ERECTILE DYSFUNCTION
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Inactivity. We should all aim to do some moderate physical activity on most days of the week for at
least 30 minutes. For example, brisk walking, swimming, cycling, dancing, gardening, etc.
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Diet. Aim to eat a healthy diet. See separate leaflet called Healthy Eating.
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Alcohol excess.
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Diabetes. If you have diabetes, good control of the blood sugar level and blood pressure can help to
minimise the impact of diabetes on the blood vessels.
What are the treatment options?
A referral to a specialist is sometimes needed for assessment and treatment. However, GPs are now treating
more cases of ED than previously, as the treatment options have improved in recent years. Your GP is more
likely to suggest referral if you have been found to have an hormonal problem, if the cause is related to another condition like circulatory problems, or if you are young and the condition started after an injury.
The following gives a brief summary of treatment options. There is a good chance of success with treatment.
There are pros and cons of each treatment, and your doctor will advise further.
Have you considered your other medication?
As mentioned, some medicines can cause ED. Check the leaflet that comes with any medication that you take
to see if ED is a possible side-effect. Do not stop any prescribed medication, but see your doctor if you suspect this as the cause. A switch to a different medicine may be possible, depending on what the medicine is
for.
Medication (tablets taken by mouth)
In 1998, the first tablet to treat ED was launched. This made a huge impact on the treatment of ED. For treating ED, tere are now four different tablets licensed in the UK:
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Three of the tablets work by increasing the blood flow to your penis. They do this by affecting cGMP,
the chemical involved in widening (dilating) the blood vessels when you are sexually aroused (described
above). They are sildenafil (Viagra®), tadalafil (Cialis®), and vardenafil (Levitra®). You take a dose before you
plan to have sex. Because of the way they work, these medicines are called phosphodiesterase type 5 (PDE5)
inhibitors.
So, even if the nerves or blood vessels going to your penis are not working so well, a tablet can cause the
blood flow to increase in your penis, and cause an erection. Tablets can treat ED caused by various underlying conditions.
Note: none of these tablets will cause an erection unless you are sexually aroused.
There is a good chance that a medicine will work (about an 8 in 10 chance of it working well). However, they
do not work in every case. There are pros and cons for each of the above, and your doctor will advise. For
example, you may not be able to take certain tablets for ED if you have certain other medical conditions or
take certain other medicines. For example, you should not take a PDE5 inhibitor if you take nitrate medicines
(including glyceryl trinitrate (GTN)) which are often used to treat angina. Also, if you take a certain type of
medication, called alpha-blockers, for high blood pressure (doxazosin, indoramin, terazosin or prazosin)
you need to wait until you are on a stable dose, as the combination with a PDE5 inhibitor can cause a sudden
pressure drop.
Vacuum devices
There are several different devices. Basically, you put your penis into a plastic container. A pump then sucks
out the air from the container to create a vacuum. This causes blood to be drawn into the penis and cause an
erection. When erect, a rubber band is placed at the base of the penis to maintain the erection. The plastic
container is then taken off the penis and the penis remains erect until the rubber band is removed (which
must be removed within 30 minutes).