What is Erectile Dysfunction?

The consistent or recurrent inability of a man to attain and/or maintain a penile erection sufficient for sexual performance

How common is it? 

You are not alone! It is estimated that there are 2.5  Million men in UK,18 Million men in USA (between ages 40-70) who suffer from the problem. Nearly 2% Population @ 40 years, 25% Population @ 65 years, 35 -50% of Diabetics are in the same boat.

What causes it?

There is no single cause. Usually a mixture of factors contribute to the problem. These  may  include :

• Age
• Cardiovascular disease
• Hyperlipidaemia (high Cholesterol)
• Diabetes mellitus
• Drug side effects: eg medication for high blood pressure etc
• Smoking and alcohol use
• Trauma- damage to spine or pelvic nerves by injury or operations
• Pelvic surgery
• Neurological disorders - Multiple sclerosis
• Hormonal disorders
• Psychological factors- stress, relationship problems

Can anything be done about it?

Of course there are several remedies to overcome the problem. But you will need a detailed clinical examination and some times special tests to rule out diabetes, low testosterone etc.

What options do I have?  

1. Alteration of  modifiable risk factors: eg: cutting down smoking, excessive alcohol etc
   
2. Oral  Medication:  Availability of oral drugs has revolutionised the treatment of ED. Latest drugs are CIALIS (Tadalafil)- can betaken from 30 minutes to 12 hours prior to sexual activity. Efficacy of tadalafil may persist up to 24 hours, LEVITRA (Vardenafil)- which is 10 times more potent than Sildenafil . Others include Viagra (Sildenafil), Uprima (Apomorphine) etc. However they are not for every one and may have side effects like head ache, nausea etc.
   
3. Local Therapies:  MUSE (tiny pellet administered via urethra), Penile injection therapy - Using ALPROSTADIL (Caverject)
   
4. Physical method: Vacuum tumescence device 
   
5. Surgery: last resort. Only suitable for a small proportion of carefully selected patients. The methods include venous ligation, or penile implant.
   
6. Sexual and relationship therapy . Your local 'RELATE' may be the starting point.

What is the next step?

Do speak to your GP or practice nurse, who may be able to assess and initiate therapy if suitable. You may be referred  to Erectile Dysfunction clinic for further assessment and management. We all appreciate that it does take a lot of courage to speak to people about sensitive issues like these.

Where can I find further information? 

please see useful links page