfunction became an actual condition, a fact, rather than simply an obscure term. In order to transform the term from one of insignificance into one which was recognizable and accepted, many events had to take place. These events included Pfizer’s construction and ‘branding’ of erectile dysfunction, the creation and incessant marketing of a link which made the condition synonymous with Viagra, and the transformation of previously embarrassing events occurring in men’s bodies into a recognized and accepted universal ‘fact’. The term erectile dysfunction was first used in the literature by Levine in 1976 in order to describe impotence originating from mixed organic and psychological causes. It has been argued however, that the Pfizer-sponsored Massachusetts Male Aging Study (MMAS), the results of which were published in 1994, actually put the term ‘on the map’ (Loe, 2004; pg. 48). In this important study for the field of urology, impotence was assigned a new name and redefined more broadly. The MMAS was a subjective, self-administered questionnaire characterizing erectile potency not as an either/or but rather as a continuum. On the questionnaire, subjects were asked to rate their potency on a scale of one to four: (1) not impotent, (2) minimally impotent, (3) moderately impotent, or (4) completely impotent. These responses were then assigned gradations of erectile dysfunction, ranging from “no ED” to “mild ED (usually able)”.

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