Erectile dysfunction - ED treatment in Essex area

Erectile dysfunction

Erectile dysfunction (ED), also known as impotence, is the inability to get and maintain an erection.

Erectile dysfunction is a very common condition, particularly in older men. It is estimated that half of all men between the ages of 40 and 70 will have it to some degree.

Why does erectile dysfunction happen?

Erectile dysfunction can have a range of causes, both physical and psychological. Physical causes include:

• narrowing of the blood vessels going to the penis – commonly associated with high blood pressure (hypertension), high cholesterol or diabetes.
• hormonal problems
• surgery or injury

Psychological causes of ED include:

• anxiety
• depression
• relationship problems

Sometimes erectile dysfunction only occurs in certain situations. For example, you may be able to get an erection during masturbation, or you may find that you sometimes wake up with an erection, but you are unable to get an erection with your sexual partner.

If this is the case, it is likely the underlying cause of erectile dysfunction is psychological (stress related). If you are unable to get an erection under any circumstances, it is likely that the underlying cause is physical.

Erectile dysfunction can also be a side-effect of using certain medicines.

Diagnosis

Although you may be embarrassed, it is important to get a diagnosis so that the cause can be identified.

Your GP can usually diagnose erectile dysfunction. This will involve answering questions about your symptoms, as well as a physical examination and some simple tests.

Read more about diagnosing erectile dysfunction.

How is erectile dysfunction treated?

Erectile dysfunction is primarily treated by tackling the cause of the problem, whether this is physical or psychological.

The narrowing of the arteries (called atherosclerosis) is one of the most common causes of ED. In these cases your GP may suggest lifestyle changes, such as losing weight, to try to reduce your risk of cardiovascular disease. This may help to relieve your symptoms as well as improving your general health.

You may also be given medication to treat atherosclerosis, such as cholesterol-lowering statins and drugs to reduce your blood pressure.

A number of treatments have been successful in the treatment of erectile dysfunction. Medication, such as sildenafil (sold as Viagra), can be used to manage it in at least two-thirds of cases. Vacuum pumps that encourage blood to flow to the penis and cause an erection are also successful in 90% of cases.

Psychological treatments include cognitive behavioural therapy (CBT) and sex therapy.

Overall, treatments for erectile dysfunction have improved significantly in recent years. Most men are eventually able to have sex again.

Read more about treating erectile dysfunction below:

Phosphodiesterase-5 (PDE-5) inhibitors

Phosphodiesterase-5 (PDE-5) inhibitors are one of the most widely used and effective types of medication for treating erectile dysfunction. They work by temporarily increasing the blood flow to your penis.

In England, four PDE-5 inhibitors are available for treating erectile dysfunction. They are:

• sildenafil – sold under the brand name Viagra 
• tadalafil – sold under the brand name Cialis

Sildenafil works for about eight hours and they are designed to work 'on demand'. Tadalafil lasts for up to 36 hours and is more suitable if you require treatment for a longer period of time, for example, over a weekend.

Depending on the type of PDE-5 inhibitor you are taking and the dose, it should take about 30-60 minutes before it starts to work. With sildenafil, vardenafil and avanafil, you should be able to have sex from one to 10 hours after taking the medicine. After taking tadalafil, the effects will last for up to 36 hours.

It may take longer to notice the effects if the tablet is taken with food, so it's best to take it on an empty stomach. You can then eat after an hour without affecting the medicine.

Only take one tablet within a 24-hour period.

Your prescriber will explain the benefits of each medication and how it works. The choice may depend on:

• how often you are sexually active. 
• whether you have tried any of the medications before

There have been many studies to test the effectiveness of these medications. In general, at least two-thirds of men report having improved erections after taking one of these medicines.

If you do not find that PDE-5 inhibitors are effective it may be because:

• you have not waited long enough after taking the dose.
• you have waited too long after taking the dose.
• the dose is not high enough.
• you have not had enough sexual stimulation.

These medications are triggered by sexual stimulation, so you also need to be aroused for it to work.

Warnings

PDE-5 inhibitors should be used with caution in men who have cardiovascular disease, such as coronary heart disease. However, sexual activity is also likely to be beneficial for your cardiovascular health. You should discuss the risks and benefits with your GP.

PDE-5 inhibitors should also be used with caution in men who have anatomical problems with their penis, such as Peyronie's disease (a condition that affects the tissue of the penis).

PDE-5 inhibitors should also be used with caution in men who:

• are at risk of priapism – a painful erection that lasts for several hours.
• are also taking long lasting alpha-blockers – a medication used to treat a number of conditions, such as high blood pressure (hypertension)

Do not take PDE-5 inhibitors if you are also taking medicines or recreational drugs that contain nitrates. The combination of the two substances can have a dangerous effect on your heart.

Organic nitrates are often used to treat angina, and butyl nitrate is a recreational drug that is more commonly known as 'poppers'.

You are also warned not to take PDE-5 inhibitors if you:

• have been advised not to take part in sexual activity or in activities that widen your blood vessels. 
• have low blood pressure (hypotension) 
• have recently had a stroke – a medical emergency that occurs when the blood supply to the brain is interrupted.
• have unstable angina – an underlying heart condition that causes symptoms such as chest pain.
• have had a heart attack – a medical emergency where the blood supply to the heart is suddenly blocked
• have a history of non-arteritic anterior ischaemic optic neuropathy – an eye condition that causes a sudden loss of vision.

Side effects

PDE-5 inhibitors can cause some side effects, including:

• headaches and migraines
• flushing (redness) 
• indigestion
• nausea (feeling sick)
• vomiting (being sick)
• a blocked or runny nose
• back pain
• vision disturbances
• muscle pain

If you are having difficulty achieving or maintaining an erection, our Prescribing Pharmacist may be able to help you.

Once you complete this form, you can then book an appointment with our Prescribing Pharmacist to discuss your needs in private.

All information you supply will be kept securely and used for the sole purpose of assessing your suitability to recieve errectile dysfuntion medication.

This is a private service and charges apply as follows.

Please complete our form before booking and appointment.