What is the solution?
‘I felt so much better after I had talked to my partner – we were able to work together to overcome my impotence.‘
There are effective treatments for ED and nearly all men can be helped in one way or another. But it is difficult to beat it on your own. There are several steps you can take yourself before seeking medical help.
Come to terms with the fact that you have a problem. ED is common, it can be treated and it’s not a reflection on your manliness. If you don’t face up to what is happening, it will not go away, and will probably get worse.
Talk to your partner if you have one. Sex is not the only basis for a relationship, but it is an important part. Trying to hide any problems may only make matters worse and may have a negative impact on your relationship.
Try to identify a cause. What happened around the time you first noticed a problem? Were you under stress from work or at home? Did you start taking a different medication?
Now you are ready to see your doctor. He/she will need to ask questions about your sex life and relationship as well as any other illnesses you may have or that run in your family. You will also be asked about how much alcohol you drink and if you smoke. Don’t be embarrassed. Your doctor can only help if you are open and honest about things.
What treatment will I be offered?
‘I didn’t go to my doctor, because I thought he would suggest an operation. I didn’t realise there were so many different treatments available.‘
This depends on your individual situation. If your doctor has found a treatable organic cause such as thyroid problems, or a side effect of medicine, then he or she may be able to sort things out by dealing with this. If your condition appears to be caused by an underlying psychological or emotional problem, your GP or a psychosexual counsellor can deal with this fairly easily.
In many sufferers though, no obvious cause can be found or if it can there is no current treatment to help. But even though the cause of the ED cannot be treated, most men can regain their erections through either medication, vacuum therapy, or in some cases, surgery.
This involves giving drugs that mimic the natural changes to the blood supply which occur during a normal erection. These drugs can be given in various ways – as an injection, a pellet that is inserted in the tip of the penis or as an oral tablet. If you try one therapy and it doesn’t work, try not to worry as there are several therapies available you can try – one of which is likely to work for you.
Sildenafil is the first licenced oral treatment for impotence. In common with other treatments it will not work for everyone. Sildenafil cannot be taken by patients who also take nitrate medication for heart disease (2). For patients for whom sildenafil does not work or who are unable to take sildenafil other treatments are available.
Intracavernosal injection (ICI)
Here, an injection is given straight into the base of the penis. While the thought of this may be off-putting, many men have found this easy to do at home and to be an effective treatment for impotence. Side effects can occasionally occur, such as bruising at the injection site.
Here, a pellet is inserted into the urethra using a special applicator. Though this treatment may be of use for some patients, studies have shown it to be less effective and to have more side effects than the injection treatment (1).
Here, a special plastic cylinder is placed over the limp penis, and a pump used to create a vacuum. This encourages blood to flow into the erectile tissues. Once the penis is erect, an elastic ring is placed around the base to prevent the blood from leaking out again. This ring is removed after lovemaking and the erection subsides naturally.
Surgical treatment is highly specialised and is generally needed for only a minority of patients who, for example, have major circulatory problems.
Action Plan for men with ED
- Admit to yourself and your partner (if you have one) that you have a problem.
- See your GP. If he/she is not sympathetic, ask to see another member of the practice.
- Be open and honest in answering the doctor’s questions.
- If you are still not sure about your treatment, ask for referral to a specialist.
- Be patient. By working together with your specialist (and partner) you will find a treatment that works for you.
- Don’t be tempted to take short cuts like buying remedies that are advertised in newspapers. They probably won’t work and you will just waste your money.