Erectile dysfunction (ED) or impotence is defined as the inability of a man to achieve or maintain an erection that is sufficient to achieve the kind of sex desired by the man and his partner. Erection is quite a complex process with many psychological and physical aspects and there are therefore many ways in which ED can be caused. As a result ED is one of the commonest forms of sexual problem a man can have. In a US study (The Massachusetts Male Ageing Study, 1994) 52 per cent of men between 40 and 70 years old reported some degree of impotence – mild in 17.1 per cent, moderate in 25.2 per cent and complete in 9.6 per cent.

ED is one of the most common male sexual problems, with over 50 per cent of men bewteen 40 and 70 years old experiencing it to some degree.


Age is one factor that increases the likelihood of ED – 5 per cent of men aged 40 report complete inability to obtain a satisfactory erection compared to 15 per cent at age 70. Many men therefore wrongly accept ED as a normal part of the ageing process and the majority of men with ED do not seek or receive adequate advice or treatment for ED.

As recently as 20 years ago the majority of people with ED were thought by doctors to have mainly a psychological cause for their problem and as a result were usually recommended to have sexual therapy or counselling as treatment (if anything). It’s now known that psychological reasons alone account for about a third of ED cases, with the rest being due to physical conditions or, much more frequently, to a combination of physical and psychological causes. As ED commonly gives rise to anxiety in men and can be a cause of stress in a relationship it is probably true to say that all men with ED have some degree of psychological component to their condition. Fortunately both the public and the medical profession have become better informed about ED, particularly in the past few years because of the recent appearance of far better treatments. However, ED is still a subject that gets less attention than it deserves.