The International Consultation on Sexual Medicine defined erectile dysfunction (ED) as the consistent or recurrent inability to attain and/or maintain penile erection sufficient for sexual performance. A 3-month minimum duration is accepted for establishment of the diagnosis (Recommendations of the 1st International Consultation on Erectile Dysfunction Paris, France; Health Publications Ltd, 2010). The introduction of phosphodiesterase inhibitors has greatly changed the face of sexual medicine. Prior to this, sexual issues were shrouded in mystery and ignominy. Ancient cultures have all described sexual problems. Treatments in the form of herbs, spices, tonics, potions, mixtures, magic spells, and surgery have all been presented as remedies. Not until the past 30–40 years have we been able to understand and treat sexual issues commendably. That spirit continues today as we continue to investigate the finer points of erectile dysfunction management and turn our attention to address premature ejaculation, disorders of orgasm, hypogonadism, and female sexual dysfunction.