For many men with erectile dysfunction (ED), the impact of this condition can extend far beyond sexual performance. ED, which is defined as the inability to get and keep an erection firm enough for sex, can affect a man’s overall emotional wellbeing, but can also be a sign of a more serious health condition.
“ED can be an overall barometer of a man’s health. There are some serious conditions that can cause ED, so rather than looking at ED as the symptom, we prefer to look at the underlying causes,” says Dr Bradley Wood, a Urologist in private practice from Fourways, Johannesburg.
Prof Shingai Mutambirwa, Head of the Urology Department at The Sefako Makgatho Health Sciences University (SMU) in Ga-Rankuwa, says that ED can be an early warning sign linked to serious conditions such as heart attacks, strokes, limb loss, and certain cancers. “Because the penile arteries are smaller than those supplying the heart and brain, erectile dysfunction can appear earlier, often before a heart attack or stroke,” explains Prof Mutambirwa.
Dismissing ED as “just getting older” can delay diagnosis of potentially serious health issues and prevent men from receiving effective treatment, says Dr. Jireh Serfontein, a medical doctor working exclusively in the field of sexual medicine, based in Pretoria. She adds that approximately 40% of men experience some degree of erectile dysfunction by age 40, with prevalence increasing significantly thereafter. Many men remain undiagnosed because they do not seek medical help.
Stigma remains one of the biggest barriers to treatment. “The longer ED persists untreated, the more likely psychological factors become intertwined with the original physical cause,” adds Dr Serfontein. “I think it’s important that we don’t delay treatment for patients. The embarrassment and stigma is real, and we know it’s there, but we need better communication so that men understand this is not a condition that should be taken lightly,” says Prof Mutambirwa. “If you don’t seek treatment, you could miss the opportunity to identify and manage other underlying health issues”.
Fortunately, Dr Wood says, there are very effective treatments for erectile dysfunction. “The medications we use, particularly PDE5 inhibitors, are highly effective and very safe3”. These include older options like sildenafil and newer options which offer more flexibility like tadalafil, both of which have affordable generic versions of these medicines. They work by helping improve the body’s natural erectile response by helping increase blood flow and make it easier to achieve and maintain an erection. Importantly, these medications do not automatically cause an erection, and sexual stimulation is still required for them to be effective.
Some PDE5 inhibitors can be taken daily or on demand. Treatments such as tadalafil may remain effective for up to 36 hours, offering greater spontaneity, while factors such as food and alcohol may influence the choice of treatment. Dr Wood says that while men are often reluctant to seek medical help, it is important that they feel encouraged to talk openly about their concerns and seek support when needed.
Dr Serfontein agrees. “ED is common, treatable, and often provides valuable insight into a man’s overall health. Seeking medical advice early can improve sexual function, strengthen relationships, and in some cases identify serious health conditions before they become life-threatening”.
