According to the national institute of health statement of consensus, erectile dysfunction is defined as an inability to achieve or maintain an erection sufficient for satisfactory sexual performance . The increasing prevalence of chronic conditions, such as Diabetes mellitus (DM), chronic complications such as erectile dysfunction (ED) rapidly rising . There has been an increase in the prevalence of ED in the general population, especially among diabetic patients [3, 4].
Some studies have shown that the impact of erectile dysfunction among men is both psychological and social effects such as lose of confidence in lifestyle, anxiety, depression, lose of a personal relationship, marked effects on their self-esteem, and lose of social and work activity .
Erectile Dysfunction (ED) is one of the major social problems causing significant distress in men. Despite the increasing difficulty in management, knowledge and understanding of factors responsible for its development are important for prevention, and care. Also, Erectile Dysfunction impairs the quality of life and is associated with depression, increased anxiety, and poor self-esteem in affected patients .
In 2025 about 322 million men will be affected by ED . The prevalence estimates of ED in cross-sectional studies of diabetic populations range from 35 to 71% this year [4, 7].
As a study conducted in the USA, erectile dysfunction was 18.4% of the male population aged 20 years or older. However, the crude prevalence of erectile dysfunction was over 50% among men with diabetes . In the study conducted in Israeli, the prevalence of ED was 57% , in china 90.9% , in India approaching 50% in both type 1 and type 2 DM , in Vietnam 66.9% , in Brazil 66.19%  and Iran 59.5% of type 2 DM patients . According to the studies done in African countries the prevalence of ED was 71.1% in Nigeria , 48% in Guinea , 85.7% in Egypt , 95% in South Africa , 68.8% in Kenya , 74.1% in Ivory Coast , 74% in Nigeria , 73.9% in Zimbabwe , 94.7% in Nigeria, 36.0% in South Africa , 55.1% in Tanzania with 12.8% of participants suffering from mild dysfunction, 11.5% from moderate, and 27.9% from severe Dysfunction , and 69.9% Tigray Ethiopia with 32.9% suffering from mild, 31.7% moderate, and 5.2% severe erectile dysfunction ..
The pooled prevalence of ED among patients with diabetes in Ethiopia was 54.3%  with 69.9% in the Tigray region , 53.1% , and 85.5% in the Amhara region , 53.3%  and 60.4%  in Oromia region of Ethiopia.
The magnitude of erectile dysfunction is usually underestimated in many developing countries because of several reasons. Firstly, ED is not a life-threatening condition, thus not reported. The second is associated with stigma attached to the problem, men with the problem rarely seeking help. There is also the problem of early detection and management of factors responsible for the development of erectile dysfunction .
Socio-demographic factors such as Age [2, 31, 32], Occupation, Monthly income [2, 31, 33], educational status [8, 13], Marital status [33, 34], and residence  are major factors in ED among DM patients. Moreover, Clinical Factors such as Duration of diabetes [3, 15, 35, 36], testosterone deficiency, peripheral neuropathy, peripheral vascular disease , Body mass index (BMI) [33, 37], Fasting blood glucose level (FBG) [14, 31, 36], Type of DM , Hypertension [15, 30] and Type of anti-diabetic drugs , also the determinant factors of ED among DM patients. Also Behavioral or lifestyle factors such as Smoking [31, 37], not involved in physical exercise [4, 8, 33], Alcohol drinking [12, 13] and Adherence to the drug  is the factors that affect ED among DM patients. Therefore, this study was aimed to determine the prevalence and associated factors of ED among diabetic patients at Hawassa teaching referral hospital and Adare General Hospital in Hawassa city. There are a few reports about the ED in Ethiopia; however, there is no related study in this study area.