Erectile Dysfunction (ED)

Many men have erection problems – some 1 in 10 men experience them. These may involve difficulties with getting an erection or difficulties with maintaining an erection. Many men experience occasional erectile difficulties, which can be associated with stress or tiredness, but when experienced consistently for over three months it may be time to look for some help.

What are the commonest causes of erection problems?
Erection problems can be caused by:

• Physical factors
• Psychological factors or,
• A mixture of physical and psychological factors.

Physical Causes
There are many physical causes, which tend to occur in the older man (over 50 years old) and tend to start gradually and slowly get worse. Examples of physical causes are:

• Damage to the nerve supply to the penis such as in diabetes and multiple sclerosis.
• Damage to the blood supply to the penis such as with high blood pressure, atherosclerosis, and diabetes.
• A lack of hormones required for such as testosterone or thyroxine.
• Prescribed drugs can effect erections such as those for high blood pressure, depression, schizophrenia, and epilepsy.
• A high intake of substances such as smoking, alcohol, cannabis, heroin, and cocaine.

Psychological Causes
It is surprising how one episode of being unable to get or keep an erection can lead to anxiety which then leads to further episodes of erection problems and so on in a vicious cycle. When psychological factors predominate, the problem is often of a sudden onset and is variable over time and in different situations. Some factors include:

• Stress, anxiety and tiredness
• Relationship problems such as poor communication, poor understanding and habitual conflict.
• Decline in sexual interest
• Depression

What do we offer at the Regents Park Clinic?
We will carry out a full assessment by taking a medical history and asking questions about the problem, about your sexual relationship/s, and about stresses such as work or money problems.

After that we will do an examination, which includes taking blood pressure, and examining the heart, abdomen and genitals. We check the nervous system by testing reflexes and the blood supply by checking leg pulses.

Finally we will check urine for glucose to rule out diabetes, and carry out a blood test to assess kidney function (U&E’s), liver function (LFT’s), thyroid function (TFT’s), and testosterone level.

What treatments do we offer?
Having discussed the possible causes of the problem we can advise on physical treatment, psychosexual therapy or a combination of both.

We can prescribe either Viagra (sildenafil) or Cialis (tadalafil), which are effective and safe drugs. These drugs can be used to treat the problem in the long term or can be useful in the short term to regain lost confidence. They are also useful diagnostically as if they don’t work for some men it can mean that further tests are needed.

Our assessing doctor can offer information on psychosexual therapy with or without a partner and where to find help. This may involve one or two sessions to help with stress or anxiety management or more in depth therapy such as looking at relationship problems or looking at issues from the past, which may be affecting the present.