Dr. S.M.Sadikot.
Hon. Endocrinologist,
Jaslok Hospital and Research Centre,
Mumbai 400026

Erectile dysfunction is defined as the persistent inability to attain or maintain penile erection sufficient for sexual intercourse. Widely known as "impotency" it was in 1992, that the National Institutes of Health Consensus Development Conference recommended use of the term "erectile dysfunction" rather than "impotence," because it more accurately defines the problem and has fewer disparaging connotations.
Erectile dysfunction is not new either in medical texts or in human experience. There are some who feel that the famous scupture of the Thinker was really a self portrait of of the sculptor who had erectile dysfunction. Judge for yourself…..

In any case, erectile dysfunction is not openly discussed by most people as our misplaced concepts of "manliness" forces many a man to refrain from mentioning it even to their physicians. Which perhaps is a good reason why the nomenclature has been changed from importancy (a term which comes from the Latin meaning "loss of power.") to erectile dysfunction.

Erectile dysfunction is a major problem in men with diabetes. It has been reported that after around 15 years of diabetes, more than 60-70% of men will show varying degrees of erectile dysfunction. But as we have seen above, it rarely forms a part of the complaints by the patient and if one is true to oneself, many of us will agree that sexual history is rarely inquired into by us when managing a man with diabetes. Men do not talk of it to their doctors and doctors also avoid discussing this problem. Men feel that bringing up this problem is a sign of their "unmanliness", whilst it is possible that the physician's attitude may have to do with the fact that till a few years back there was little that one could offer by way of definite help.

Moreover, it was widely believed that erectile dysfunction was more a psychological and emotional problem, and had little to do with somatic medicine, falling into the realm of psychotherapists.

This should no longer be accepted as true.

Increased understanding of the male erectile process and the development of several modes of therapy in correcting erectile problems, have brought about a sea change in this dismal picture.

Slowly, but surely, awareness that erectile dysfunction is treatable is growing and more and more men are seeking help and returning to near-normal sexual activity because of improved, successful treatments for impotence

In order to offer the patients the full benefits of these advances in the management of erectile dysfunction, it is important to review the anatomy and physiology of erection, the etiological factors leading to erectile problems, and the methods of evaluating a patient who presents with erectile dysfunction so that the optimal form of treatment can be offered.