Erectile dysfunction

Mr. Zaman, forty-six, runs an engineering firm and has had diabetes for six years. A year ago, on one tired night, he could not keep an erection. Now the worry arrives first, every time, and the problem follows it. He has bought tablets online from a seller he does not know. He has told no one, including his doctor.

An illustration drawn from common experience. The person is invented; the pattern is not.

Understanding erectile dysfunction

Erectile dysfunction, persistent difficulty getting or keeping an erection, is common. Causes are often physical: diabetes, high blood pressure, heart disease, high cholesterol, smoking, alcohol, and some medicines. Anxiety about performance, stress and depression often add to it, and fear of failure becomes a cycle of its own.

The finding worth knowing

A 2005 JAMA study of American men aged 55 and over found that, in some men, erectile dysfunction came before cardiovascular events such as heart attacks. That makes it a reason to see a doctor, not only a private worry.

Signs and symptoms of erectile dysfunction

• Difficulty getting or keeping an erection over several months
• Anxiety and avoidance building around intimacy
• Diabetes, high blood pressure or heart disease alongside it
• Using unregulated tablets bought online

Treatment for erectile dysfunction

A doctor checks the heart, blood sugar, blood pressure and medicines first. Treatment can include medication, managing physical conditions, and psychosexual therapy for the anxiety cycle, often with the partner involved. Medicines bought from unknown sellers can be dangerous, especially with heart conditions.

What getting better can look like

Mr. Zaman might see his blood sugar under control at last, a safe prescription in his pocket, and the worry losing its head start.

Common questions about erectile dysfunction

Can erectile dysfunction be a sign of heart disease?

Sometimes. A 2005 JAMA study of American men aged 55 and over found that, in some men, erectile dysfunction came before cardiovascular events such as heart attacks. That is why a doctor checks the heart, blood sugar and blood pressure, not only the erection problem.

Is it safe to buy erectile dysfunction tablets online?

Medicines bought from unknown sellers can be dangerous, especially for men with heart conditions or on other medicines. A doctor can check what is causing the problem and prescribe safely. The conversation is confidential.

When to see a psychiatrist

Erectile dysfunction is common and treatable. Talking to a doctor in confidence is also a check on your heart.

Care here is personal: built around your history, your health and what you want to change, and reviewed with you as it goes.

If you or someone else is in immediate danger, call 999 or go to the nearest hospital emergency department.

Sources

• Thompson et al., JAMA, 2005