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Erectile Dysfunction

Advice and help about impotence and erection problems

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Dr Hilary Jones discusses erectile dysfunction and the treatments available at HealthExpress

Erectile dysfunction (also known as impotence) is more common than many think, with 1 in 5 men likely to experience difficulties in gaining or sustaining an erection at some point in their lives. If you believe you may be having some trouble with your erections, it's important to understand that you're not alone. This condition usually occurs as the result of the brain or body failing to respond adequately to sexual stimulus.

Erectile dysfunction (ED) can occur at any adult age although figures do show it is more prominent in older men, with an increase in prevalence of 5% to 15% for men between 40 and 70 years of age. There are various factors that contribute to the condition and if you require effective treatment for impotence then you can simply order one of the medically proven treatments below after taking a quick online medical consultation.

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What is erectile dysfunction?

Erectile dysfunction is diagnosed when a man has a difficulty achieving and/or maintaining an erection, after experiencing sexual arousal. This means he is unable to stay sufficiently aroused to engage in satisfactory sexual intercourse. Caused by a lack of blood flow to the penis, it can eventually lead to other problems such as anxiety, relationship difficulties and loss of self-esteem.[1]

Is it the same as premature ejaculation?

No. Whilst both fall under male sexual dysfunction, they are separate conditions. 'Impotence is the inability to achieve or sustain an erection after arousal, whilst premature ejaculation occurs when a man can achieve/sustain an erection, but reaches orgasm before a satisfactory duration.

What causes erection problems?

Erectile dysfunction can be caused either by psychological or physical issues, or sometimes a combination of the two. A great way for a man to identify the underlying cause is usually to see whether an erection occurs naturally in the morning or if there is a general struggle to achieve an erection when aroused. If this is the case, then there are various physical or psychological causes that can be looked at.

Psychological causes include: Physical causes include:
Guilt Depression Diabetes Smoking
Anxiety Stress Alcoholism Deterioration of the arteries
Exhaustion Conflict with your partner Being overweight Medications
Unresolved sexual orientation Sexual boredom Cerebral or spinal cord injuries Abdominal or prostate surgery

When erectile dysfunction is observed in young males, it is often assumed that it's psychological, however a physiological issue can't always be ruled out. That is why it's important to speak with a medical professional such as a urologist. Stress, testosterone levels, depression and relationship problems can all contribute to erectile dysfunction. Older gentlemen suffer from erectile dysfunction at a higher rate than their junior counterparts, so if you are in the 60+ age bracket then it really is nothing to be alarmed about, as it affects around 40% of men in that demographic.[2]

Stress & Depression

ED can be exacerbated by stresses at work or at home, from money worries, as well as bouts of depression. Like anxiety, depression can also be brought on by sexual dysfunction itself, due to a loss of confidence and feelings of inadequacy.

Low testosterone levels

Testosterone gradually decreases as man ages, however for some men more than others. If you think you're suffering from low testosterone, it's always wise to get it checked by a doctor as you may benefit from male hormone replacement therapy.

Pornography

Recent studies have suggested that over-consumption of pornography among young males has led to the rise in porn-induced erectile dysfunction, a psychological phenomena which can only be cured by ceasing pornography consumption and seeking the necessary help.

Binge drinking

Lastly, heavy nights out can lead to temporary erection problems. Alcohol and nicotine both affect blood flow to the penis, and both drinking and smoking can have long-term effects on a man's sexual functioning.

Is impotence related to other conditions?

Absolutely. Current medication, lifestyle habits and also mental health can contribute to erectile dysfunction.[3] Take a look at the illustration below to get a better understanding of the wide-ranging reasons why you may be experiencing difficulty achieving and maintaining an erection.

Medications – Beta-blockers used to treat conditions such as high blood pressure are known to contribute towards erectile dysfunction.

Being overweight – Being overweight can lead to other health conditions like diabetes and high blood pressure, which are also known risk factors for erectile dysfunction.

