• Hi there. Thank you for your question. Firstly, let’s see if you truly have erectile dysfunction (ED). Erectile dysfunction happens when there is an inability to erect or maintain an erection for sexual penetration. It is a common sexual disorder for men. It affects your quality of life and most men do not talk about it.

• As for your case, the first step that you need to do is to reduce smoking gradually and then stop completely. This is because smoking is known to cause impotence. For men under the age of 40, smoking is known to be the main cause of erectile dysfunction. This is due to the fact that maintaining an erection requires a good and healthy blood supply. The nicotine content in cigarettes makes the blood vessel contract, subsequently causing reduced blood flow to the penis.

• If this does not work after you completely quit smoking, I would suggest you to consult a doctor to determine the other possible causes. Psychological, physical or even medication factors may contribute to this. Having financial or relationship problems or depression could be a possible cause and to treat this, you need to see a doctor or a counsellor for therapies such as psychological therapy.

• Physical factors may be pre-existing or new conditions such as heart problem and diabetes. Intake of medication such as beta-blockers for hypertension is a known cause of erectile dysfunction. If this is the case, medication change will be needed. There are 3 types of treatment, mainly non-invasive treatment, penile injections and surgery.

• The first treatment that will be given are the non-invasive ones, mainly medication such as phosphodiesterase-5 (PDE5) inhibitors, such as Viagra. If this does not work for a period of time, external device like vacuum device may be given.

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