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What is Erectile Dysfunction?

Erectile dysfunction, or ED, is defined as when you are unable to keep or get an erection for sexual intercourse. It is most common in men of ages between 40 and 70, however it can affect men of all ages to some degree. Experiencing ED from time to time can be quite common, however if you notice you are experiencing ED symptoms more and more frequently, it may be time to speak to a GP. Erectile dysfunction occurs when there is an insignificant amount of blood flow to the penis and you cannot get erect; erections occur when blood flows into the penis after physical or mental sexual arousal. 

Thankfully, there are a vast sum of treatment options available, varying from tablets, creams, and gels. Lifestyle advice can also play a huge role in helping overcome ED.

What Causes Erectile Dysfunction (ED)?

Male arousal is a complex process that involves every part of the body from the brain, to the hormones, emotions, nerves, and muscles. Erectile dysfunction (ED) can result from a problem with any of these systems. Likewise, stress and mental health can influence or worsen ED. Physical and psychological issues cause erectile dysfunction. For instance, a minor physical condition that slows your sexual response might cause anxiety about maintaining an erection. The resulting anxiety, or performance anxiety as it is normally called, can lead to or worsen erectile dysfunction, which again worsens anxiety - it is quite a brutal cycle to get out of. Some common causes of ED are as follows:

Physical Causes: Heart disease, atherosclerosis, high cholesterol, high blood pressure, diabetes, and obesity

Hormonal Changes: Such as thyroid issues, hypogonadism and Cushing's syndrome.

Medication: Some common medicines such as diuretics, antipsychotics, anticonvulsants, antihypertensives, and fibrates can possibly cause or worsen ED. Speak to your GP if you are concerned that a prescribed medicine is causing ED. Alternative medication may be available, but it is important that you do not stop taking any medication unless your GP has allowed it.

Psychological Issues: Some common triggers such as stress and depression have been known to cause ED in some patients. There are many emotional issues that may also affect your physical ability to get or maintain an erection. These include relationship problems, past sexual problems, sexual abuse, and being in a new relationship

Other factors that can cause or worsen ED can include excessive alcohol consumption, nicotine, tiredness, and drugs such as cocaine and weed.

How to Treat Erectile Dysfunction (ED)

Depending on the cause and severity of your erectile dysfunction and any underlying health conditions, you might have various treatment options. If your erectile dysfunction is caused by an underlying health condition, such as heart disease, that condition should be addressed first. In some cases, treating the underlying cause may also resolve the problem in time. If you are started on medication for ED, the most common initial treatment pathway is a class of drugs called phosphodiesterase-5 inhibitors. The most commonly known drugs in this class are sildenafil tablets (Viagra) or tadalafil tablets (Cialis). They work by temporarily increasing the blood flow to your penis. Sildenafil, Viagra Tadalafil and Spedra (avanafil) tablets all require a prescription. The non-prescription variant of Viagra is known as Viagra Connect Tablets.

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.. Some common side effects of these tablets include headaches, flushing, nausea and vomiting.

A slightly less common method for getting over your ED is by using a penis pump. The vacuum consists of a clear plastic tube that is connected to a pump, which is either hand or battery operated. You place your penis in the tube and pump out all of the air. This creates a vacuum that causes the blood to fill your penis, making it erect. You then place a rubber ring around the base of your penis to keep the blood in place, allowing you to maintain an erection for around 30 minutes. It is not advised to use one of these if you are on anticoagulant medication so please speak to your GP before considering getting one.

If the latter options have little success, there is a drug called alprostadil. Alprostadil, which is a synthetic hormone, helps to stimulate blood flow to the penis. Alprostadil is available as an injection directly into your penis or as a small pellet placed inside your urethra. Alprostadil can cause some side effects including changes in your blood pressure, dizziness, headache, and pain in your penis.

If your ED is caused by stress, anxiety or depression (or the condition is creating stress and relationship tension) your doctor might suggest that you visit a psychologist or counsellor. By addressing the underlying condition, if you get to the root of the issue it can help your symptoms

Lifestyle advice such as losing weight, exercising more, cutting down on alcohol, and smoking can also help get a healthier you and reduce your ED symptoms.

How to Tell if You Have Erectile Dysfunction?

Sometimes ED 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 during sex. Erectile dysfunction symptoms might include trouble getting and keeping an erection as well as a reduced sexual desire.

ED should not be confused with ejaculation problems such as premature ejaculation, which is a condition where the process of arousal, orgasm and ejaculation occurs very rapidly.

 

Author: Matt Jennings MRPharmS

Clinically Reviewed By:

Ibrahim Nakib BSc(Hons) MRPharmS

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