Erectile dysfunction (ED), the persistent inability to achieve or maintain an erection, is far more common than most South Africans realise, and increasingly, medical professionals say it's not just a bedroom issue.
It may be the body's earliest warning sign of heart disease, diabetes, or hypertension.
If a man in your life has been quieter than usual, or brushing off what he calls "just stress," it might be worth a deeper conversation.
Dr Shingai Mutambirwa, head of Urology at Sefako Makgatho Health Sciences University (SMU), explains that ED is often misunderstood.
"Erectile dysfunction is often misunderstood as simply a quality-of-life issue, when in reality it can be one of the earliest warning signs of more serious underlying conditions such as cardiovascular disease, diabetes or hypertension," said Dr Mutambirwa.
"Because blood vessel health plays such an important role in erectile function, ED may present long before other symptoms of chronic disease become apparent," he adds.
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The numbers are hard to ignore
A study conducted at a primary healthcare clinic in Durban, KwaZulu-Natal, found that ED affected 64.9% of men surveyed, with rates climbing sharply among older men and those living with conditions like diabetes and hypertension. Globally, research estimates that between 30% and 60% of men over 40 are affected, though the true burden is thought to be much higher due to underreporting.
Among men living with diabetes on the African continent, the prevalence of ED may be as high as 71%.
The link between ED and cardiovascular health is not coincidental. Erections depend on healthy blood flow, and the same damage that narrows arteries in the heart can quietly affect blood vessels elsewhere in the body – often years before a diagnosis is made.
Why men stay silent – and why they shouldn't
Stigma, embarrassment, and cultural pressure to appear strong keep many men from ever raising these concerns with a doctor. But health professionals are urging a mindset shift: seeking help for ED is not an admission of weakness – it's potentially a lifesaving act.
Routine screening for erectile dysfunction could open the door to identifying undiagnosed chronic conditions before they become life-threatening. The earlier these are caught, the better the outcomes.
If you or someone you know is experiencing ED, the first step is a visit to a general practitioner or urologist – not Google, and certainly not silence.
*Awareness of erectile dysfunction as a broader health indicator is being championed locally by Viatris South Africa, a subsidiary of global healthcare company Viatris (Nasdaq: VTRS), as part of their EmpowerED for Life campaign this Men's Health Awareness Month.
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