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What Exactly is Erectile Dysfunction?

What is Erectile Dysfunction?

Most men enjoy sexual activity that includes penetrative intercourse. For this to happen successfully, the penis has to become fully erect and hard enough to enter their partner and to achieve an orgasm.

Erectile dysfunction is an inability to achieve or maintain an erection that allows sexual activity that includes penetration. Complete erectile dysfunction is defined as the total inability to obtain or maintain an erection during sexual stimulation and the absence of nocturnal erections.

In studies, complete erectile dysfunction occurred in approximately 10% of the respondents. Lesser degrees of mild and moderate erectile dysfunction occurred in 17% and 25% of responders respectively. Impotence is common in the elderly and other select groups of patients, including sufferers of diabetes, high blood pressure and heart disease.

Who Gets It?

Exact figures on the incidence of erectile dysfunction are not available due to the perceived socially embarrassing nature of the condition. Studies conducted internationally demonstrate rates as high as 52% of men aged between 40-70 years reporting some degree of erectile difficulty.

How Many Men are Affected?

Erectile dysfunction is common and becomes even more common in older men. A recent survey in Australia showed that at least 1 in 5 men over the age of 40 years experience erectile problems regularly and about 1 in 10 men are completely unable to have erections.

With each decade as a person's age increases, so the possibility of erectile problems increases. Not all affected men want to engage in sexual activity with a partner or are in a position where it is possible. However, it is estimated that about one in three affected men are concerned about the loss of erectile function and require some form of treatment.

Approximately 100 million men are estimated to suffer from erectile dysfunction worldwide and approximately 1 million Australian men have the condition. Numerous studies have identified age as the strongest contributing factor causing the onset of impotence; so erectile dysfunction is expected to increase as the Australian population ages.

How is it Diagnosed?

When diagnosing the condition of erectile dysfunction, a doctor may order additional tests such as a nocturnal penile tumescence study. Extensive testing may not be necessary but this is a way of assessing how often erections are attained while the person is asleep. A Doppler test using ultrasound of the blood vessels in the penis is also occasionally used to establish a cause for poor erections.

Hormone levels in the blood may also give clues to the underlying aetiology (the study of causes). Although a doctor may not be able to give a specific reason as to why the erectile dysfunction has developed, there are many pharmaceutical treatments that work well no matter what is causing the problem. Viagra, Cialis and Levitra are three of the most trusted and reliable erectile dysfunction medications for the effective treatment of the condition.

How is it Treated Apart From Medication?

The successful treatment of erectile dysfunction has been demonstrated to also improve sexual intimacy, general feelings of confidence and to relieve symptoms of depression. There are a few ways of helping the situation apart form taking erectile dysfunction medications including:

  • Changing one's lifestyle can help, by not smoking or taking illegal drugs and by drinking alcohol moderately.

    Getting plenty of rest and find time to relax.

    Getting enough exercise and eating a healthy diet to maintain a good circulation.

    Talking openly to your partner about sex and your relationship or getting counselling if required.

    What Can be Confused with Erectile Dysfunction?

    It is important not to confuse erectile dysfunction with other sexual problems. Some men have little interest in sex or a low libido but can still get an erection, while other men can get an erection but cannot reach an orgasm or ejaculate. Ejaculation can also occur too early (premature ejaculation) or semen may sometimes go back into the bladder without coming out of the penis (retrograde ejaculation). These different problems may need a different approach to diagnose to be treated effectively.

    How Does an Erection Happen?

    Getting an erection relies on nerve messages from the brain, blood flow in the penis and a balance of chemicals in the body. There are two tubes of spongy tissue that run along the length of the penis and a tough fibrous, partially elastic outer casing, that surrounds this spongy material.

    Erections happen in response to sexual arousal. They begin with a message from nerves at the base of the spine telling the blood vessels entering the spongy tissue of the penis to let more blood in. The spongy tissue then arranges itself in such a way that more blood can be stored in the penis. Blood flowing out of the penis is blocked off so the penis fills with blood and stretches within the outer casing, causing an erection.

    What Part Does the Brain Play in Getting an Erection?

    The brain plays an important part in getting an erection. For an erection to happen the brain must be stimulated by pleasure sensations either real or imagined. These sensations can include images, smells or sounds. When the brain receives this stimulus, impulses are sent down the spinal cord to the penis through nerves in the lower part of the spinal cord.

    Erections can also arise from local feelings around the penis such as touch or a full bladder, which send impulses directly into the spinal cord to affect the erection nerves. The brain also sends stimulus for an erection to occur at least three or four times during a night’s sleep.


    At the start of ejaculation, waves of involuntary muscle contractions transport the sperm, with a small amount of fluid, from the epididymis through to the vas deferens. Extra fluid from the seminal vesicles enters the urethra via the ejaculatory duct. During ejaculation, this mixture of fluid from the testes and other accessory glands travels along the urethra to the tip of the penis where it is discharged or ejaculated at the time of sexual climax (orgasm).

    A ring of muscle called the internal sphincter surrounds the opening of the bladder. This muscle ring closes tightly during ejaculation to stop sperm passing backwards into the bladder. Closure of this muscle ring stops urine and semen leaving the body through the urethra at the same time. If this muscle contraction does not happen, the ejaculate can pass back into the bladder, which is called retrograde ejaculation. The function of this ring of muscle can be damaged after surgery to the prostate gland.

  • About the Author

    has over 20 years experience as a sexual health medical practitioner and has specific expertise in male sexual dysfunction.