Erectile Dysfunction

Erectile dysfunction (ED) is the persistent inability to get or maintain an erection good enough for satisfactory sex. Occasional difficulty is normal and not a diagnosis. Persistent ED is common, treatable, and — importantly — often an early warning of heart, blood vessel or hormonal problems.

Common causes

• Blood vessel disease — the same process as coronary heart disease; ED can precede a heart attack by years.
• Diabetes — damages nerves and blood vessels.
• High blood pressure and some BP medicines.
• High cholesterol, smoking, obesity.
• Low testosterone and other hormonal issues.
• Depression, anxiety, relationship stress.
• Medicines — some antidepressants, antipsychotics, antihypertensives, opioids.
• Alcohol and recreational drug use.
• Nerve injury — after pelvic surgery or trauma.
• Pelvic radiation or prostate surgery.

What a Health Expert will check

• History — onset, pattern, morning erections, relationship factors, medicines.
• Examination — BP, pulses, genital examination.
• Tests — blood sugar, lipid profile, sometimes testosterone, thyroid.
• Because ED is often a marker of heart disease, cardiovascular risk is assessed.

Treatment

• Manage underlying conditions — diabetes, BP, cholesterol, weight, smoking.
• Lifestyle — exercise, healthy weight, quit smoking, cut alcohol — improves ED by itself.
• Medicines — several effective tablets are available; safe and effective for most men, but some interact with heart medicines and shouldn't be combined — talk to a Health Expert, not a chemist counter.
• Counselling or sex therapy — especially where psychological factors dominate.
• Vacuum devices, injections, or penile implants — for selected cases.

Important caution — India-specific

ED is heavily targeted by unregulated online and clinic advertising for "sexologist" treatments, ayurvedic pills and herbal kits. Some contain hidden Western medicines or steroids that can be dangerous, especially with heart disease. A proper Health Expert evaluation is quick, inexpensive and far safer. ED is a medical condition — talking about it openly is the first step to fixing it.