What is erectile dysfunction (ED)?ED is a problem for men that cannot be ignored.ED is commonly known as “impotence” and is defined as the persistent (over the past 3 months) inability of the penis to achieve and/or maintain an erection hard enough for satisfactory sexual intercourse.1 ED is the most common sexual dysfunction in men and is closely associated with physical and mental health and has a significant impact on the quality of life of patients and their families. ED can be classified as mild, moderate or severe according to its degree. There are four levels of hardness. Are there many men with ED? Almost no one wants to talk openly about ED, so many men think that ED is only unique to them. But in fact, ED is a fairly common disease. 52% of men aged 40-70 have varying degrees of ED2, and it is estimated that a total of 152 million men worldwide suffer from ED; by 2025, the number of men with ED will increase to 322 million3; in China, according to a report by Professor Zhu Jichuan, an expert in urology at the People’s Hospital of Peking University4, the prevalence rate among people aged 40 and above is 40.2%. According to this projection, the number of men with ED in China’s urban population is about 26 million, and is still in a growing trend. What causes ED? There are three main causes of ED: organic, psychological and mixed.5 Among ED patients over the age of 50, 80% are organic ED.6 The causes of organic ED are complex and can be subdivided as follows:7,8,9,10 C Vascular factors: such as hypertension, diabetes, cardiovascular disease, or medications, can lead to poor vasodilation of the penis, less blood filling and consequent erectile dysfunction or The risk of ED can also be increased by diseases such as prostatitis. C penis itself: such as genetics, trauma or surgery, resulting in poorly developed or altered physiological structure. C neurological factors: due to various reasons such as paraplegia, resulting in somatic nerve dysfunction, vegetative neuropathy or central nervous system malfunction, etc., so that nerve messaging can not reach the smooth muscle of the penile corpus cavernosum, and thus can not get an erection. C hormonal disorders, such as: androgen levels are reduced. Psychological ED mainly comes from mental stress during sexual behavior, bad sexual life experience, lack of sexual knowledge, etc. Mixed ED is a combination of psychological and organic factors. Do you also have misconceptions about ED? C Do not go to the hospital. Influenced by traditional Chinese morality and culture, many people do not think ED is a disease, but only as a natural aging phenomenon ignored. In addition, the feeling of personal privacy, more influenced men to actively seek medical treatment. C because of the relationship between personal privacy and go to informal medical institutions. Many informal medical institutions take advantage of the patient’s privacy psychology, tempting patients to spend a lot of money, but delayed treatment. C. Prefer to use health care products instead of regular drugs. In fact, many “health care products” or so-called “aphrodisiacs” on the market are irregularly added with western medicine ingredients, but the dose is very unstable, long-term use will have a negative impact on men’s health. C poor diet and lifestyle habits. ed and diabetes, hyperlipidemia is closely linked; and long-term irregular life, staying up late, alcohol, smoking, etc. will bring interference to sexual activity, and in the long run erectile function decline, ed will come quietly. C think stop masturbation, ED will gradually get better. It has been proven that long-term frequent masturbation is indeed associated with the occurrence of ED and premature ejaculation, but is not a direct cause. Excessive masturbation can cause long-term congestion in the genitourinary system and a decrease in local immunity, which can lead to the occurrence of urethritis and prostate disease. It also leads to sexual nerve fatigue and decreased libido. This series of combined effects lead to the occurrence of sexual dysfunction such as impotence and premature ejaculation. If you stop masturbating, ED and so on will not be cured without a cure. What will be the consequences of not paying attention to ED treatment? The ED is not only affected by the erectile function of the penis, but can also lead to depression, lack of self-confidence or other mental problems in men. More importantly, the presence of ED may be a warning sign of other potential health problems. Studies have found that ED and other diseases such as hypertension, diabetes, cardiovascular disease, atherosclerosis and other vascular pathogenesis of the same factors, ED is likely to manifest as a precursor to these diseases. Alert to the most instinctive signals from the body, can help you detect potential disease and seek medical attention early. In fact, 95% of EDs can be effectively treated12, so you have nothing to worry about. The important thing is that you have already taken the first step in facing the problem, and then you just need to take action and cooperate with your doctor to treat it. Treatment of ED – CUA* guideline recommendations4 CUA: Chinese Medical Association Section of Urology ü First-line treatment: oral medication represented by PDE5 inhibitors (e.g. sildenafil, etc.) ü Second-line treatment: vacuum negative pressure erection device, intracavernosal penile drug injection, transurethral drug therapy ü Basic treatment: correction of Risk factors such as smoking and alcohol cessation, treatment of primary diseases, psychological adjustment, etc. ü Third-line treatment: penile prosthesis implantation, vascular surgery u Please take Viagra® properly under the guidance of a doctor to help patients have a more satisfying sexual experience. Sexual stimulation: Viagra® does not give the user an immediate erection, it only works with sexual stimulation and the erection will subside after sexual intercourse.13 In the absence of sexual stimulation, the recommended dose of sildenafil does not work.2 Dosing time: Take Viagra® approximately 1 hour before you are ready to start sexual intercourse.14