Smoking – Tobacco restricts the blood flow to the arteries, which leads to erectile dysfunction.

Diabetes – Conditions such as type 2 diabetes can damage the nerve and blood vessels in the penis, making it difficult to achieve an erection.

Alcohol – Drinking alcohol in excess has been found to cause impotence - both temporarily and in the long-term.

Prostate cancer/surgery – Prostate medications and surgery can lead to erectile dysfunction.

Heart disease – Chronic heart problems can cause the arteries to harden. This can affect the blood supply to the penis, causing erection problems to occur.

Depression and anxiety has also been linked to erectile dysfunction. This is mainly because the science behind the erection process is reliant on a delicate balance of hormones and nerve impulses, which can sometimes be disrupted by depression.

Because impotence can sometimes point towards other conditions such as high cholesterol, diabetes and high blood pressure, if you're concerned it's always best to book an appointment with your GP and get advice tailored to your personal situation.

What are the effects of impotence on a man?

Primary effects Secondary effects
  • Difficulty achieving an erection
  • Difficulty sustaining an erection suitable for sexual intercourse
  • A loss of self esteem
  • Relationship issues
  • Performance anxiety

Effects of erectile dysfunction on a partner

It's important that there is effective communication between a person with ED and their sexual partner. Having an open understand of the problem and how it can be resolved can go a long way in ensuring that both people feel confident when engaging in sexual activity. If not communicated properly, a man can continue to have anxiety or performance related impotence and their partner may also believe they are to personally to blame for the problem. That means it's always important that there is reassurance to show it isn't the case, and that you can work together to help restore a healthy sex life.

Sometimes relationship problems can be a factor in E.D, so if that is the case then it's just as important to communicate how you feel to each other.[4]

The benefits of treating erectile dysfunction

Getting the help you need to restore your erectile health doesn't only extend to your sexual activity, it can have wide-reaching positive consequences for your entire life. Due to the way it can increase your confidence, it's possible that you'll feel more motivated to make the changes you were previously putting on hold. Confidence is a significantly important factor in a man's well being and self-esteem, so it makes perfect sense to ensure it's at the highest it can be.

Furthermore, restoring your sex life to how it was before you started experiencing problems could spur you on to make active changes in other areas of your life. Reducing stress, giving up smoking, cutting back on alcohol and losing weight by having a healthy diet and exercising regularly can not only improve your erectile problems but also your quality of living in general.

  • A reinvigorated sex life
  • Increased self esteem and self-confidence

How can I treat erectile dysfunction?

Although most cases of erectile dysfunction can be resolved with lifestyle changes of psychological help, some cases are longer term and therefore and effective treatment method is required. From herbal supplements and natural methods, to prescription medication such as Viagra and Cialis, there are various options available and touted to be effective in treating this condition.

Natural treatments for impotence

According to studies, improving your diet and exercise can help better your erectile dysfunction. As high blood pressure and high cholesterol can damage the arteries, they are less capable of delivering sufficient blood to the penis when aroused. Taking active measures to lower blood pressure and cholesterol has been found to have a positive effect on a man achieving a successful erection. It is documented that certain lifestyle changes and 'natural remedies' can benefit erectile problems in the long run. Whilst eating healthily, reducing your high readings, and lowering your cholesterol are always good things, they are still not a guarantee they'll treat your erectile problems.

Diet - A healthy diet is linked to low numbers of men reporting erectile dysfunction. So, loading up on fish and low fat meats, vegetables, whole-grain foods and fruits is certainly a step in the right direction.[5]

Communication – This could be in the form of counselling, group therapy sessions, or most importantly, discussing your erectile problems with your partner. This isn't to be underestimated. In fact, some of the psychological causes surrounding ED can sometimes be resolved with simple communication.

Alcohol – Studies have shown that alcohol isn't just a short-term problem, but it can actually last for months after stopping heavy drinking.

