Written by Aqilah Nadirah, Provisionally Registered Pharmacist (PRP)

What is Erectile Dysfunction (ED)?

ED or impotence is a condition where there is inability to achieve or maintain erection which allows satisfactory sexual performance.  Men can either experience occasional or frequent ED depending on their condition.  Stress may contribute to ED while prolonged ED can be a sign of health problems that need medical attention.  While this condition is not life threatening, the psychological consequences may result in withdrawal from sexual intimacy, reduction in quality of life, under productivity, and increase in healthcare utilization.  Based on a Malaysian study in 2017, the overall prevalence of ED was 69.2% with 54.1% and 73.0% urban and rural area respectively (Hasan et al, 2017).  Worldwide prevalence of ED was 3-76.5% with association of increasing age and high prevalence in young men is identified using International Index of Erectile Function and Massachusetts Male Aging Study  (Kessler et al, 2019).


ED can be caused by vascular, neurologic, psychological, and hormonal factors.  Other common causes from certain disease conditions include diabetes mellitus, hypertension, hyperlipidemia, obesity, testosterone deficiency, and prostate cancer treatment.  Medications and substances like antidepressants and tobacco can also cause or aggravate ED.



Prior to commencing any treatment, diagnosis by doctor is required to determine the best treatment and intervention for the problem.  Recommended initial treatment are non-invasive such as lifestyle changes are tobacco cessation, regular exercise, weight loss, and diabetes control then followed by medications before proceeding to the invasive treatment such as injections and implants.


Myth vs Fact

Myth Fact
ED is normal part of growing older and men have to learn with it Although ED is more common among older men, it doesn’t mean it’s something you have to live with
ED doesn’t affect younger men It is common in men aged 75, guys of any age can be affected
ED may be upsetting, but there’s nothing dangerous about it Although ED itself isn’t dangerous, it can be an early warning sign of a serious health problem
You have trouble getting an erection because you are not attracted to your partner Many things can cause ED
Pills are the only way to treat ED There are many options for ED treatment. Among them are medications, injections, or implants



1. Rew, K.T., Heidelbaugh, JJ. (2016) ‘Erectile Dysfunction’, American Family Physician, 15:94 (10):820-827

2. Kessler, A., Sollie, S., Challacombe, B., Briggs, K., Hemelrijck, M.V. (2019) ‘The global prevalence of erectile dysfunction: a review’, BJU International, 124(4):587-599

3. Hassan, M.R., Samsuri, M.F., Azhar Shah, S., Safian, N., Md Zainuddin, Z., Ghazi, H.F. (2017) ‘Prevalence of Premature Ejaculation and Erectile Dysfunction and Their Associated Factors Among Urban and Rural Population of Malaysia’, Malaysian Journal of Public Health Medicine, 17(3)