The condition is described as the inability to achieve or maintain an erection long enough to achieve satisfactory sexual intercourse

Erectile dysfunction, otherwise known as impotence, is, for many men, the most embarrassing condition to discuss with their friends, family and even their doctor. We need to break down the stigma surrounding the subject for patient and healthcare professionals alike.

Healthcare professionals may fail to initiate these discussions as a result of their own embarrassment, lack of knowledge or time constraints.  If the healthcare professional is embarrassed this is bound to exacerbate any embarrassment being felt by the sufferer

The side effects of ED can be devastating and can affect relationships along with mental health and self-esteem of the sufferer.  Many men believe that the ability to  ‘perform’ is the very foundation of their manhood and if that ability is lost it equates to their losing their masculinity.  For partners, the repeated ‘rejection’ they may experience will have a detrimental effect on their own self-esteem and this, in turn, may generate relationship difficulties

However, erectile dysfunction is far more common than most men (and women) may realise and it affects as many as 50% of men aged between 40 and 70 years 

 

Causes

Causes may be physical in origin as well as psychological.

Amongst the psychological causes, we may include relationship problems, stress and depression and amongst the possible physical causes are cardiovascular disease,  diabetes and hormone imbalance issues.   Other possible causes include the use of prescribed medication such as antidepressants and hypertensives (drugs to treat high blood pressure) along with smoking, being overweight.

We also need to consider if the sufferer’s testosterone levels are lower than they should be

 

Why we must discuss erectile dysfunction

Embarrassment aside, there are very valid reasons why we should seek medical help and advice when erectile dysfunction is being experienced.  The reason for this is that whilst ED in itself can be considered a ‘benign’ complaint in that it is not life-threatening, it can, however, be an indicator of an underlying disease.  ED can be caused by prostate cancer, cardiovascular disease, diabetes and stroke.  If we choose to delay seeking help from a doctor we risk these underlying conditions not being discovered at an early enough stage to be treated successfully.

In studies of men who had suffered a heart attack(s), it became apparent that a large proportion of these men had suffered ED previously.

The moral of this story is that men should not procrastinate when considering a visit to the doctor to discuss ED issues

 

Treatment

Having put aside your embarrassment around this issue, there are now a number of treatments that can be suggested by your GP and there is no need to continue to suffer in silence.

If the doctor finds any underlying disease which may be causing the ED the first step will be to treat this. This would also include the cessation of smoking and losing weight, 

 If, when the underlying condition is stabilised, the sufferer is still experiencing symptoms of ED, then there are further treatments which can be considered

If the probable cause of the ED is psychological, the GP can prescribe psychosexual counselling from a sex therapist.  If the cause seems to be physical, the GP may consider offering one of several drug treatments which are now available.  These include the PDE inhibitors which include sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis).  Sadly for men suffering from cardiac disease or are using nitrates, this group of drugs are contra-indicated.   However, for a large number of men, these drugs are considered to be miracle drugs  which can restore their ability to have a fulfilling love life and in so doing, restores the sufferer’s self-esteem as well as bringing harmony back to what may have been a strained relationship

 

Sources

Erectile dysfunction or performance anxiety? The truth behind a modern malaise https://www.theguardian.com/lifeandstyle/2018/oct/18/erectile-dysfunction-performance-anxiety-truth-modern-malaise

Why erectile dysfunction treatment needn’t be embarrassing https://www.telegraph.co.uk/health-fitness/living-with-erectile-dysfunction/overcoming-embarrassment-of-erectile-dysfunction/

Erectile Dysfunction https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1397739/

Speaking About the Unspeakable on National Impotence Day https://www.theurologyfoundation.org/news/speaking-about-the-unspeakable-on-national-impotence-day