Erectile dysfunction is a sensitive issue. But you’re not alone and you can be helped. Find out how

You’ve played all the right moves: a slow, seductive dinner; fingers lingering on her waist and sparks flying from your eyes to hers so that the room vibrates. She’s all yours tonight. You lead her upstairs and after the kissing and the petting, she reaches down… But her hand pulls back as though it’s touched a hot plate, except it’s quite the opposite – no hard heat, just the softness of a newborn chick nestling quietly below. A sure mood-spoiler, yes. Embarrassing, oh yes. Common? Sure. Erectile dysfunction? Not necessarily.


The most difficult job in the world is probably also the most coveted one: male porn star. In the sleazy world of the erotica industry, everyone from casting agents to directors is after one thing: a man who can get wood – under all conditions. Find him, and you’ve touched gold. It’s understandable that the male libido is frequently crushed by the harsh stage lights of showbiz, but many men are let down even in the warm soft glow of their bedroom.Although upsetting (and normal), it’s not always due to erectile dysfunction (ED). Sexologist Dr Esther Sapire says most men will have difficulties getting or maintaining an erection from time to time. So how do you know if you’re suffering from ED or just a bad case of stage fright?There are two factors to consider: persistence and personal distress. If erection problems happen frequently and are affecting your mental state, then you may have ED. To diagnose you, doctors use an instrument to measure the rigidity of the penis called the RigiScan. Urologist Dr Frans Van Wijk explains that, although the RigiScan is still used, it cannot be relied on for a 100 percent accurate diagnosis, so doctors will also rely heavily on a clinical history of the patient, probing the frequency and severity of the condition.


It’s common to think of ED as primarily a psychological problem. Sapire doesn’t. “It’s fundamentally a vascular disorder – there is a problem with the lining of the vessels inside the penis,” she says. ED used to be thought of as 80 percent psychological in origin, and 20 percent physical. These figures have now been reversed. However, specialists still agree that there are a host of potential psychological causes: stress, anxiety (a single experience of ED can set up a vicious performance-anxiety cycle), guilt, depression, low self-esteem or feelings of inadequacy, indifference (a man may have lost interest in sex due to problems in the relationship). Aside from these, age or medication can also play a role.

Talk to Her

Don’t keep your partner in the dark European Urology found that only 59 percent of men suffering from ED had actually spoken with their partner about their sexual dysfunction. Yet in The Strike Up a Conversation Study published in the Journal of Men’s Health and Gender, men reported frustration, shame and depression when they didn’t speak to their partners about their problem. Interestingly, men tended to talk to their partner because they were concerned that they weren’t sexually satisfying them. They were less motivated by their own sexual frustration. As expected, women are likely to think the sexual problem is caused by their own loss of attractiveness to their mate.

Here’s how to decipher if it’s all in your head: if you get normal erections during sleep or the early morning, it suggests a psychological cause, but loss of these “night erections” could indicate an underlying disease or physiological cause. Common diseases co-existing with ED include diabetes, hypertension (high blood pressure), coronary heart disease and hypercholesterolemia (high cholesterol). Whether caused by mental or physical factors, Van Wijk assures the different treatments available are likely to raise your game. The first step – you’ve heard this before – is admitting you have a problem.


Medication Prescription drugs, known as PDE5 inhibitors, increase blood flow to the penis, causing an erection. These work effectively in about 80 percent of cases. But you need to be sexually stimulated for the action to take place. You’ve heard of Viagra – there’s also Levitra and Cialis. “The duration of the effect differs between them,” explains Van Wijk. Also, the side-effect profi le is slightly different. And herbal remedies? They’re difficult to assess, because with ED the placebo effect is about 30 percent due to the psychological component, says Van Wijk.Intra-penile injections Not as bad as it sounds. These are used where there’s too much damage for a PDE5 inhibitor to be effective. After the injection, you’ll get hard in about 10 minutes, regardless of whether you’re aroused. Van Wijk’s verdict: “Not too painful and can be highly effective.”Vacuum erection device Vacuum devices are effective, safe and fairly easy to use. The penis is placed inside a cylinder, which creates a vacuum, causing blood to flow into the region. A rubber band is tied securely around the base of the penis, thus retaining the erection. The cylinder is then removed. It takes about three to five minutes to complete the process.Penile prosthesis This is the least popular intervention for ED and is generally used where there is severe damage following trauma. A device is implanted within the penis, which has a valve that is pressed to get an erection.It takes two When addressing ED, it’s important to take into account your partner’s role. “It’s not the man’s problem alone,” says Sapire. Often the couple has gone so long without sex that the woman also requires treatment, for example, she might need a lubricant or hormone replacement therapy to become sexually active again.