Have You Met ED?

By Professor Dr. George Lee – Consultant Urologist, Gleneagles Intan Medical Centre 

Erectile dysfunction, or ED for short, could drive any man stiff with fear. Defined as the inability to get or keep an erection firm enough for sexual intercourse, ED can also mean an inconsistent or total inability to achieve an erection, a lack of rigidity of the penis or a tendency to sustain only brief erections[1].

ED has long been associated as an issue prevalent only in older men, as the incidence of ED tends to correspond directly with an increase in age. However, this condition can no longer be branded as an old man’s disease, as male sexual dysfunction can also be due to unhealthy lifestyle patterns that play an important role in the onset of ED.

A recent study allowed us a peek into this problem among Malaysian men. It showed that ED can occur among younger men in their 20s as well. The condition can be caused by psychological factors (such as stress, anxiety, depression, low self esteem and fear of sexual failure) and problems in social lives (relationship and marital issues). However, these are not the only causes and reasons behind the onset of ED[2].

What is even more important to note is that ED doesn’t stand alone and is often accompanied by other lifestyle co-morbidities namely diabetes, heart disease and hypertension1. Scientists are now realising that ED can be a marker (or a sign) for clogged blood vessels or nerve damage from diabetes[3]. This makes it even more important for men to seek medical attention when faced with ED as it is a pre-cursor to more serious conditions.

Most men with ED prefer not to seek treatment5.It does not help that mainstream culture portrays successful men as virile and with unwavering sexual prowess. Mortal men have a tough act to follow; this makes them shy away from seeing a doctor when they have sexual problems. Instead they prefer to think that it’s just something transient, or in their heads and can be easily transformed with a change of mindset.

Needless to say, this situation can potentially spiral out of control once there are some issues in their relationship or sex life. Men need to realise that ED is no small problem. It can lead to loss of self confidence that could affect work performance, relationships and opportunities. Many (young) ED patients may even end up feeling as if they are losing out while they’re in their prime.

ED patients should realise that they are not alone and the wellness of their health is not one to be compromised. Reaching out to their healthcare providers and partners will provide men the encouragement and confidence needed to seek treatment. Diagnosis is simple as men can assess their degree of erectile dysfunction through the Erection Hardness Score (EHS)6

The EHS is an easy-to-use, reliable measure of hardness of erection on a scale of 1 to 4, with 4 being the maximal score6. It has been validated against the International Index of Erectile Function (IIEF) and is a simple and direct clinical tool so that men with ED can use the scale to assess the severity of their condition and to monitor the impact of treatment6. The mainstays of ED are PDE-5 inhibitors and after figuring out a health regimen that is suited to your needs, your doctors will be able to draft out a treatment plan for you.

However, this does not mean going to secondary sources such as the internet or street vendors to purchase cheaper drugs. Online sites offering ED treatments are a dime a dozen – unfortunately many of these sites are manned by unscrupulous conmen. News reports have uncovered scams by online pharmacies that offered counterfeit drugs or ineffective medicines. Not only are these drugs ineffective, they could actually cause serious harm[4].

Your best bet is to go to your local doctor for help. They are there to help. Have confidence to discuss your problems with your doctor and take your partners along for support. You are not alone in the battle against ED. Do enquire more about ED  as its treatment from your doctor. Find out what works well for your body. It’s not that hard!

This article is supported by Pfizer (Malaysia) Sdn Bhd. For more information on ED, visit www.menshealth.com.my.


[1]National Kidney and Urologic Diseases Information Clearinghouse. Available

at: http://kidney.niddk.nih.gov/KUDiseases/pubs/ED/index.aspx. Accessed 29 October 2012.

[2] Quek KF, Sallam AA, Ng CH, and Chua CB. Prevalence of sexual problems and its association with social, psychological and physical factors among men in a Malaysian Population: A cross-sectional study. J Sex Med 2008;5:70–76.

[3] Medline Plus. Erectile Dysfunction. Available at: http://www.nlm.nih.gov/medlineplus/erectiledysfunction.html. Accessed 29 Oct 2012.

[4] FDA. Inspections, Compliance, Enforcement, and Criminal Investigations. Available at: http://www.fda.gov/ICECI/CriminalInvestigations/ucm240823.htm. Accessed 29 Oct 2012.

5 Shabsigh R, et al. Drivers and barriers to seeking treatment for erectile dysfunction:  a comparison of six countries. J.Sex Med 2004:94:1055-1065.

 6  Mulhall JP, Goldstein I, Bushmakin AG et al. Validation of the Erection Hardness Score. J Sex Med 2007; 4: 1626-1634

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