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Lex maniac

Investigating changes in American English vocabulary over the last 40 years

erectile dysfunction

(1990’s | doctorese? therapese? | “impotence”)

In 1998, Viagra was introduced. Around the same time, pharmaceutical companies sharply increased direct-to-consumer advertising of prescription drugs following changes in guidelines issued by the FDA. Anyone else think the fix was in? That was, to say the least, a windfall for Pfizer. Many different medications could expect to do well by attracting the attention of the actual users (not the prescribers, as in the good old days), but those commercials featuring Bob Dole as pitchman sent American men dashing to the doctor to ask about treatment for erectile dysfunction, which had not been a favorite topic among American men before. (The implied commentary on Dole’s performance as a presidential candidate went charitably unreported.) Viagra made impotence respectable.

“Erectile dysfunction” is another euphemism, intended to palliate the misery of the older word, to make us less ashamed, less trapped in a debilitating medical condition. That’s the promise of Viagra: it’s not in your mind, it’s just a little problem with the blood vessels. Pop a pill, wait an hour, and your troubles will be over. Researchers started to find in the 1980’s that impotence is most often caused by an underlying physical condition, not some deep, dark psychological problem or even old age; the success of Viagra and its cronies seems to bear that out. How has it changed us? Too early to tell, I guess. The prospect of eighty-year-old geezers bragging about their prowess does not appeal, and we won’t know until 2026, when the first baby boomers hit eighty. Previous generations had a certain delicacy about such things, but those days are long gone; even as euphemisms proliferate, the talk gets more frank.

There may have been published uses of the term “erectile dysfunction” before 1970, but it seems to have emerged during the following twenty-five years. It remained the property of doctors and therapists well into the 1990’s; most of us continued to struggle along in our benighted way with “impotence” or “can’t get it up.” One urologist, Dr. Fernando Borges, preferred the term because “impotence suggests powerlessness, weakness” (St. Petersburg Times, 1987). The phrase seems to be a short step from “sexual dysfunction,” a general term already in wide use in the 1970’s, and is almost certainly a descendant. I’m not sure whether a doctor or a therapist used it first (New York Magazine cited it as psychologists’ jargon in 1979), but they were the only ones who used it for a long time. In the last half of the 1990’s, the phrase became legion, and you heard it everywhere. Which still seems to be true. Especially on all those blankety-blank commercials.

“Erectile dysfunction” is commonly abbreviated “ED,” another innovation we probably owe to widespread advertising. Oddly, “ED” also stands for “eating disorder,” which also entered therapese in the 1970’s (the Clinic for Eating Disorders at the University of Cincinnati opened in 1974), although it went mainstream by the mid-1980’s — much quicker than “erectile dysfunction” — perhaps because there really was no earlier word for it. There is little danger of confusing the two meanings, since the number of people who suffer from both conditions must be the null set, or pretty darn close.

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