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By Dr T W Ngwenya Changamire

We have been discussing various topics around men’s health and as we come to the end of the men’s health series we will discuss a very important and prevalent problem. This is a rather difficult and sensitive topic for most men to discuss or to bring up during a medical consultation.

Erectile dysfunction is the topic and contrary to what many may think, it is affecting many young men. People think that this is a condition that affects elderly men only, mostly those above 50 but this is not the case. Advanced age is not the only contributory factor to development of erectile dysfunction.

Erectile dysfunction is a condition in men where the penis is not able to become erect or an inability to stay erect during sexual activity. It is sometimes referred to as impotence.

This condition also reduces your sexual desire.

Healthy nerves and healthy blood vessels in the penile area are required for a strong and lasting erection. Sexual stimulation of the nerves surrounding the penis causes opening of the blood vessels to the penis thus increasing blood flow to the area.



Erectile dysfunction is a problem in young men but is more common in elderly men. There is a growing problem of erectile dysfunction in men who are under the age of 40 and it is even expected that this growing trend is underestimated.

This is because this growing incidence of ED is based on men that have presented to a medical facility for help. We do know however that based on the sensitivity of the problem a large number are not presenting.

We hope that with better knowledge about the condition men will have a better understanding about the factors that increase the risk of erectile dysfunction and will improve their health-seeking behaviour so as to prevent this condition and to also get treated if they are already affected by it.

Erectile dysfunction can vary from an ability to achieve an erection and maintain it in most but not all cases to an inability to achieve and maintain an erection in some cases and the most severe is an inability to achieve and maintain an erection all the time. It is estimated that about 50% of men with erectile dysfunction have severe symptoms.



There are different causes of erectile dysfunction which can be largely classified into organic causes, psychological causes. This does not mean that that the 2 classes are mutually exclusive. Causes under each category may contribute to erectile dysfunction in an individual. A thorough history, examination and investigations will help to identify all the factors that are causing erectile dysfunction.

Psychological factors include conditions like anxiety, depression, relationship difficulties and psychological stress like job instability, post-traumatic stress disorder, or performance anxiety. Organic factors include medical conditions like high blood pressure and diabetes, neurologic conditions like spinal injury, hormonal problems like hypogonadism where the testes do not secrete enough hormones and drugs.

Certain drugs that are used to treat conditions like high blood pressure, depression, allergies, severe pain and prostate. By visiting the doctor your treatment will be reviewed if these drugs are on your list of chronic medication. Certain lifestyle habits are related to erectile dysfunction.

These lifestyle habits include sleep deprivation, increased screen time, smoking and substance or drug abuse, unhealthy eating and inactivity which lead to obesity.

The lifestyle-related factors contributing to erectile dysfunction are similar to the factors that increase a person’s risk to developing cardiovascular disease and peripheral vascular diseases which include strokes, ischemic heart disease and peripheral vascular disease. Erectile dysfunction is a signal that there is a health condition or lifestyle habit that needs to be addressed.



Diabetes largely increases the risk of developing erectile dysfunction. It is estimated that between 35% to 75% of men with diabetes will experience some degree of erectile dysfunction. It is even more common when they age. This is because diabetes affects the nerves and blood vessels which are required for development of an erection.

Diabetes affects nerves (neuropathy). Nerves affected have reduced sensation and have reduced stimulation to the blood vessels resulting in reduced blood flow and a flaccid erection.

Diabetes affects blood vessels too.  The affected blood vessels are hardened and stiff so these blood vessels fail to open wide enough to allow good flow of blood to penis.

Control of Diabetes will help to delay or prevent development of erectile dysfunction. Refer to our article on Diabetes to know how to best control Diabetes.

Erectile dysfunction is a common but often treatable condition which is affecting more young men. It may last for several months or even years if it is left untreated. Treatment includes controlling and managing the underlying factors. Other treatment options are also available that aid in developing an erection like Viagra (Sildenafil).

Please note that Viagra may not work in Diabetics who have severe damage to their nerves and blood vessels. Viagra requires well functioning nerves and blood vessels. Viagra also has contraindications. Please visit your doctor prior to taking the pill.



Erectile dysfunction is a problem because it affects an individual’s reproductive capacity. It may also affect your relationship with your sexual partner. Erectile dysfunction affects your mental wellbeing and quality of life because people who are affected end up feeling inadequate, they lose their confidence and self-esteem and they may also feel worthless.

It should not be ignored. Summing it all up, erectile dysfunction is an inability to achieve and maintain an erection. It is affecting more young men. Psychological factors, organic factors and lifestyle choices play a role in development of erectile dysfunction. Erectile dysfunction is a red flag. Visit a local GP or Men’s health clinic and get checked!


Contact All In 4 Health – Dr TW Ngwenya Changamire – for General Medical Consultation, Health Screening, Medical Check-up, Health Education and Promotion. The Glen Marais Shopping Centre, 57 Veld Street, Glen Marais, Kempton park 1619













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