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Erectile Dysfunction: Breaking the Silence

Sexual health is often a subject shrouded in secrecy, and one rarely discussed aspect is the prevalence of erectile dysfunction (ED) in men. ED is a significant but often unspoken truth that affects many individuals due to various reasons, from stress to underlying health issues. The stigma surrounding ED is so profound that many men hesitate to talk about it openly, even with medical professionals. In this article, we aim to shed light on this common sexual health concern.

Imagine a situation in which a stereotypically macho male character, who is typically the household's decision-maker, receives fervent encouragement from his friends to spend a romantic evening with his partner, only to discover that he is unable to do so. While this might seem like a scene from a movie, the reality is that it plays out in many homes worldwide.

The truth about ED is not widely acknowledged, and discussing this health issue remains taboo, causing many men to believe it's something that only affects others. Men grappling with ED often struggle to engage in sexual activities or experience pleasure. They feel deep shame and embarrassment, even though ED is a treatable condition. Seeking help for erectile dysfunction should be the initial step if you are facing it.

As many men choose to remain silent about ED, we have taken it upon ourselves to provide guidance on the topic. Let's explore it further:

What is Erectile Dysfunction?

Erectile dysfunction, also known as impotence, occurs when a man encounters difficulty achieving or maintaining an erection. Some men may achieve an erection but struggle to sustain it during sexual activity, while others may not be able to get an erection at all, even if they desire to. In most cases, ED is a consequence of an underlying health problem. It is not considered a normal part of aging and is often linked to other sexual health issues, including low sex drive and ejaculation problems.

Erectile dysfunction is a prevalent sexual health concern and can affect men of all ages. Failing to achieve an erection more than 50% of the time generally indicates a problem that requires treatment. On the other hand, experiencing occasional difficulties in getting an erection (less than 20% of the time) is not unusual and typically does not necessitate treatment.


Several factors related to the vascular, nervous, and endocrine systems can contribute to erectile dysfunction in men. Certain medical conditions and diseases that may lead to ED include:

  • Type 2 Diabetes

  • Heart and Blood Vessel Disease

  • Atherosclerosis

  • High Blood Pressure

  • Chronic Kidney Disease

  • Multiple Sclerosis

  • Peyronie’s Disease

  • Injury from treatments for prostate cancer, such as radiation therapy and prostate surgery

  • Injury to the penis, spinal cord, prostate, bladder, or pelvis

  • Surgery for Bladder Cancer

Psychological factors can also increase the risk of erectile dysfunction, including:

  • Fear of sexual failure

  • Anxiety

  • Depression

  • Guilt related to sexual performance or specific sexual activities

  • Low self-esteem

  • Stress, either about sexual performance or life in general

Additionally, certain lifestyle factors, such as smoking, excessive alcohol consumption, illicit drug use, being overweight, and leading a sedentary lifestyle, can contribute to ED.

Diagnosis of Erectile Dysfunction

The first step in addressing erectile dysfunction is to consult a urologist and discuss your sexual health concerns. Before undergoing any tests, the doctor will review your medical history and conduct a comprehensive physical examination. Since ED can have various underlying causes, the urologist may recommend a series of tests to identify the source of the issue. These tests may include:

  • Complete blood count (CBC)

  • Liver and kidney function tests

  • Lipid profile

  • Thyroid function test

  • Blood hormone studies

  • Urinalysis

  • Duplex ultrasound

  • Bulbocavernosus reflex

  • Nocturnal penile tumescence (NPT)

  • Penile biothesiometry

  • Vasoactive injection

  • Dynamic infusion cavernosometry

  • Cavernosography

  • Arteriography


The initial step in treating ED involves taking care of your heart and vascular health. Making lifestyle changes, such as improving your diet, quitting smoking, reducing alcohol and drug consumption, and engaging in regular exercise, can be beneficial.

If you are dealing with psychological issues, such as depression or anxiety, you may be referred to a mental health professional to address these concerns. Non-invasive treatments are typically attempted first, including:

  • Oral drugs or pills, known as phosphodiesterase type-5 inhibitors (such as Viagra, Cialis, Levitra, and Stendra)

  • Testosterone Therapy (if low testosterone is detected in blood testing)

  • Penile Injections (ICI, intracavernosal Alprostadil)

  • Intraurethral medication (IU, Alprostadil)

  • Vacuum Erection Devices

  • Penile Implants

  • Surgery to bypass penile artery damage for younger men with a history of severe pelvic trauma (not recommended for older men with hardened arteries)

It's crucial to discuss potential side effects with your healthcare provider when considering these treatments.


Erectile dysfunction remains a taboo topic in our society, with many men feeling embarrassed to seek help from a doctor. However, it is essential that men overcome this stigma and receive treatment without shame or embarrassment. It is possible for physical, psychological, and lifestyle-related factors to contribute to the development of ED, which is a treatable condition. The first step to regaining your sexual health is to open up to a urologist and explore the right treatment options.

Written by: Deepti Dogra

Edited by: Aniket Joshi

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