💊 Men's Health
Erectile Dysfunction (ED)
Very common, highly treatable — and often an early warning sign of something else.
Erectile dysfunction affects up to 40% of Nigerian men over 40. It is not a reflection of manhood or character — it is a medical symptom with identifiable, treatable causes. In many cases, it is also the first sign of diabetes, cardiovascular disease, or low testosterone.
Signs and Symptoms
✓ Difficulty achieving an erection
✓ Difficulty maintaining an erection during sex
✓ Reduced interest in sexual activity
✓ Erections that are weaker than before
✓ Morning erections absent or reduced
When to Seek Help
RoutineED lasting more than 3 months, affecting your relationship or confidence — book a GP appointment for assessment and blood tests
SoonED in a man under 40 with no obvious psychological cause — warrants cardiovascular and hormonal screening
NowED with chest pain, exertional breathlessness, or leg pain on walking — ED may be the first symptom of significant cardiovascular disease; seek urgent review
Tests & Diagnosis
🧪 Fasting Blood Glucose and HbA1c
Diabetes is the most common reversible physical cause of ED in Nigerian men. Ruling it out first is essential. A normal result does not end the workup — pre-diabetes and insulin resistance also contribute.
🧪 Fasting Lipid Profile
High LDL cholesterol damages the endothelium — the inner lining of blood vessels — including those supplying penile tissue. Elevated lipids are both a cause of ED and a cardiovascular risk marker.
🧪 Morning Total Testosterone
Testosterone peaks between 7–10 am. A morning sample is essential for an accurate reading. Low testosterone (below 10–12 nmol/L) contributes to reduced libido and impairs erection quality.
🧪 Blood Pressure Measurement
Hypertension is independently associated with ED. If untreated, the arterial damage compounds over time. Paradoxically, some antihypertensive medications (especially older beta-blockers and thiazides) also worsen ED.
🧪 Penile Doppler Ultrasound
For men where vascular ED is suspected, a Doppler scan of the penile arteries after injection of a vasodilator agent measures blood flow and arterial function. Available at specialist urology centres.
Frequently Asked Questions
Is erectile dysfunction a normal part of ageing?
Partial — the frequency of ED does increase with age, but it is not inevitable or untreatable at any age. Age-related ED usually reflects accumulated vascular damage from diabetes, hypertension, and smoking — not ageing itself. Healthy 70-year-olds with well-controlled cardiovascular risk factors maintain erectile function. ED at any age deserves evaluation, not acceptance.
Can I buy sildenafil (Viagra) over the counter safely?
Sildenafil is widely available in Nigerian pharmacies, often without prescription. While it is generally safe for healthy men, it is dangerous with nitrates (isosorbide mononitrate, glyceryl trinitrate — used for angina), can precipitate cardiovascular events in men with undiagnosed heart disease, and does not address the underlying cause. See a doctor before starting — an ECG and cardiovascular assessment take 20 minutes and could save your life.
Does ED mean I have low testosterone?
Not necessarily. Most men with ED have normal testosterone levels — the cause is vascular or psychological. Low testosterone (hypogonadism) is one cause of ED, but primarily presents with low libido, fatigue, and mood changes rather than purely mechanical erection difficulty. A morning testosterone blood test confirms or excludes it.
Will treating ED improve my general health?
Yes — in an important indirect way. ED is a potent motivator for men to engage with healthcare. The investigation process often reveals undiagnosed diabetes, hypertension, or high cholesterol. Treating these conditions reduces cardiovascular risk, improves energy, and prolongs life — the ED improvement is often the most visible benefit of a much broader health rescue.