Dysfunction Treatments

How can erectile dysfunction be treated?
There is a wide range of effective treatments now available, each with advantages and disadvantages that have to be considered by the individual with medical advice. They include:

Change of drug usage
Where a prescription medication has been identified as a possible cause, then a change to an alternative might be an option to try. This must be undertaken in consultation with your doctor. Non-prescription/recreational drug use should be reduced or stopped entirely to see what the effect is. This includes alcohol, cigarettes, “hard” and “soft” drugs.

Counselling/sex therapy
Where erectile dysfunction is recognised as being caused or made worse by psychological factors, some form of counselling and therapy for the individual and any partner(s) may be provided. Being able to have sexual intercourse does not necessarily solve the underlying problems which led to the difficulty in the first place. Therefore often counselling is helpful to discuss these difficulties otherwise  the problem might develop again.

Certain drugs, when injected into the shaft of the penis, allow blood to enter and within about 10 minutes cause an erection which can last for an hour. This method can be used up to three times a week. The needles used are very fine and the process is not as painful as it may sound. Any mild pain is short-lived. This method has a high success rate, better than with oral medication, and is suitable for most individuals. Any fear of needles would have to be overcome.

The erection enabling drug is introduced directly into the urethra in pellet form, using a plastic applicator. The urethra is the tube in the penis out of which both urine and semen pass. Urinating before insertion lubricates the urethra and makes the process easier. It may be considered by those for whom oral medication or injections are not suitable. Its success rate is less than the other two treatments – 35%.

Oral Medication
Viagra is the brand name for sildenafil and is one of several oral preparations now available (others include Cialis and Levitra). It should be taken about an hour before sexual activity and its effects can last for up to 4 hours or more. An erection is only obtained with sexual stimulation – it does not occur spontaneously. Success rates depend on the cause of the erectile dysfunction and vary from 40% to 80%. Common side effects include headaches and changes to colour vision.

Viagra may be dangerous if taken in conjunction with nitrate treatments for heart conditions or with amyl-nitrate (poppers). It must not be taken when certain eye conditions exist. Always consult with your doctor before taking this or any medication.

Viagra can only be prescribed on the NHS to new patients whose erectile dysfunction is associated with a list of specific causes. These include: multiple sclerosis, Parkinson’s disease, prostate cancer, kidney failure, spina bifida, polio and spinal cord injury. It can be prescribed privately by your GP but you will have to pay for the private prescription.

Uprima (apomorphine) works in a different way from Viagra and produces an erection within half an hour in 50% of cases. It might be considered as an alternative as it can be taken by men on nitrate treatments.

Penile prostheses
These are implants which normally consist of two rods inserted into the shaft of the penis. Options are for a permanent erection or one where the penis can be pumped erect as required.

An operation is necessary for the insertion and is generally a procedure of last resort, although success rates are quite high.

Some men with erectile dysfunction opt to have a penile implant at the same time as undergoing surgery for the removal of their prostate when affected by prostate cancer.

Vacuum devices
These have been in use for many years, have few side-effects and are suitable for long term use. They might be considered by those men for whom the other treatments are not an option. The process involves placing a tube over the penis and applying suction. The vacuum created forces the penis to expand and allows blood to enter, creating an erection. A ring is then applied to the base of the penis to prevent the blood flowing back out. This should not be left on for longer than 30 minutes or complications can arise.

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