Erectile Dysfunction
Erectile Dysfunction, ED, or IMPOTENCE.
Impotence is a failure to sustain an erection sufficient for sexual intercourse. The condition has both psychological causes and physical, although often both co-exist.
Physically the the causes may include:-
Drugs, thiazides [diuretics], Beta blockers, Diabetes, Hypertension, Prostate cancer, Pelvic surgery which includes prostate surgery and neurological disorders. Therefore a healthy lifestyle of avoiding smoking, reducing salt, avoiding excess alcohol and taking exercises all reduce the risk of ED. Often there is no one cause and the process of ageing causes the smooth muscle of the penis becoming less effective.
Treatments
Psychosexual counselling is sometimes effective, although primarily it reduces the stress related to the condition.
Medical Treatments
Drugs have really totally replaced the use of implants and vacuum devices.
There are now three drugs in the same class which are effective as tablets for ED. These are Sildenafil (Viagra), Tadalafil (Cialis) and Vardenafil (Levitra). These tablets work by dilating the blood vessels of the penis, when patients are appropriately aroused. The mechanism is via cGMP cysclic guanosine monophosphate which causes dilation of the arteries of the penis and constriction of the corresponding veins. These tablets have a good safety record, the main side effects relate to facial flushing, headaches and indigestion all of which are fairly minor. A few deaths have been related to Viagra but these have virtually always related to patients already taking Nitrates, used for angina, which should never be used at the same time. Initially it was only available on a private basis but since the government's guidelines this has been extended to a limited NHS availability.
The drugs are usually prescribed privately unless patients fulfill the criteria below.
· Have had radical pelvic surgery or prostatectomy
· Have a spinal cord injury
· Are diabetic
· Have multiple sclerosis
· Have single gene neurological disease
. Severe psychological stress as a result of impotence
Impotence is a failure to sustain an erection sufficient for sexual intercourse. The condition has both psychological causes and physical, although often both co-exist.
Physically the the causes may include:-
Drugs, thiazides [diuretics], Beta blockers, Diabetes, Hypertension, Prostate cancer, Pelvic surgery which includes prostate surgery and neurological disorders. Therefore a healthy lifestyle of avoiding smoking, reducing salt, avoiding excess alcohol and taking exercises all reduce the risk of ED. Often there is no one cause and the process of ageing causes the smooth muscle of the penis becoming less effective.
Treatments
Psychosexual counselling is sometimes effective, although primarily it reduces the stress related to the condition.
Medical Treatments
Drugs have really totally replaced the use of implants and vacuum devices.
There are now three drugs in the same class which are effective as tablets for ED. These are Sildenafil (Viagra), Tadalafil (Cialis) and Vardenafil (Levitra). These tablets work by dilating the blood vessels of the penis, when patients are appropriately aroused. The mechanism is via cGMP cysclic guanosine monophosphate which causes dilation of the arteries of the penis and constriction of the corresponding veins. These tablets have a good safety record, the main side effects relate to facial flushing, headaches and indigestion all of which are fairly minor. A few deaths have been related to Viagra but these have virtually always related to patients already taking Nitrates, used for angina, which should never be used at the same time. Initially it was only available on a private basis but since the government's guidelines this has been extended to a limited NHS availability.
The drugs are usually prescribed privately unless patients fulfill the criteria below.
· Have had radical pelvic surgery or prostatectomy
· Have a spinal cord injury
· Are diabetic
· Have multiple sclerosis
· Have single gene neurological disease
. Severe psychological stress as a result of impotence
Alprostadil Caverject
This is a penile injection which is self administered but only after specialist instruction and is prescribable on the NHS. It is effective in over 50% of cases irrespective of the arousal of the patient.
Alprostadil Muse
Alprostadil Muse
This is the same medication as Caverject although this can be inserted directly into the urethra avoiding injections. Both can be related to side-effects of which the most notable is priapism [persistent erection] which requires urgent treatment if lasting over 6 hours, by attending a casualty department.
Most patients with ED are now managed entirely by the GP. For the majority this involves the prescribing of one of the oral tablets mentioned above. For those patients where this is ineffective, patients are often prescribed Alprostadil additionally, which may involve a specialists opinion.
Impotence association: www.impotence.org.uk
Most patients with ED are now managed entirely by the GP. For the majority this involves the prescribing of one of the oral tablets mentioned above. For those patients where this is ineffective, patients are often prescribed Alprostadil additionally, which may involve a specialists opinion.
Impotence association: www.impotence.org.uk