ED often occurs because of a diminished blood flow and PDE5 inhibitor drugs taken orally can help restore the supply for some men. But if the blood vessels surrounding the penis are narrowed, its likely other blood vessels are too- a problem with the penis can sometimes be an indicator of an underlying cardiovascular problem. ED can also result from diabetes, prostate problems or be the side effect of other prescribed drugs such as antidepressants.
Testosterone deficiency (TD) may have a part to play in ED too. Just as women’s hormones change in middle age, causing low libido, so too can testosterone decline in men, with much the same results. Testosterone replacement therapy can help improve men’s erections in those men that are testosterone deficient, especially when combined with other treatments.
It’s not just medical interventions that can help. Diet may be a factor too. 79% of older adults are overweight. Overweight men are more likely to suffer from ED and losing weight can make a difference. Taking 30 minutes of exercise a day, stopping smoking and drinking moderately all are good initial measures, as well as adding elements of the Mediterranean diet to your meals. Basically, anything that is good for the heart is good for the penis- So the addition of foods such as olive oil, fish and nuts can be helpful.
In up to 20% of cases, ED stems from a psychological or emotional problem, which means that counselling can help. Psychological causes of ED can lead to a decrease in confidence and self-esteem and a subsequent worsening of symptoms. Performance anxiety is something many men suffer from. Porn also has an impact. Lots of young men have learned how to be sexual through porn rather than through an intimate sensual relationship. They have learned to have an unhealthy fixation on the end result — the orgasm — rather than on the sensual pleasure. Talk Therapy can help deal with any psychological issues at play and can positively impact over time on how they feel about their relationships and their intimacy levels.
A number of options are available to treat erectile dysfunction
There is a range of medical treatments for erectile dysfunction:
- PDE5 inhibitor drugs. All are taken in pill form. Some are taken up to an hour before intercourse while others are taken on a regular basis in low doses. Low-dose options increases blood flow over time, with a view to improving the quality of erections in the long term.
- Injectable therapies involve a drug called prostaglandin being injected directly into the penis. They are effective within five to 10 minutes.
- This same drug can also be taken 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 is an option for some. A permanent prosthesis can be implanted into the penis. Nothing is visible externally. The resulting erection is as hard and sensitive as before and the man can achieve climax.
- There’s a less complex option involving a malleable implant or the non-invasive option of a vacuum device. The resulting erection is different to a normal erection but some patients are very satisfied with it.
- LIST is a procedure where doctors use an ultrasound probe to deliver 1,500 shocks to five points along the penis. This procedure is carried out over four to 12 sessions over the course of four weeks. It works by encouraging the growth of new blood vessels to the penis. We are happy to refer patients for LIST if we feel this is appropriate.