Erectile dysfunction, also commonly known as ED, is considered an "embarrassing" condition - one in which, the less said of, the better.
Some men see the malfunction as a sign of weakness and shame but experts say the condition may be communicating other health hazards.
Shane*,36 , says he has been struggling with ED for two months in secret before he sought help.
“Not having a functional penis is embarrassing and it affects your ego as a man. But I only realised how much it was affecting my relationship during the past few months because I ran out of excuses on why I didn't want to have sex,” said Shane.
After a few consultations with his doctor and urologist, Shane was diagnosed with depression which experts say was the root cause of ED.
“I’m glad I eventually sought help. Chances are if it didn't affect my sex life, I probably would have been starting this year, grumpy, moody and depressed, like I was last year,” said Shane.
According to experts, ED could indicate a serious health condition such as heart disease, hypertension, diabetes or depression - highlighting the need for men with this condition to consult a urologist.
A 2014 study in the South African Medical Journal indicated that approximately 31% of men suffer from sexual dysfunction in their lifetime.
Dr Odion Aire from The Urology Hospital, Pretoria, says the main causes of ED were either organic physical, emotional or psychological such as suppressed trauma or conflict, or a combination of both.
He says organic ED could be rooted in vascular, neurological or hormonal problems. The side effects of the medication might also play a role, as may co-morbid diseases such as diabetes, hypertension and depression. Old-age, smoking, heavy alcohol consumption, obesity and Peyronie’s disease -- which manifests in an abnormal penis – may also be behind the condition.
“Sometimes there may be more than one underlying cause of ED. It’s important for men with ED to move past the embarrassment and consult a urologist as it may be treatable. The appropriate action or treatment will emerge after a consultation” he added.
Dr Ahmed El-Shafei, Medical Advisor: Neuroscience and ED for Lilly South Africa says, "Even if erection problems only occur from time to time, they should still be taken seriously as ED can be indicative of more serious underlying medical conditions such as diabetes, high blood pressure and cardiovascular disease.
"In fact, ED is more common in men with cardiovascular disease since their risk factors are closely aligned, so ED often represents a ‘sentinel symptom’ or a marker in patients that there could be an underlying cardiovascular disease, where no other symptoms are present,” explained Dr El-Shafei.
There are a number of treatment categories for ED, but the most commonly prescribed first-line therapy is an oral medication that falls in the category of phosphodiesterase-5 or PDE5 inhibitors, for short. All medicines in this category – while having some pharmacological differences that translate into differing clinical effects - essentially have the same action,” explains Dr El-Shafei.
Following sexual stimulation, PDE5 inhibitors increase blood flow to the penis, causing an erection. Penile erection is caused by the engorgement of the penis with blood. This engorgement occurs when the blood vessels delivering blood to the penis increase the delivery of blood, and the blood vessels carrying blood away from the penis decrease the removal of blood. Under normal conditions, sexual stimulation leads to the production and release of nitric oxide in the penis.
As many continue to want to lead healthy lifestyles in 2020, experts say it’s important to listen to your body and seek help from a medical professional whenever there is a malfunction.
Shane* not his real name