The hard facts about erectile dysfunction

He’s good-looking, successful and an adventure racer and cyclist. Clearly, Steven Adams* is the archetypal macho man.

But when this 38-year-old executive describes his struggle with erectile dysfunction (ED), the machismo and confidence begin to droop.

“I’d been married for three years but had ‘intimacy issues’ for more than half of that time,” he explains. “Part of me realised there was a deeper problem but I couldn’t admit it to myself or my wife. It wasn’t that I didn’t feel attracted to her or my libido was waning. It was just impossible for me to maintain an erection…”

He began looking for excuses for his failure to launch. First he put it down to stress. Then he said he was run down. Finally he considered the possibility that he was depressed.

“After about nine months my wife thought she was to blame,” he says. When she wanted answers, Steven still couldn’t face the problem. Instead he lied, saying she was putting too much pressure on him to perform.

“After that the distance between us just grew,” he explains. Unable to cope with the strain, the couple eventually got divorced and in the aftermath of his failed marriage Steven thought the problem had passed.

But a few months into a new relationship, the bedroom bombshell returned. “That’s when I got help and was medically diagnosed with erectile dysfunction,” he says.

It became apparent that Steven’s particular problem was rooted in a history of childhood molestation. “Once the cause was identified, I was able to process by means of therapy what happened to me and put the problem to bed.”

And speaking of beds, Steven’s new wife has no complaints in that department.

Although this story ends happily, Steven’s struggle is more common than you’d imagine. An estimated 40% of Australian men are affected by erectile dysfunction. To make matters worse, it remains one of the most common untreated conditions in this country.

In most cases the condition is treatable, but the social stigma and emasculating misconceptions cause many men to suffer in silent denial.

It’s time to change this and face the get-it-up facts…

You may not have a problem
“Erectile dysfunction is the consistent or recurrent inability to attain, and in some cases, maintain a penile erection sufficient for sexual intercourse,” according to Dr Evangelos Apostoleris from Wits University’s Department of Urology in South Africa.

This means ED isn’t just about getting it up, but also about keeping it up. It also means that falling flat once in a while isn’t necessarily cause for concern.

“It’s relatively normal if a man is occasionally unable to achieve an erection,” Apostoleris says. “It becomes a problem only when there’s frequent failure.”

So in order for a diagnosis of ED to be made, you need to suffer from a “consistent or recurrent” slump. The extent of the slump determines the severity of the condition.

How do you measure up?
- Mild ED: You achieve a successful erection seven or eight times in every 10 attempts.
- Moderate ED: You achieve a successful erection four to six times in every 10 attempts.
- Severe ED: You achieve a successful erection zero to three times in every 10 attempts.

You’re not alone
Many healthcare practitioners don’t enquire about their patients’ sexual health. And patients aren’t always upfront about it so it’s difficult to establish the exact number of men suffering from ED.

Nevertheless, it’s clear that ED isn’t uncommon. Statistics indicate more than 50% of men over 40 experience ED – and the problem can start at an even younger age.

In fact, the condition is far more common than most men would like to admit – some of your buddies are probably dealing with it too. So don’t feel singled out; rather face facts and get medical help.

As your age goes up…
It’s a fact: the likelihood of developing ED increases with age. According to the American Urological Association, four in 10 men at age 40 suffer from ED, six in 10 men at age 65, and eight in 10 men at age 75.

With the passing of the years, a man may notice his erections take longer to develop or aren’t quite as rigid. But ED isn’t an inevitable consequence of the ageing process alone.

Normally ED occurs in older men simply because they’re more likely to have another medical condition – such as high blood pressure – that may interfere with erectile function.

Is your behaviour to blame?
In up to one in five cases of ED, a simple lifestyle change can provide the necessary lift.

Exercise, a proper diet, packing away those cigarettes, monitoring cholesterol and controlling chronic illnesses such as diabetes and hypertension could help the problem to take care of itself.

Top tips on lifestyle changes are:

- Slash stress. Exercise, see a shrink, get a life coach, take a trip, organise your life – or do whatever it takes to lower your stress levels.
- Stop smoking. Because smoking decreases blood flow, quitting can have a significant effect.
- Don’t overindulge. Alcohol and recreational drugs can’t only cause ED, they may also be responsible for a decreased sex drive.
- Lose the spare tyre. Obesity is associated with a host of complications such as high blood pressure. This just adds to the fact that men who are overweight are more likely to develop ED.
- Manage your meds. If your ED is related to your chronic medication, your doctor should be able to find a combination that suits your sex life.

Take a chill pill
The good news is ED is treatable. Even if the condition doesn’t respond to psychological intervention or lifestyle improvements, countless men have found the pick-me-up they need in prescription pills.

There are numerous prescription drugs available, but the phosphodiesterase type 5 inhibitors – which include Viagra and Cialis – constitute a significant breakthrough in treating ED.

The results speak for themselves and Viagra manufacturer Pfizer reckons 83% of men are able to enjoy sex again within a few weeks of taking the drug.

If at first you don’t succeed…
For severe cases of ED, more extreme treatment options are available. Vacuum devices, for example, create a partial vacuum that draws blood into the penis, causing expansion.

There are also three surgical procedures for more extreme cases: implanting a device that causes the penis to become erect; reconstructing the arteries to increase blood flow to the penis; or blocking off the veins that allow blood to flow quickly from the penis.

These procedures can be pricey, but the success rate is reported to be between 90 and 95%.

Don’t be duped
Because ED is at the root of a hefty human insecurity, potential solutions attract big bucks. Perhaps that’s why an ever-expanding range of over-the-counter remedies jostle for space and attention on pharmacy shelves.

But do they really work? They might. But while most contain only herbs and vitamins, alternative remedies could be dangerous because they’re not regulated or tested as stringently as their pharmaceutical counterparts.

The American Food and Drug Administration has voiced concerns that the ingredients aren’t indicated and the remedies could contain substances that are harmful when used in conjunction with prescription drugs or if a patient has a pre-existing medical condition.

Get to the root of it
If you think the problems associated with ED are limited to the bedroom, think again. In truth, your member is a window to your general well-being.

Why? Because ED can be associated with bigger health issues such as cardiovascular disease, diabetes, prostate cancer and hypertension.

Instead of fixating on the symptom itself, ask your doctor to check for these concomitant health conditions before it’s too late. The big bonus: treating the underlying condition could eliminate your ED.

And now for the good news
Research has shown that regular sexual activity can actually help to prevent the development of ED.

A 2008 study published in The American Journal of Medicine investigated a group of 989 Finnish men between the ages of 55 and 75 and found the men who went a week or more without having sex had twice the risk of developing ED, compared with those who had sex once a week.

The even better news: engaging in sexual intercourse three times a week has been found to reduce the risk of cardiovascular disease by as much as 50%!

Who would’ve thought preventing ED could be such a pleasure?

* Not his real name
We live in a world where facts and fiction get blurred
In times of uncertainty you need journalism you can trust. For only R75 per month, you have access to a world of in-depth analyses, investigative journalism, top opinions and a range of features. Journalism strengthens democracy. Invest in the future today.
Subscribe to News24
Voting Booth
Have you entered our Health of the Nation survey?
Please select an option Oops! Something went wrong, please try again later.
30% - 9645 votes
70% - 22655 votes