Erectile dysfunction (ED)

Erectile dysfunction (ED) is a distressing condition, which, due to the associated myth and stigma, is often suffered in silence. It is a condition, though, that can be readily treated, and shown below are the stories of 4 men who, after suffering with erectile dysfunction, found that help and treatments are available to end the pain of ED.

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Dominic’s Story

Dominic Jones (aged 68) was experiencing a gradual deterioration of the quality of his erections over recent years. At first he noticed that the erection did not last as long as it used to, then it appeared to be less rigid than before. Penetration became increasingly difficult and as things got worse, he and his wife stopped trying so often. Feeling frustrated and angry that this part of the relationship was failing, Dominic eventually went to see his GP.

The doctor explained that the problem could be connected with his smoking and high blood pressure. Although relieved that there may be a cause, Dominic had been smoking for years and felt sure that the problem must really be due to a lack of testosterone. He therefore asked if he could see a specialist.

When Dominic attended the hospital clinic he was examined and asked lots of questions about his medical and sexual history. Blood tests were performed and all were perfectly normal, so ruling out a testosterone problem. He was told that the likely cause of his erectile dysfunction was the combination of high blood pressure and smoking. This had caused a narrowing of the blood vessels in the penis preventing adequate blood supply for achievement and maintenance of a satisfactory erection.

The options for treatment were discussed. First he tried an intraurethral pellet that is placed in the tip of the penis. This failed to achieve a very good response so he decided to try injection therapy. Dominic had heard of this treatment before, but had been very nervous about trying it. The nurse at the clinic was very reassuring, explaining that the majority of men think it will hurt, but actually find that they can hardly tell when the needle goes in. She showed Dominic how to use it, and made sure he was happy with the technique before he tried it at home.

Dominic was delighted with the result. It had been much easier to use than he expected and the erection he got was just like it used to be. After just a short time Dominic felt very confident using the injection, and he and his wife were able to return to having a more active and fulfilling sexual relationship.

Doctor’s comments:
Don’t be put off by the thought of injection therapy. Many people have to inject themselves for all sorts of conditions and in practice find the injections relatively painless. An easy-to-use system is available for treating impotence and most people quickly get used to it and incorporate it in to their lovemaking.

Michael’s Story

My wife, Sheila, and I had just celebrated our Silver Wedding anniversary when I first suffered from erectile dysfunction. We had previously had a perfectly satisfactory sex life, and I never imagined it would happen to me. I can still remember that night. We had a few friends round for drinks and went to bed quite late. The whole week had been quite stressful, our son had smashed his car and we had to ferry him around to work and to the garage. My boss had been particularly demanding, and two of my work-mates had been made redundant. We naturally thought the problem was due to stress, and wouldn’t happen again. Although the following week I did get an erection, every so often, I would fail miserably. Sheila was very understanding, but it made me feel very inadequate. Six months later, it was happening more often and I was increasingly anxious about making love, worried that I would fail every time. Eventually Sheila persuaded me to see my GP. I explained that I had been under stress and asked if that was likely to be the cause of the problem. The doctor agreed with me and suggested I try relaxation exercises and maybe even consider taking early retirement. I managed to reduce my hours and became much happier spending more time at home and working on the allotment. However, 18 months later, I was still unable to get an erection and asked if I could be referred to a consultant at the hospital.

The consultant was very understanding and asked lots of questions regarding the circumstances surrounding my problem. He then examined me and booked another appointment for an ultrasound examination called cavernosography. This revealed that I was suffering from a condition known as Peyronie’s disease. The consultant explained that this makes the spongy erectile tissues become hard and unable to fill with blood. This explained why I had been unable to get an erection – it was not a psychological problem after all! The consultant suggested that I should have an operation to insert a semi-rigid prosthesis – this was a big decision, as the operation would not be reversible. We were given plenty of time to discuss our options and Sheila was fully involved. We eventually decided that I should have the surgery, it was very unpleasant at first, but now we are pleased with the result – I now feel more like a real man again, and not a failure like before.

Consultant’s comment:
“Physical abnormalities of the penis are a common cause of erectile dysfunction and can usually be detected by simple examination. Many of these abnormalities are simply treated and successful treatment usually restores erectile function.”

John’s Story

I am 58 and during the past year I’ve been having problems with loss of libido, depression, headaches and an inability to maintain an erection. I assumed it was just part of getting old, but my wife went to the doctor who said there was probably something they could do. I was reluctant to go and see him as I have known him for years and I felt really embarrassed, but eventually I went. He found nothing wrong physically, but a blood test showed that I had a low testosterone level. The doctor tried giving me injections of testosterone, but this still didn’t improve my libido or my erections.

I then saw a consultant at the hospital who took more blood samples. He also sent me for a scan, and examined my eyes and vision. They found that I had a tumour in my pituitary gland, which was what had been causing all my symptoms. I then had to have an operation to remove the pituitary gland. After all this, my depression and headaches disappeared, and now I am taking pituitary hormone replacement, I have also regained my libido and my erections.

Consultant’s comment:
“Hormonal abnormalities are rare but well-recognised causes of erectile dysfunction. Not all patients with a low serum testosterone obtain symptomatic improvement from hormone replacement. If the loss of libido is associated with other symptoms, more detailed hormone tests should be performed.”

Ramesh’s Story

Although I was born in Bradford, I come from an Asian family who strongly abides by their traditional religion and customs. Three years ago my parents arranged a marriage for me – to a girl they believed to be a very good match. Her family was high caste and although we only met once before the wedding, she seemed to be a pleasant character. But once we were married, she became very bossy and demanding, making me feel very inferior. Although I tried, I was unable to obtain an erection and consummate my marriage. I went to see my doctor who couldn’t find anything wrong. My wife told me I had to take some medicine, to make me into a “real man”, but I knew it wouldn’t work. I became very withdrawn and lost a good chance of promotion at work. My wife made me go and see an Erectile Dysfunction Nurse and a psychosexual counsellor, although she refused to come with me. After several sessions I began to talk to the counsellor, and I was surprised at the depth of feeling that came out. Because deep down, I felt inferior to my wife, this was affecting all aspects of our relationship. If she had also attended some counselling sessions, we might have been able to sort things out, but throughout the whole story, she maintained it was purely my problem. Eventually, my wife and I agreed to separate.

I have now formed a new relationship with a lovely woman, who is undemanding and supportive. I am able to obtain full erections and enjoy sexual intercourse spontaneously.

Consultant’s comment:
“Major psychological problems cannot usually be helped by physical treatment alone. Lack of insight into such problems by patient and/or partner can make treatment very difficult and, in some cases, can result in breakdown of the relationship.”