Dr. Lemuel Davis Bray, a urologist at Tema General Hospital, has explained that erectile dysfunction (ED) is often driven by psychological, hormonal, and cardiovascular factors rather than problems with the sexual organs alone. He made these remarks during a health discussion on GTV’s Breakfast Show on Wednesday, December 3, 2025.
The discussion was prompted by questions from men who reported difficulty performing sexually with their spouses while experiencing better performance with other partners. Dr. Bray stressed that sexual performance begins in the mind, not just the body.
“Erectile dysfunction is not just about the body; it starts from the mind,” he said. He clarified that ED, or impotence, is defined as a man’s inability to obtain or maintain an erection sufficient for sexual activity. Disruption at any stage of the sexual process—including desire (libido), nerve stimulation, blood flow, ejaculation, and climax—can lead to ED.
Dr. Bray highlighted libido as the first and most critical stage, noting that hormones, stress, emotional well-being, and relationship satisfaction influence sexual desire. Stress, depression, anxiety, hypertension, and other chronic illnesses can suppress libido even if the sexual organ functions normally, leading men to mistakenly believe they are impotent.
Using an electrical wiring analogy, Dr. Bray compared the erection process to turning on a light: chemical signals from the brain must pass through several stages before blood flows into the penis to create an erection. He noted that penile blood pressure during erection can reach 200 mmHg—much higher than normal body blood pressure—which is both normal and necessary for sexual function.
The urologist also discussed how high blood pressure and its medications can affect erectile function. Persistent hypertension can harden and narrow blood vessels, reducing blood flow to the penis. He warned against discontinuing blood pressure medication due to fear of sexual weakness, describing it as potentially life-threatening, increasing the risk of stroke, heart attack, or blindness.
Dr. Bray further cautioned against combining nitrate medications with sexual enhancement drugs, explaining that this combination can dangerously lower blood pressure and potentially cause fainting, collapse, or sudden death.
Addressing the prevalence of ED, Dr. Bray noted that the condition is extremely common but often underreported due to stigma. Many men avoid medical care, opting instead to discuss issues with friends or suffer in silence, which can lead to frustration, anxiety, depression, and relationship strain.
He emphasized that ED affects men of all ages—from young men seeking performance enhancement to older men experiencing hormonal decline or chronic illnesses—and that professional medical help is essential. He advised men, especially those on blood pressure medication, to consult doctors for proper diagnosis and medication adjustment rather than self-medicating.
“Erectile dysfunction is treatable when men seek medical help early,” Dr. Bray concluded, stressing the importance of open communication, responsible medication use, and timely medical intervention to restore both physical and emotional wellbeing.