Erectile dysfunction is a persistent difficulty achieving or maintaining an erection sufficient for satisfactory sexual activity. It is common, often linked to treatable health conditions, and should not be a cause for embarrassment. Erectile dysfunction can be an early warning sign of cardiovascular disease.
CONDITIONS
Erectile Dysfunction
Common Risk Factors
• Blood vessel disease and cardiovascular risk factors
• Older age, obesity, a sedentary lifestyle and smoking
• High cholesterol, high blood pressure, diabetes and metabolic syndrome
• Depression and anxiety
• Some medications (antidepressants, blood pressure tablets, 5-alpha-reductase inhibitors)
• Pelvic surgery or radiation, and neurological conditions
• Psychological and relationship factors
How We Diagnose Erectile Dysfunction
• A detailed history, including how and when the problem started, morning erections, and any psychological or relationship factors
• Blood tests including hormones, sugar and cholesterol
• Review of current therapy attempts
• IIEF questionnaire
How We Manage Erectile Dysfunction
We first try to address reversible causes and lifestyle factors where possible, such as stopping smoking and reducing alcohol.
• Address psychological and relationship factors, which may need a psychologist or sexual psychologist
• Consider whether pelvic floor exercises may help
• Testosterone replacement (if confirmed deficiency)
We then carefully discuss further options to see what best suits your circumstances. Treatment options include:
• Vacuum erection devices
• PDE5 inhibitors – such as sildenafil (Viagra) and tadalafil (Cialis)
• Intracavernosal injections – you are taught how to self-administer very small injections into the penis when needed
• Penile implant – surgical procedure to insert an inflatable device into the penis
