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How can you fix your erectile dysfunction?

How can you fix your erectile dysfunction?

Stefano Mirabello NowPatientGreen tick
Medically reviewed by Stefano Mirabello, BPharm and written by Rajive Patel, BPharm - Updated on 30 Aug 2023
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Table of contents
OverviewWhat is erectile dysfunction?How is erectile dysfunction diagnosed?What are the treatment options for erectile dysfunction?MedicationLifestyle changesOther treatment optionsSources

Sexual health is an important part of men’s health and wellness and sexual dysfunction can be a major concern yet it is often neglected. Sexual difficulties can impact all aspects of a man’s life, from his sexual relationships to his self-esteem. Sexual dysfunction can also be a sign of an underlying medical condition, so you’re always recommended to talk to a doctor regarding your sexual health.

Many different types of sexual dysfunction can affect men including poor sex drive and problems with ejaculation and each one has its causes and treatment options. Erectile dysfunction (ED) is one of the most common types of sexual dysfunction, it can have a significant impact on a man’s sex life. There are many potential treatments for ED, so it’s important to speak with a doctor to find out which option is best for you. Let us take a look at what is available to increase your understanding and knowledge.

What is erectile dysfunction?

Erectile dysfunction (ED) is the inability to get or keep an erection firm enough for sexual intercourse. Sexual dysfunction can technically happen to anyone at any age, but it’s most common in older men. There are a variety of physical causes of ED, including:

  • Atherosclerosis, or hardening of the arteries
  • Cardiovascular disease/heart disease
  • Diabetes
  • High cholesterol
  • Hypertension, or high blood pressure
  • Obesity
  • Side effects of medications such as antidepressants
  • Pelvic surgery
  • Spinal cord injuries
  • Prostate cancer or enlargement
  • Smoking

There are a variety of psychological causes that bring about erection problems including:

  • Stress
  • Performance anxiety
  • Relationship issues

In many cases, erectile dysfunction is a result of a combination of physical causes and psychological factors. Treatments for erectile dysfunction may include oral medications, hormone therapy, injections, surgery, lifestyle changes or even sex therapy. The most effective treatment depends on the underlying cause of the condition.

How is erectile dysfunction diagnosed?

Urology is a branch of medicine that focuses on the urinary tract and the male reproductive system. As such, urologists are often able to diagnose and treat conditions that affect these organs, such as erectile dysfunction (ED). Before a referral to a urologist, your GP will see you first.

Your GP will carry out basic health checks, such as taking your blood pressure, weight and height. Your genitals will also be examined to rule out any obvious physical cause. Symptoms such as frequent peeing may also require an examination of your prostate.

Your doctor will take your full medical history, ask about your lifestyle and relationships and the symptoms and problems you are having with ER. Questions like the following may be asked:

  • What prescription drugs, over-the-counter drugs or supplements do you take?
  • How much physical activity do you get?
  • Do you smoke or drink alcohol?
  • Are you under a lot of stress or has something recently upset you?
  • How long have you had ED symptoms? Did they come on slowly or rapidly?
  • Do you wake up in the morning or during the night with an erection?
  • If you do have erections, how firm are they? Is penetration difficult?
  • Do you have any anxiety, depression or other mental health issues?
  • Have you ever had trauma in the pelvic area?
  • Do you have any urinary problems?
  • Do you have other health conditions (treated or untreated)?

Some of these questions may seem private or even embarrassing. However, be confident that your doctor is a professional and your honest answers will help find the cause and the best treatment and medical advice for you.

What are the treatment options for erectile dysfunction?

The good news is that there are treatments available that can help most men overcome ED. In some cases, simple lifestyle changes like exercising more and quitting smoking may be enough. For other men, oral medications, injections or implants may be necessary.

Medication

Erectile dysfunction treatment includes:

  • Viagra (Sildenafil). Viagra is also called sildenafil. Viagra is a prescription medication used to treat erectile dysfunction. It works by relaxing the blood vessels in the penis, allowing more blood to flow into the area, causing an erection. Viagra can be taken with or without food, and it typically begins to work within 30 minutes. The effects of Viagra usually last for four hours, although it may last longer if taken with a high-fat meal. Viagra is available in 25mg, 50mg, and 100mg tablets, and should be taken as needed before sexual activity. For most men, the recommended dose is 50mg. Viagra should not be taken more than once per day. Some men may experience side effects such as headache, flushing, dyspepsia or visual changes. Rarely, more serious side effects, such as dizziness, fainting or prolonged erection can occur. If you experience any of these side effects, you should seek medical help immediately. Viagra is a safe and effective treatment for erectile dysfunction, but it is not suitable for everyone. You should speak to your doctor before taking Viagra if you have any other medical conditions or are taking any other medications
  • Vardenafil. This drug has very similar characteristics and works the same as Viagra but the dosage differs
  • Tadalafil (Cialis). This drug works like the two drugs above but it stays active for 36 hours and its onset of action is 20mins, half the time of Viagra and vardenafil

Viagra, Cialis, and vardenafil are all PDE-5 inhibitors. They work by inhibiting the enzyme PDE-5, which is responsible for the breakdown of cGMP (cyclic guanosine monophosphate). cGMP is a messenger molecule involved in the relaxation of smooth muscle cells. By inhibiting PDE-5, these drugs allow cGMP to build up, leading to the relaxation of smooth muscle cells and increased blood flow.

