Expert answers top ten questions about erectile dysfunction
Erectile dysfunction is often thought of as a problem that affects the older generation, but the men’s health issue is actually becoming more and more prevalent in younger men.
In fact, a 2013 study published in the Journal of Sexual Medicine discovered that 26 per cent of patients with ED were under 40. And by 2025, the condition is expected to affect around 322 million men worldwide - a figure that has more than doubled since 1995. The problem is incredibly common, and there is never any need to feel embarrassed or ashamed by it. Most men experience ED occasionally, for example, when stressed or after drinking too much alcohol, and this is not a cause for concern.
As part of Men's Health Awareness Month, your Mirror got in touch with Dr Catherine Hood, a specialist in sexual medicine and an advisor to www.eroxon.co.uk - the first clinically proven over-the-counter (OTC) topical erectile dysfunction therapy. Here she answers some of the most common problems relating to erectile dysfunction.
What's the most likely cause of my erection problems?
Age is the single biggest factor for erectile dysfunction (ED). And in older men the most common reason for erectile dysfunction is lack of blood flow to the penis. In research conducted for Eroxon, ED is shown to affect at least half of men over 40 and around a quarter of men under 40.
What are other possible causes?
Obesity is another huge cause for erectile dysfunction. Testosterone dysfunction, stress, tiredness and drinking too much alcohol may also cause ED. Certain medical conditions such as heart disease, high blood pressure and diabetes as well as certain medications may cause it, too.
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What kind of tests do I need?
Erectile dysfunction can be diagnosed by your GP. They may ask about your mental and physical health, your alcohol consumption, your symptoms and any medications you are taking. If you have symptoms of enlarged prostate your doctor may do a digital rectal examination. Your doctor may also check your cardiovascular health and blood sugars. You will also be asked about your sexual history. Try not to be embarrassed. ED is very common. But if you don’t want to visit your GP to talk about ED you can visit a genito-urinary medicine (GUM) clinic.
Is my erectile dysfunction most likely temporary or chronic?
In many cases, ED is temporary. This will depend on the cause and if the cause is manageable. Losing weight, managing stress and excess alcohol consumption are helpful and ED usually improves quite quickly if these issues are managed. Feelings are also important.
According to the Eroxon research, 41 per cent of ED sufferers have felt like a failure; 40 per cent have felt awkward and embarrassed and 30 per cent have felt guilty. With the stress leading to a vicious circle impacting ED. For those who are single, ED is causing 63 per cent of sufferers to feel anxious about embarking on a new sexual relationship. Talking about ED and realising you are not alone helps to reduce these feelings and ED may then be only temporary.
ED may be chronic and more difficult to reverse if caused by medical issues such as nerve damage, diabetes and Parkinson’s disease. But in many cases medical conditions can be managed such that ED improves.
What treatment can I try?
One new treatment to try is Eroxon, which is a clinically proven topical gel for the treatment of mild, moderate and severe ED - available over the counter and without prescription. Eroxon gel is clinically proven to help you get an erection within ten minutes. The gel is applied to the head of the penis and has a unique evaporative action that stimulates vascular and neural nerve endings by rapidly cooling and warming the area. This triggers the release of nitric oxide, which relaxes blood vessels, increases blood flow to the penis and leads to an erection.
What are the alternatives?
Cardiovascular exercise to improve the circulation is important for your overall health and fitness and helping ED. Aim for 30 minutes exercise each day (150 minutes a week) and within that 150 minutes aim for 75 minutes of cardiovascular exercise which after checking with your doctor may include running, cycling or joining a gym to work on a treadmill, bike or core building exercise. It’s also important to quit smoking, moderate your alcohol intake and eat a healthy diet.
How can I best manage other health conditions with my erectile dysfunction?
ED can be an early warning sign of other health conditions so it’s important to see your doctor if you start having problems with erections, particularly if you’re over the age of 40 or have other known health conditions such as diabetes or high blood pressure. Some medications your doctor may prescribe for other conditions can also affect erections as a side effect. Don’t be nervous about letting your doctor know if this is the case.
Are there any restrictions I need to follow?
The oral medications for ED are pretty safe but as for all drugs, there can be some do’s and don’ts and it’s important to discuss these with the doctor who is prescribing. The drugs can also have interactions with other medical conditions and prescribed medications so it’s really important you let your doctor know what other drugs you’re taking. One of the benefits of a topic preparation like Eroxon is that you don’t have these interactions so you can be confident it’s safe to use.
Should I see a specialist? What will that cost, and will it be covered by my insurance?
Visit your GP first who will do basic examinations and ask health and sexual history related questions. Sometimes it can be helpful to see a specialist, particularly if there is a psychological element to your problem. You can ask your GP about services that are available in your area.
You can find psychosexual specialist doctors and counsellors by looking at the Institute of Psychosexual Medicine website (www.ipm.org.uk) or COSRT (www.cosrt.org.uk). Unfortunately, many insurers will not cover psychosexual problems but check your policy.
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If medication is prescribed, is there a generic alternative?
If your GP prescribes an oral ED treatment, many of these are available as generics. But in the first instance try Eroxon Gel which is a safe and clinically proven effective topical therapy and is also safe for use by men for whom current front-line treatments for ED are unsuitable.
NHS says 'most men occasionally fail to get or keep an erection'
The NHS says most men occasionally fail to get or keep an erection - and it's nothing to worry about. The health body advises that lifestyle changes can sometimes help, such as losing weight if you're overweight, stopping smoking, eating a healthy diet, exercising daily and trying to reduce stress and anxiety. They also advise not to drink more than 14 units of alcohol a week and not to cycle for a while if you cycle more than three hours a week.
Other medications that can help increase the blood flow to the penis include:
- sildenafil (Viagra)
- tadalafil (Cialis)
- vardenafil (Levitra)
- avanafil (Spedra)
You can get sildenafil on prescription or you can buy it from a pharmacy. You need a prescription for the other types. Vacuum pumps are another option to try. They work by encouraging blood to flow to the penis, causing an erection. They work for most and can be used if medicine is not suitable or does not work. However, they're not always available on the NHS. Speak to a doctor about where to get a vacuum pump.
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