Erectile Dysfunction, or male impotence, is a sexual dysfunction characterised by the inability to get or maintain an erection that can sustain satisfactory sexual performance.
It is a common problem in men which occurs more frequently with advancing age, diabetes, high blood pressure and following radical prostatectomy. It is estimated that between 15 to 30% of men suffer from erectile dysfunction. Although it is more common in older men, about 1 in 4 men seeking help with erections are under 40.
It is common for men to struggle with getting or keeping an erection from time to time. This is often due to stress, fatigue, anxiety or drinking too much alcohol. However, if it happens more often it could indicate an underlying physical or emotional problem that requires medical attention.
Buying tablets for erectyle disfunction without a proper assessment can be dangerous as the condition is often the first sign of an underlying vascular disease (such as high cholesterol, high blood pressure or undiagnosed diabetes).
Men with underlying health conditions may experience improved sexual performance when receiving adequate treatment. There are also several effective treatments available that can help men regain the ability to have sexual pleasure. These treatments include tablets, injections, vacuum pumps, and novel treatments such as shockwave therapy.
What Causes Erectile Dysfunction?
Erectile dysfunction can be caused by both health-related and psychological factors.
Many people go through episodes of financial difficulties, relationship problems, anxiety and drinking too much alcohol. In men, these factors can have a major impact on libido (sexual desire) and erections. Social and cultural factors, such as religious and moral beliefs, can also affect sexual performance.
Erectile dysfunction in these cases can often be overcome by avoiding alcohol, reducing stress or anxiety, and resolving relationship problems.
There are several medical causes of erectile dysfunction. These include:
- Cardiovascular disease, including high blood pressure, high cholesterol, coronary artery disease
- Low testosterone
- Medication such as antidepressants, blood pressure medications, medications for hair loss, painkillers and antihistamines
- Hormone disorders involving the thyroid or pituitary
- Obesity and sleep apnoea
- Cancer treatments
Because persistent erectile difficulties can be the first sign of cardiovascular disease, which can result in heart attack or stroke, men over 40 suffering with the condition should not delay seeking medical advice.
How Is Erectile Dysfunction Treated?
Many men suffer with erectile dysfunction in silence, partially due to embarrassment or in the mistaken belief that it only affects a small percentage of men. Erectile dysfunction is, however, a common problem in men over 40. In most cases it can be effectively treated and men can regain good sexual function and performance. The following treatments may be used to treat erectile dysfunction:
- Lifestyle changes: Regular exercise, including strength-based exercise can increase your testosterone levels and decrease your risk of erectile dysfunction.
- Sex and relationship therapy: Psychosexual therapy may help you overcome relationship difficulties and belief systems that have a negative impact on your sexual health. This kind of therapy involves a combination of cognitive behavioural therapy (CBT) and sex therapy.
- Treating underlying medical conditions: Treating underlying medical conditions (such as high blood pressure, cholesterol, and diabetes) is the first step in improving sexual function.
- Tablets such as PDE5 inhibitors: Well-known examples include sildenafil (Viagra) and tadalafil (Cialis). Sildenafil is taken an hour or two before sexual activity, while tadalafil can be taken once a day,
- Alprostadil penile injections: Some men do not respond well with tablets. These men (who often have diabetes, severe cardiovascular disease, or nerve damage) may achieve good results with injections.
- Alprostadil urethral suppository: Commonly called Muse, this intraurethral therapy involves placing a small alprostadil suppository inside your penile urethra. You use a special applicator to insert the suppository into your penile urethra. The erection usually starts within 10 minutes.
- Testosterone replacement: ED that is connected to low levels of the male hormone testosterone may be resolved with testosterone replacement therapy.
- Penile pumps: Vacuum constriction devices help men achieve an erection by pulling blood into the penis. It is used in conjunction with a band that is applied at the bottom of the penis once an erection has been achieved.
- Penile prosthesis: For men with extensive nerve damage a penile prosthesis may be necessary to regain erectile function.
- Shockwave therapy: This treatment uses targeted sound waves to stimulate penile tissue and encourage blood flow. Low-intensity shockwaves may help new blood vessels to grow and improve blood flow in the penis.
Frequently Asked Questions
Men suffering with erectile dysfunction may have an underlaying health condition. Blood- and urine tests can check for signs of heart disease, diabetes, low testosterone levels and other health problems.
Medications for treating depression can cause symptoms such as low libido and erectile dysfunction. They can also make it more difficult to have an orgasm.
No, you cannot buy Viagra over the counter. In the UK, however, you can purchase Viagra Connect over the counter without a prescription. It contains the same active ingredient as Viagra (sildenafil citrate).