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Erectile Dysfunction: Signs & Symptoms

ED Men's Health

Without treatment, erectile dysfunction (or ED) can make sexual intercourse difficult. Erectile dysfunction is generally defined by consistent and repeated problems in sustaining an erection.  ED is reported by 1 in 5 men and that number can increase with age.

There are several forms of male sexual dysfunction, including poor libido and problems with ejaculation, however ED refers specifically to problems achieving or maintaining an erection. Men with ED often have a healthy libido, yet the body fails to respond. In most cases, there is a physical basis for the problem.


  • Erections that are soft for sexual intercourse.
  • Erections that are brief for sexual intercourse.
  • Inability to achieve erections.

The key definition for ED is when obtaining or maintaining an erection to complete sexual intercourse is no longer possible. 

Surgery, including treatments for prostate cancer, bladder cancer, or benign prostatic hyperplasia (BPH) can sometimes damage nerves and blood vessels near the penis, this can result in ED. In some cases, the nerve damage is permanent, and the patient will require treatment to achieve an erection. In others, surgery causes temporary ED that can improve on its own after 6 to 18 months.

Smoking, excessive drinking, and drug abuse may damage the blood vessels and reduce blood flow to the penis. Being overweight and getting too little exercise also contribute to ED.  Studies indicate that men who exercise regularly have a lower risk of ED.

The link between chronic disease and ED is most striking for diabetes. Men who have diabetes are two to three times more likely to have erectile dysfunction than men who do not have diabetes. Among men with erectile dysfunction, those with diabetes may experience the problem as much as 10 to 15 years earlier than men without diabetes. Yet evidence shows that good blood sugar control can minimize this risk. Other conditions that may cause ED include cardiovascular disease, atherosclerosis (hardening of the arteries), kidney disease, and multiple sclerosis. These illnesses can impair blood flow or nerve impulses throughout the body.


1. First-Line Therapy, are non-invasive treatments, which include:

  • PDE5 inhibitors, such as Viagra, Cialis and Levitra
  • Androgen/Testosterone Replacement Therapy
  • External Devices, such as rubber rings and vacuum devices
  • Lifestyle modifications
  • Counselling/Sex Therapy

2. Second-Line Therapy, are injectable treatments, which include:

  • Penile Injection Therapy, such as Caverject

3. Third-Line Therapy, are surgical treatments, which include:

  • Penile Prosthesis
  • Vascular Surgery

It is important that all men receiving treatment for erectile dysfunction are supported with counselling.



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