It is estimated that 52% of men over 40 worldwide suffer from erection problems, but less than 15% of these men seek or receive therapy for their condition.

In South Africa, a recent survey of primary health care clinics in the Western Cape, found that seven out of 10 men between the ages of 35 and 70 years had some degree of erectile dysfunction (ED). In Africa in general, 11,5 million men suffer from erection problems.

* 30 million men in the United States have erectile dysfunction.
* 50% of men with diabetes have erectile dysfunction, frequently within 10 years of diagnosis.
* The likelihood of erectile dysfunction increases with age: 39% at age 40, 65% over the age of 65.
* Smokers have a higher likelihood of erectile dysfunction. Men who smoke more than 1 pack per day have a 50% higher chance of impotency than nonsmokers the same age.

Erectile Dysfunction appears to be on the rise:

* More men are experiencing impotency because the baby boomer generation is getting older. According to same reports, every 7 seconds a baby boomer turns 50 years old.
* Awareness of the problem is increasing, which increases the number of men who are treated.
* Because, in the past, men have generally been unwilling to talk about their problem or seek treatment, erectile dysfunction has been underreported.
* Many physicians are not aware of the treatment options, so patients have been either undertreated or not treated at all.
* According to a report in Newsweek, 11/17/97, "Each new drug, with its attendant publicity, brings more men into the game. Some urologists expect the number of men seeking treatment to double in the coming years."

Causes of Erectile Dysfunction:

* Arterial Insufficiency (Vascular disease): Diabetes, high blood pressure, smoking
* Surgery: Prostate removal for prostate cancer, pelvic surgery for colon cancer
* Nerve damage: Spinal cord injury, multiple sclerosis, stroke
* Endocrine imbalance: Low testosterone levels
* Emotional/psychological: Depression, stress, anxiety
* Medications/drugs: Blood pressure medication, alcohol, sedatives, narcotics

Erectile dysfunction Treatments

Viagra's rival is here. Cialis, the new treatment for erection problems hit South African pharmacy shelves on Thursday, bringing with it the promise of "36 hours of freedom" to achieve an erection. DAILY HEALTH TIP Get a daily dose of health in your inbox. Subscribe to our bite-sized no-nonsense tip service and stand a chance to win R1000 every month! Daily tip Weekly tip Weekly newsletter Name: Email: Advertisement The drug is virtually side effect free and can be taken without food or alcohol restraints. What's more is that it has been shown to take effect in as little as 16 minutes. Cialis provides stiff competition to other drugs in its category, that only have the capacity to act for four to six hours. Cialis is the latest innovation by pharmaceutical company Eli Lilly in an attempt to capture South Africa's lucrative anti-impotence market that is estimated to be worth about R50 million.

The ALL-weekender pill
Cialis, an oral PDE5 inhibitor, works by improving the response of the penis to sexual stimulation. The drug does this by relaxing the smooth muscle cells causing improved blood flow to the penis, allowing a full erection to occur long enough to enable sexual activity.

Lilly's market research showed that couples using other oral PDE5 inhibitors felt under considerable pressure to have sexual intercourse within a few hours of taking the treatment. They complained that this pressure often ruined the mood for sexual activity and destroyed intimacy and spontaneity in sexual relationships.

With the new drug, a man can take one 20mg tablet that will last for more than a day. In fact Cialis, which was launched three months ago in Europe, Australia and New Zealand, has already gained the name the "weekender pill," because it allows couples to enjoy sexual intimacy from Friday through to Sunday.

It's not all in your head?
In the past it was believed that 80% of ED cases were caused by psychological problems, today this idea has been reversed with doctors claiming that the majority of causes of ED are physiological.

According to urologist Dr David Smart, common medical problems such as diabetes, coronary artery disease, hypertension and hyperlipidaemia make up 60-70% of initiating factors of ED. In fact, Smart says that "Fifty percent of diabetic men have profound erectile problems."

Prostate surgery, multiple sclerosis, Parkinson's and spinal cord injuries have also been known to cause ED.

Even the drugs given to treat common conditions like hypertension, anxiety, depression and cardiac conditions actually cause ED as a side-effect, says Smart.

The downside of getting it up
Cialis boasts remarkably few side effects, in fact in clinical trials, only 4% of men reported experiencing them. The most common side effects included things like headaches, indigestion and facial flushing – all side effects common to other oral PDE5 inhibitors.

Men who are receiving treatment with nitrates or those with severe kidney, liver or heart disease should not take Cialis. Neither should men who have suffered a heart attack in the last three months, a stroke in the last six months or have low blood pressure or uncontrolled high blood pressure.

The drug is competitively priced and is only available on prescription. – (Ingrid Bosch, Health24)

For general information on sexual health contact the confidential telephone help line service of The Southern African Sexual Health Association (SASHA) on 0860 100 262.