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Erectile dysfunction - How is it treated?

Is there anything I can do to help myself?

Addressing all the stresses in your life and altering your lifestyle may help. You should give up cigarette smoking. There are many herbal remedies that claim significant results but for many there is no scientific evidence of effectiveness.

What else can be done?

Psychosexual help

Your GP may recommend that you try some anti-depressant drugs. They can be extremely effective. Professional psychosexual counselling is usually available through your GP. You will meet your professional counsellor who will talk through and explore any problems that you have. It is quite a lengthy process and may require quite a few hours of visits.

Testosterone treatment and impotence

If the testosterone is low, then a cause will have been detected. If this can be alleviated, then your natural testosterone levels may rise and your erections will improve. If not, then you can have testosterone replacement therapy and this is given either as a gel that you smear on your body or regular injections.

Erection problems and poor libido are common in men with low testosterone levels. Other symptoms include tiredness, low energy and poor concentration. Hormone supplements may be helpful.

Medication for erections

Oral medication with Sildenafil (Viagra), Tadalafil (Cialis) and Vardenafil (Levitra) can be very effective for all types of impotence. They vary slightly in the rapidity of onset of effect and its duration, but usually they are taken 15-60 minutes before sexual intercourse is planned. Most men with impotence find that Viagra can improve the strength and duration of their erections. They work best in patients who have malfunction of nerves and least well in patients where there is reduction in blood flow.

It is recommended that you try on six occasions as the medication is not always effective straight away. Rather than taking the tablet every time you want to have intercourse, some doctors recommend that you take a tablet each day or every other day.

There are restrictions to Health Service prescription for these drugs which your doctor will discuss with you. If you can’t have them on the Health Service your doctor will provide a private prescription for you.

Injection treatments

There are some special drugs that can be injected directly into the side of the penis that stimulate blood flow and produce an erection. Your doctor can show you how to do this. There can be side effects with bruising and occasionally the erection lasts too long. If it is more than 4 hours you will need to seek help to stop the erection, otherwise it can damage the inside of the penis. Your doctor will have given you instructions about this.   The same prescribing restrictions apply as for oral medication.

Other treatments for impotence

Vacuum pumps are cylinders that fit over the penis. The air is pumped out, which should draw blood into the penis and produce an erection. To maintain the blood when the cylinder is removed a band has to be placed at the base of the penis. This produces a lasting erection.

Vacuum pumps are usually very effective at creating a strong and lasting erection, but some patients find them off-putting because of the mechanical nature of the device. They are available on a Health Service prescription. 

Penile implants can be inserted into the penis to provide a permanent but bendable erection. Other types of implant can be pumped up to produce an erection when it is needed. This is sometimes complicated surgery and there may be problems in your area with obtaining funding for inflatable prostheses on the Health Service.