Erectile Dysfunction

Erectile dysfunction (also known as ED) is when you cannot get an erection or maintain an erection. Sometimes the penis can become slightly erect, but is not hard enough to have proper sex with.

How common is erectile dysfunction?

The majority of men will occasionally be unable to get an erection. This can happen when you are stressed, overly tired, distracted, or have consumed too much alcohol. This is usually only temporary, and you will get an erection most of the time when you experience sexual arousal.

For some men, however, the ED can be persistent or recurring. This is more common as you get older, but can happen at any age, with half of all men who are 40 to 70 years old experiencing ED.

At your IPSA erectile dysfunction consultation

Your erectile dysfunction consultation with an IPSA doctor will be undertaken in a highly confidential and private setting. Your IPSA practitioner, who is experienced in this area of medicine, will always take a holistic approach to your treatment and diagnosis, involving you in the process, as they run through all your symptoms and risk factors, as well as your family history. Working with you, your IPSA doctor will rule out any of the underlying medical disorders which may be causing your erectile dysfunction, and will discuss with you, and recommend, any necessary blood tests. Your IPSA practitioner will also provide immediate treatment for your erectile dysfunction and arrange any further follow-ups, if they are needed.

Men’s health: What are the causes of erectile dysfunction?

The causes of ED fall into two main groupings: physical causes and psychological (mental health) causes.

Physical causes

80% of ED cases are linked to a physical cause:

In men over the age of 40, the most common cause for ED is a reduced blood flow to the penis, where the arteries taking blood to the penis narrow, as they can do in other parts of your body. This reduced blood flow may then not be enough to bring about an erection.

Sometimes the nerves that go to the penis can be injured through having things such as radiotherapy in the genital region, a fractured pelvis, a spinal injury, or after surgery on any nearby areas of the body.

Some medicines produce side effects leading to ED. These include beta-blockers (like propanolol or atenonol), some diuretics (commonly known as water tablets) and drugs such as cimetidine. There are many other tablets that can sometimes lead to ED.

Drug and/or alcohol abuse.
Long-distance cycling commonly causes ED, which is most likely due to pressure being placed on the nerves (from sitting on the saddle for extended periods) that go to the penis.
A venous leak, where blood flows out through the veins from the penis, is a rare disorder, but can be caused by various conditions relating to the penis.
There are diseases that can affect the nerves that go to the penis. Among them are multiple sclerosis, strokes, Parkinson’s disease and so on.
One of the most common conditions causing ED is diabetes, as this disorder affects the nerves and blood vessels.
A rather uncommon cause is that of a hormonal imbalance. The hormone testosterone (a hormone produced in the testes), can become imbalanced and lead to ED. With a reduced testosterone level, other symptoms can include changes in mood and a reduced libido (sex drive).

Mental health (psychological) causes

The various mental health conditions that may lead to you developing ED include:

Depression
Relationship problems
Anxiety
Stress (for example, due to problems at home or at work)

Often, these types of psychological causes mean that the ED develops suddenly.

If I develop persistent erectile dysfunction, then what steps should I take?

It is recommended that you see your IPSA practitioner, who can then discuss the problem with you, look at any medication that you may currently be taking and carry out a physical examination. This can help in identifying or ruling out any of the possible underlying causes. Prior to treatment, your IPSA practitioner may suggest having some tests done.

What tests might be done?

Your IPSA doctor may recommend having some tests carried out depending on the probable cause of your ED, your symptoms, your age and so on. These tests are mostly to check up on any of the risk factors noted above which may increase the risk of you developing a narrowing of the arteries. The tests may involve:

A blood test to determine the level both of cholesterol and of other lipids (fats)
A blood-sugar level test
Blood tests that will rule out liver/kidney disease
A urine test
A blood-pressure check
An ECG (heart tracing)
If heart disease is suspected, then other heart tests are sometimes done, when appropriate

What are the treatment options?

If you are experiencing a physical problem, then treatment is mainly based on trying to determine the underlying cause of your ED. Because the treatment options available for ED have improved in recent times, doctors are now treating many more ED cases than they previously did.

Medications for erectile dysfunction

These tablets are used to treat ED that is caused by various underlying conditions:

Sildenafil (Viagra®);
Tadalafil (Cialis®); and
Vardenafil (Levitra®).

The tablets are taken by mouth and you take a dose of the medication before you are going to have sex. They cause an increased blood flow to your penis, which leads to an erection.

If erectile dysfunction is making you feel concerned, then book a same-day IPSA erectile dysfunction consultation.