​Erectile dysfunction: What your penis is trying to tell you

Men often only seek medical help when their sex lives suffer. They are so bad at seeking medical help that they often get to a doctor too late, says urologist Kalli Spencer. 

“Men are notoriously bad at coming to the hospital. It is a cultural or societal norm.” 

According to the World Health Organisation, in Central Sub-Saharan Africa, men live on average five years less than women. 

A 2014 study published in the journal Global Health Action revealed that “men are expected to be strong and tough, and by implication healthy”. Being sick is seen as a weakness. 

“It is usually only when their sex lives are affected that men seek medical help, like in the case of erectile dysfunction or early ejaculation,” says Spencer. “But even then they might not come to the doctor because it’s humiliating for a man to not be able to have an erection.”

However, erectile dysfunction can be a sign of a more severe illness. 

“Very often men have erectile dysfunction before they have a heart attack,” says Spencer. “That is when they come to the hospital and when we check them we find other conditions like benign prostatic hyperplasia (BPH).”

Benign prostatic hyperplasia is an enlarged prostate which also affects erectile function, he says. It is not cancerous but if untreated it can block the flow of urine out of the bladder and cause bladder, urinary tract or kidney problems, according to the medical research organisation, Mayo clinic.    

“But men are afraid of getting a rectal examination – which screens for an enlarged prostate and prostate cancer. In the public sector we see a lot of patients who become paralysed as a result of prostate cancer because they present to us in the late stages of the illness.” 

Spencer says that men’s health in general is neglected and more efforts are needed to highlight these conditions. “All the aspects of men’s health are interrelated. Conditions like diabetes and hypertension can lead to erectile dysfunction, heart attacks or strokes.”

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