Erectile dysfunction is a common problem, which occurs when men are unable to get and maintain an erection; it is most common among men aged over 50 years old, but can also affect younger men. In most cases, impotence can be treated very effectively using medication, surgery, lifestyle changes and psychological therapies.
What causes impotence?
In most cases, the cause of impotence dictates the treatment options, so it is important to understand the possible causes of erectile dysfunction in order to gain a better understanding of the treatments.
Impotence can be caused by psychological and physical issues, from underlying health conditions and structural abnormalities, to depression, stress and anxiety.
When you approach your doctor about impotence, they will ask you a series of questions and carry out a physical examination to determine the possible causes and identify potential treatment options.
Treatment options for impotence
Psychological treatments include couple’s therapy, counselling and talking therapy; anti-depressant medication may also be prescribed.
Medical treatments depend heavily on the cause; one of the main causes of erectile dysfunction is cardiovascular disease, which reduces blood flow around the body. Risk factors for cardiovascular disease include being overweight or obese, high cholesterol, high blood pressure, smoking, drinking and diabetes. Many of the risk factors are related to lifestyle and before formal medical treatments are recommended, a doctor will probably advise lifestyle changes, which include:
- Adopting a healthy, balanced lifestyle
- Following a calorie-controlled diet
- Doing regular exercise
- Cutting down on drinking
- Giving up smoking
- Cutting out fatty, processed foods
Medication is a commonly used treatment for erectile dysfunction; medicines known as PDE-5 inhibitors (phosphodiesterase-5 inhibitors) are designed to treat erectile dysfunction by increasing blood flow to the penis. The most common PDE-5 inhibitors are:
These medicines are designed to work ‘on demand’ and should be taken before a man intends to have sexual intercourse; your doctor will give you dosage instructions and advise you how and when to take the medication. PDE-5 inhibitors are very effective but they are not suitable for some people; your doctor will ask you about your medical history, the medication you take and your general health before prescribing medication, as these medicines can interact with other drugs and they are not suitable for people who have underlying health conditions, bleeding disorders, low blood pressure and a history of strokes or heart attacks. Possible side-effects of PDE-5 inhibitors include dizziness, headaches, nausea and vomiting and redness in the face.
Other treatment options include vacuum pumps and penile implants. Penile implants are generally only recommended in severe cases, when other treatments have been unsuccessful; the most common type of implant is an inflatable implant, which comprises of cylinders and a combined pump and reservoir; the patient simply presses on the pump to inflate the implant and create an erection.
Vacuum pumps are not widely used; they are designed to bring about an erection by increasing blood flow to the penis. There are different types of vacuum pump available and your doctor will explain how and when to use the device.