Smoking – Smoking can clog the arteries and lessen blood flow. Not to forget, nicotine also restricts your blood vessels. So stopping smoking can have a significant positive effect on ED.

Stress – Some men have found cutting their stress levels i.e. via meditation has had a positive effect on both their erection problems and sex drive in general.

Herbal treatments

The use of herbal treatments are very subjective depending on the individual; some react better to these compounds than others. As ED herbal remedies don't have the same success rate as prescription treatments and in nearly all cases don't underrun clinical studies, it is highly advised for you to consult your GP and research the options fully before making your decision.

Counselling

As mentioned under prevention, counselling is a good solution for those with psychologically induced impotence. This is also a promising option when teamed with prescription medication to help really get to the root cause of the problem.
This can include psychosexual therapy as well as Cognitive Behavioural Therapy (CBT).[6]

Vacuum Constriction Devices

Vacuum constriction devices (penis pumps) create a vacuum that draws blood into the penis which causes it to swell and become erect. Although there is no proven evidence in the efficiency of vacuum pumps, studies suggest that between 50%-80% of men are satisfied with the results. As the effect is temporarily and the usage of respective products don't come without risk it's highly advised to seek medical assistance before using a VCD.

Surgery

Surgery is usually a 'last resort' method, when all other options have proven unsuccessful. Surgery is however usually the first go-to procedure for men who've been in serious accidents, or for men who have damage, disfigurement or anatomical issues with their penis.

Alongside these NHS surgical procedures there are penile implants (semi-rigid and inflatable), which are considered a cosmetic operation, and thus not available on the health service. However, 75% of men report satisfaction with this treatment.

Testosterone replacement therapy (TRT)

Once a man reaches his thirties, his testosterone levels begin to decrease. Things like exercise, healthy diet and genetics can help prevent large drops until later in life, as can TRT. Get your testosterone levels checked by your doctor if you feel like you have no libido. There's no harm in getting tested, even if it's just to rule it out.

Prescription medicines

Oral tablets are the most popular form of erectile dysfunction treatment as they are clinically proven through research and governing bodies and can provide either a long or short-term solution. There are quite a few prescription treatments available with varying dosages and strengths including:

All of the above work by increasing blood to flow to your penis, and are grouped together as PDE5 inhibitors. This enables you to achieve a firmer, and longer lasting erection during sexual intercourse and all have been proven via clinical studies.

These medicines are ineffective without sexual stimulation, which is why it's important to address any psychological factors as well as the physiological ones.

What options are available to treat ED?

Here at HealthExpress we only offer medically proven, prescription medication for this condition. Whilst Viagra is the most popular, there are various other active treatments manufactured with the intent of enabling a man to gain and sustain a stronger erection when previously unable to. Each treatment has its individual benefits although they all work in the same way. For example, Cialis Daily is the lowest dosage and can be taken once-a-day, which can be handy for those requiring spontaneity, whilst Levitra is suitable and effective for those suffering from diabetes or high blood pressure.

We understand that this condition may be embarrassing for some men to discuss with others, which is why we offer this premium service geared towards ensuring that you get the most suitable treatment, discreetly and by the next day (same day if in London). If you're not sure which medication is right for you, you can take our free and quick online consultation and one of our doctors can help to recommend a treatment most suited to your individual circumstances.

Sources

Dr Hilary Jones, HealthExpress Medical Advisor

What to do if you experience persistent ED

If you are experiencing persistent symptoms of ED, the worst thing you can do is suffer in silence. The first thing to do is to discuss your condition with your partner and a doctor for emotional and professional support. Talking to someone can also help you to find out the underlying cause for your erection problems. If you feel too uncomfortable speaking to your doctor, our discreet and confidential consultation service can help. Our service means you can avoid a face-to-face consultation with the doctor and get your treatment delivered to your door. Just complete our short, no-obligation online consultation, where our registered doctors can help to find the most effective impotence treatment for you.

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