Do not take Viagra, vardenafil or Cialis if you are also taking a nitrate drug for chest pain or heart problems. This includes nitroglycerin, isosorbide dinitrate, and isosorbide mononitrate. Nitrates widen the blood vessels and can cause dangerous drops in blood pressure.

  • Alprostadil (Caverject or Viridal Duo). Alprostadil is a synthetic hormone that is similar to the naturally occurring hormone prostaglandin E1. It works by relaxing the muscles in the walls of blood vessels, which increases blood flow and makes it easier for men to get and maintain erections. It can be used either as a self-injectable solution or as a suppository that is inserted into the urethra (the tube through which urine and semen are discharged). Although alprostadil is generally well tolerated, it can cause side effects such as pain at the injection site, swelling and redness. In rare cases, it can also lead to priapism (a prolonged erection that can cause permanent damage to the penis). As a result, it is important to follow the instructions of a healthcare provider when using alprostadil
  • A vacuum device. Vacuum constriction devices are commonly used to treat erectile dysfunction. They work by creating a vacuum around the penis, which helps to draw blood into the penis and produce an erection. An elastic ring is then slipped onto the base of the penis to keep the blood inside it. When there is severe nerve damage or blood vessel damage, using a ring can help to keep blood in the penis. The devices can be used with or without a pump and are typically worn for 30-60 minutes before sexual activity. Vacuum constriction devices are safe and effective, but may cause bruising or numbness in the penis. They should not be used by men with bleeding disorders or active urinary tract infections
  • Penile implant. A penile implant is a device that is placed surgically in the penis. The implants help to straighten and stiffen the penis, which can be helpful for men who suffer from erectile dysfunction. There are two types of penile implants: inflatable and malleable. Inflatable implants are filled with saline solution, while malleable implants are made of silicone rods. Both types of implants have their advantages and disadvantages, so it is important to discuss all options with a urologist before making a decision. In general, however, inflatable implants tend to provide a more natural erection than malleable implants. With proper care and maintenance, a penile implant can provide many years of satisfaction for both the patient and his partner
  • Vascular surgery. This is a rare ED treatment that aims to improve blood flow in the penis and is another surgical option
  • Testosterone replacement if you have low testosterone levels. This comes in skin patches, gel or injections into the muscle

Lifestyle changes

Erectile dysfunction is a common problem that can hurt both a man’s quality of life and his self-esteem. While there are many potential causes of erectile dysfunction, lifestyle choices are often to blame. Making simple changes to your diet, exercise routine and sleep habits can often improve erectile function.

For example, obesity is a major risk factor for erectile dysfunction. Losing weight can help to improve blood flow and reduce inflammation throughout the body, both of which are important for maintaining normal erectile function.

Exercise is also crucial for improving blood flow and reducing inflammation. In addition, regular exercise can help to improve mental health and reduce stress levels, both of which can also contribute to erectile dysfunction.

Excessive drinking can also lead to erectile dysfunction by interfering with hormones and neurotransmitters that are responsible for sexual arousal. Reducing alcohol use can help.

Smoking cigarettes is another risk factor which can damage blood vessels and reduce blood flow to the penis. Reducing or stopping smoking is recommended.

Getting enough sleep is also important for maintaining normal erectile function. Sleep helps to reduce stress levels and promote healthy hormone levels, both of which are necessary for normal sexual function.

Making these lifestyle changes can be difficult, but they are often essential for improving erectile function.

Other treatment options

If you only have erection problems some of the time, i.e. you get an erection when waking up in the morning, but not during sexual activity then the underlying cause is likely to be psychological. Your healthcare provider might recommend sex therapy, either on its own or in combination with other psychotherapy. Counselling and cognitive behavioural therapy (CBT) might be recommended if anxiety and depression are present.

ED not only affects the man suffering from it but also has a significant impact on their partner. For many women, ED is a source of frustration and anxiety. It can be difficult to watch your partner struggle with something that you can’t do anything about. In some cases, women feel like they are responsible for their partner’s ED, which can lead to feelings of guilt and inadequacy. In addition, the loss of intimacy that comes with ED can be hard to deal with. Some couples find themselves growing apart as a result of the problem.

Fortunately, there are ways to manage ED and keep your relationship strong. Couples therapy can help you and your partner communicate better about the issue. If you’re struggling with ED, don’t suffer in silence – reach out for help.

Sources

Medical Disclaimer

NowPatient has taken all reasonable steps to ensure that all material is factually accurate, complete, and current. However, the knowledge and experience of a qualified healthcare professional should always be sought after instead of using the information in this page. Before taking any drug, you should always speak to your doctor or another qualified healthcare provider.

The information provided here about medications is subject to change and is not meant to include all uses, precautions, warnings, directions, drug interactions, allergic reactions, or negative effects. The absence of warnings or other information for a particular medication does not imply that the medication or medication combination is appropriate for all patients or for all possible purposes.

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