This month’s column covers a topic many men find difficult to talk about: erectile dysfunction (ED).
Erectile dysfunction, sometimes also called impotence, is a really common condition and it often affects men over the age of 40. It can have many different reasons behind it and young men can be badly affected too, depending on the cause. If you start to notice regular issues with getting and maintaining an erection it is important to see your GP for assessment – this is because ED can be a sign that something else is not right within the body. Don’t be embarrassed to talk about it: help is available.
So what causes ED? Let’s start with bodily processes – in order for erections to happen, the body parts involved must be in good working order. Having high blood pressure and or raised cholesterol can damage the blood vessels required for good blood flow; without this erections cannot happen. Having diabetes that is poorly controlled can also have a negative effect on both the blood vessels and the nerves that contribute to erections, which can lead to problems. The body also needs to respond appropriately to hormones – if your hormone levels are too low then getting or maintaining an erection may be a challenge. Certain activities eg, too much cycling, can cause some genital tissue damage which may also play a role in ED.
Sometimes ED is not caused by a physical problem but is instead a bodily response to how you are feeling mentally. Emotions play a big role in our overall well-being. If you are feeling low, anxious or stressed then this may have an impact. In ED, it is important to recognise the emotions involved because it can be key to breaking the cycle. If you are feeling low you may suffer with ED. This may then make you feel anxious or embarrassed which in turn pushes your mood and self-esteem lower. ED can have a significant impact on relationships and this can make people feel pretty lousy too. Talking to the GP and being open with your partner can really help.
Erectile dysfunction can also be related to side effects from medications, alcohol or recreational substance use.
Seeing your GP about erection problems will help you find the cause and the right treatment. You might be embarrassed to mention it but we aren’t embarrassed to talk about it! Tests the GP can arrange include your blood pressure and blood tests for diabetes, cholesterol and hormone levels if needed. We will ask you how you are feeling and often about your relationships, as well as reviewing your regular medications.
For physical causes of ED, treating high BP, cholesterol and diabetes is key. Ensuring a healthy diet and lifestyle with regular exercise, and no more than 14 units of alcohol per week, with no recreational drug use, is recommended. If there is a psychological reason behind ED, sometimes specialist therapy is required by a psychosexual counsellor. These services are available on the NHS but may have long waiting times, they are also available privately.
Medications are available for erectile dysfunction. A common tablet treatment is Viagra (sildenafil) which you can now buy from the pharmacy or get on prescription. It works by increasing blood flow to the penis which helps create an erection if there is sexual stimulation. There are several other tablet medications that work in the same way, as well as injections that tend to be prescribed by specialists. Penile pumps can also be effective for ED if medication is not suitable or ineffective, but these are generally not prescribed by the NHS. Remember, if you are having problems down below then call your GP to discuss it and seek advice.
More information and advice about erectile dysfunction can be found on the Sexual Advice Association website at www.sexualadviceassociation.co.uk