Erectile dysfunction

Erectile dysfunction

Erectile dysfunction

Not being able to get it up (erectile dysfunction) is the one issue men dread talking about. It is, however, more common than previously admitted and may even be due to an underlying, non-sexual, health problem.


Erectile dysfunction (ED), previously called impotence, is the inability to have or maintain an erection that is sufficient to ensure satisfactory sex for both partners.

ED can have either a physical or psychological cause, but in the majority of cases it has a physical cause. Common physical causes include circulatory problems due to an underlying condition such as diabetes type 2, high blood pressure, high cholesterol, smoking and being overweight. Other physical factors include nervous system problems (stroke or multiple sclerosis) or nerve injury due to surgery or radiotherapy. Hormonal problems such as low levels of testosterone or an over-active thyroid may also play a role. Some prescribed medicines such as antidepressants and blood pressure lowering medicines are known to cause temporary ED.

ED should be distinguished from other male sexual functioning difficulties such as premature ejaculation, male orgasmic disorder (delay or absence of orgasm) and hypoactive sexual desire disorder (lack of or diminished sexual interest or desire). Men with erectile dysfunction may or may not suffer from these other problems too.

ED can occur at any age. Most men experience occasional problems with obtaining an adequate erection, but this should not be a cause for concern.

How common is ED?

The enormous demand for anti-impotence medications suggests that erection problems may be more common than was previously thought. Current statistics are not available for South Africa, but in America about 10% of men are believed to be affected. Incidence rises with age: about 5% of men at the age of 40 and between 15 and 25% of men at the age of 65 suffer from erectile dysfunction. The percentage grows to 70% as men reach 80 years of age. As men age, they typically report some loss of sexual desire as well, although neither loss of desire nor erectile dysfunction is an unavoidable feature of ageing.

Prevention and or treatment options

ED can cause significant distress for couples. Fortunately more and more men of all ages are seeking help, and treatment has advanced rapidly. It is important to note that ED can be treated at any age. Treatment options include the following:

  • Psychotherapy
  • Prescription medicine
  • Injections
  • Penis suppository
  • Testosterone replacement
  • Penis pump (vacuum erection device)
  • Penile implant
  • Blood vessel surgery.

Making lifestyle changes such as losing weight, exercising more, eating a healthy diet,  quitting smoking and the abuse of alcohol and drugs may help improve or even prevent ED problems.

Many erection problems can also be prevented or even reversed by a more relaxed approach to sex and by rediscovering sensuality. Sexual intimacy is a form of communication. If you and your partner talk about your lovemaking, it will help reduce your stress and anxiety so that your sexual activity becomes more relaxed. Many people avoid talking about problems in their sexual relationship, which exacerbates the problem.

It may gradually become more difficult to have and maintain an erection as you get older. However, foreplay and the right environment can increase your ability to have an erection, regardless of your age.


Erectile Dysfunction treatments. Retrieved from:

The problem we couldn’t talk about. Woman and Home, April 2015, p. 101-102.

Revised by M van Os