Definition: Inability to attain and maintain an erection long enough to achieve a satisfactory sexual intercourse. A cross national epidemiological study in Malaysia (1997/98) showed that 1.7 million men above 40 has some degree of Erectile Dysfunction (ED)

Causes of ED:

• Common medical diseases like diabetes and hypertension which lead to blockage of blood vessels (arteriosclerosis)
• Mental diseases e.g. depression, anxiety
• Brain or spinal cord injuries
• Hormonal disorder e.g. low testosterone level
• Liver or kidney failure
• Parkinson’s disease
• Stroke
• Some types of prostate or bladder surgery (rare)
• Medications

ED is also related to cigarette smoking, drinking alcohol, stress, obesity and lack of physical activity.

Symptoms

• Cannot get and or maintain an erection
• Erections are not hard enough for sexual penetration.
• Unable to maintain erection after penetration and to achieve satisfactory sexual intercourse

Complications

• Depression
• Performance anxiety
• Problems in marital relationship
• Low self esteem
• Poor quality of life

Treatment

Non medical treatment

• Healthy lifestyle changes may help some men regain sexual function – e.g
  • Quitting smoking
  • Losing excess weight
  • increasing physical activity
• Patients with diabetes or hypertension will find improvement in ED if the medical condition is well controlled.
• Stress management

Medical treatment

Medications are available to treat ED in the form of oral and locally injected drugs. In some cases where medication is ineffective or cannot be used, vacuum devices, and surgically implanted devices may be used.

Prevention

• Quitting smoking and alcohol
• Optimal control of high blood pressure and blood glucose levels
• Healthy lifestyle

Rehabilitation

• Stress management