Erectile dysfunction (ED) often arises from reduced blood flow, and oral PDE5 inhibitor drugs can assist in restoring blood supply for some men. However, if the blood vessels surrounding the penis are narrowed, it may suggest that other blood vessels are similarly affected, indicating a potential cardiovascular issue. ED can also stem from diabetes, prostate issues, or as a side effect of medications such as antidepressants.
Testosterone deficiency (TD) can also play a role in ED. Just as women's hormones change in middle age, causing low libido, testosterone levels in men can decline, leading to similar effects. Testosterone replacement therapy can improve erections in men with testosterone deficiency, particularly when combined with other treatments.
Non-medical interventions can also be effective. Diet and lifestyle have a significant impact. With 79% of older adults being overweight, and overweight men more likely to experience ED, weight loss can be beneficial.Regular exercise, quitting smoking, and moderate alcohol consumption are good starting points. Adopting elements of the Mediterranean diet, such as olive oil, fish, and nuts, is also recommended. Essentially, what benefits the heart is also good for the penis.
In up to 20% of cases, ED has psychological or emotional causes, making counselling a valuable treatment option. Psychological issues can decrease confidence and self-esteem, exacerbating ED symptoms. Performance anxiety and unhealthy fixations learned through pornography can also impact sexual function. Talk therapy can address these psychological issues, positively influencing relationships and intimacy over time.
PDE5 Inhibitors: These pills can be taken up to an hour before intercourse or regularly in low doses. Low-dose options aim to improve erection quality overtime by increasing blood flow.
Injectable Therapies: Prostaglandin can be injected directly into the penis, taking effect within five to ten minutes.
Other Administration Methods: Prostaglandin can also be administered by inserting a pellet into the urethra or by applying a cream to the end of the penis.
Surgery: For some men, a permanent prosthesis can be implanted into the penis, providing a firm and sensitive erection with the ability to climax. Alternatively, a malleable implant or a vacuum device can be used, though the resulting erection differs from a natural one.
Low-Intensity Shockwave Therapy (LIST): This involves using an ultrasound probe to deliver 1,500 shocks to five points along the penis over four to twelve sessions in four weeks, encouraging the growth of new blood vessels. Patients can be referred for LIST if deemed appropriate.
By exploring a range of treatments, both medical and lifestyle-based, men with ED can find a solution that best meets their needs.
We're here to support you on your journey to addressing ED. Please reach out to discuss the best options for your situation.
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