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Erectile dysfunction: Diagnosis and treatment

Erectile dysfunction, ED or impotence, is the inability for a man to get an erection and maintain it for satisfactory sex.

Around half of all men aged between 40 and 70 are thought to have experienced some degree of ED.

Getting treatment for ED starts with a visit to the GP or a genitourinary medicine (GUM) clinic.

If talking about ED with a female doctor is likely to cause embarrassment, ask to speak to a male doctor.

ED diagnosis

They'll want to know about:

  • Overall health, both physically and mentally
  • Symptoms experienced, such as degree of erection, ejaculation or orgasm
  • Level or libido or sex drive
  • How long the symptoms have been present
  • Diet and lifestyle
  • Medicines being taken, alcohol consumption and any other drug use.

Tests may be performed or arranged, including:

What are the treatments for ED?

If you are troubled by occasional erectile dysfunction, remember that arousal often takes longer as you get older and that satisfaction should not be equated with performance. If your dysfunction is causing you problems, you should seek medical help. The number of treatment options has increased in recent years.

Many doctors will recommend changes in lifestyle as a first step in treatment. Suggestions include the following:

  • Cut back on alcohol, tobacco and illegal drug use
  • Change prescription medications under your doctor’s guidance, as some medicines not only interfere with achieving erection but can also decrease your interest in sex and the ability to reach orgasm
  • Reduce stress
  • Eat well
  • Exercise regularly

Medication for erectile dysfunction

The most common medical treatments for erectile dysfunction include medications. Several medications may be used:

  • Sildenafil, tadalafil and vardenafil are effective in about seven out of 10 men who use them. A tablet is taken about 30 minutes to one hour (depending on the specific drug) before intercourse and, when effective, allows a normal erection with stimulation. These medications are not to be used by men who take any kind of nitroglycerin or nitrate drugs, because the combination can result in dangerously low blood pressure
  • Self-injected medications can produce an erection. The medication is injected before sex into the side of the penis; these drugs may also improve long-term potency and penile blood flow
  • Prostaglandin suppositories can be inserted into the urethra to produce erections
  • Medically administered testosterone injections or patches help some men, but no specific level of the hormone guarantees potency

Devices to aid erection

Another option for the treatment of erectile dysfunction is a vacuum inflation device (or vacuum constriction device). This instrument draws blood into the penis by creating negative pressure around it; a rubber ring is then slipped over the base of the penis to maintain the erection. The ring should be removed after 30 minutes to restore circulation and prevent damage to the penile tissues.

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