Erectile Dysfunction (ED)

We provide services for men concerned about Erectile Dysfunction (ED).
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Erectile dysfunction (ED) often occurs due to diminished blood flow, and PDE5 inhibitor drugs taken orally can help restore blood supply for some men. However, if the blood vessels surrounding the penis are narrowed, other blood vessels might be similarly affected, indicating a potential underlying cardiovascular issue. ED can also result from diabetes, prostate problems, or as a side effect of medications such as antidepressants.

Testosterone deficiency (TD) can also contribute to ED. Just as women's hormones change in middle age, leading to low libido, testosterone levels can decline in men, causing similar effects. Testosterone replacement therapy can improve erections in men with testosterone deficiency, particularly when combined with other treatments.

Non-medical interventions can also be beneficial. Diet and lifestyle play a significant role. Seventy-nine percent of older adults are overweight, and overweight men are more likely to suffer from ED. Weight loss can make a difference. Regular exercise, quitting smoking, and moderate alcohol consumption are good initial measures. Incorporating elements of the Mediterranean diet, such as olive oil, fish, and nuts, is also recommended. Essentially, anything beneficial for the heart is good for the penis.

In up to 20% of cases, ED has psychological or emotional causes, making counselling a viable treatment option. Psychological issues can decrease confidence and self-esteem, worsening ED symptoms. Performance anxiety and unhealthy fixations learned through pornography can also impact sexual function. Talk therapy can address these psychological issues, positively affecting relationships and intimacy levels over time.

Several medical treatments are available for erectile dysfunction:

• PDE5 Inhibitors: These pills can be taken up to an hour before intercourse or regularly in low doses. Low-dose options increase blood flow over time, aiming to improve erection quality in the long term.
• Injectable Therapies: Prostaglandin can be injected directly into the penis, taking effect within five to ten minutes.
• Other Administration Methods: Prostaglandin can also be administered by inserting a pellet into the urethra or by massaging a cream onto the end of the penis.

Referral for other interventions can also be discussed:

• Surgery: For some, a permanent prosthesis can be implanted into the penis, providing a hard and sensitive erection with the ability to achieve climax. Alternatively, a malleable implant or a vacuum device can be used, though the resulting erection differs from a natural one.
• Low-Intensity Shockwave Therapy (LIST): This involves using an ultrasound probe to deliver 1,500 shocks to five points along the penis over four to twelve sessions across four weeks, encouraging the growth of new blood vessels. Patients can be referred for LIST if deemed appropriate.

By considering a range of treatments, both medical and lifestyle-based, men with ED can find a solution that best suits their needs.