Erectile dysfunction
Erectile dysfunction: a medical assessment of vascular, hormonal and medication-related causes, and effective treatment. A discreet, straightforward consultation.
A symptom worth seeing us about
Erectile dysfunction is the persistent difficulty getting or keeping an erection firm enough. It affects many men from middle age onwards and, beyond your sex life, it has extra medical significance: in quite a few cases it's the first sign of a vascular problem, appearing years before a cardiovascular event. It's worth seeing us about for more than just the bedroom.
Most common causes
- Vascular: high blood pressure, cholesterol, diabetes, smoking, a sedentary lifestyle, obesity.
- Hormonal: low testosterone, thyroid problems.
- Medication-related: some blood pressure medications, antidepressants and other common treatments.
- Neurological and after-effects of pelvic surgery.
- Psychological and relationship-related: performance anxiety, stress, relationship conflict â often mixed in with the above.
How it's investigated
With a clinical interview covering your medication and risk factors, an examination, blood tests for glucose, lipids and a hormone panel, and whatever further tests the case needs. It's a normal medical consultation: there's nothing here to feel embarrassed about mentioning.
Treatment
It starts with what almost nobody wants to hear and what works best long term: quitting smoking, being more active, losing weight and controlling blood pressure, blood sugar and cholesterol. On top of that comes medication â effective in most cases â, reviewing medication that might be contributing, hormone treatment where indicated, and psychological or couples support if it's playing a part. Never buy these medications online without an assessment: they interact with heart medications.
Frequently asked questions
Is it a psychological or a physical problem?
It is often a mixture, and that is why both sides are investigated. Behind it there may be vascular causes âblood pressure, cholesterol, diabetes, smokingâ, hormonal, neurological or drug-related ones, and also performance anxiety or relationship conflicts. The assessment clarifies it.
Can I buy the pills online?
It is not advisable: they interact with heart medication, and behind erectile dysfunction there may be a vascular problem that is worth detecting. In fact, in a fair number of cases it is the first warning sign, years before a cardiovascular event. It is worth having it looked at.
What helps most in the long term?
The part nobody wants to hear: stopping smoking, being active, losing weight and controlling blood pressure, blood sugar and cholesterol. To that is added drug treatment, effective in most cases, a review of any medication that may be contributing and psychological support if that is weighing on you.
What causes erectile dysfunction?
In most cases there is a vascular cause: high blood pressure, cholesterol, diabetes, smoking, a sedentary lifestyle or obesity. Added to these are hormonal and neurological causes, the after-effects of pelvic surgery and the effects of common medicines, and almost always an element of performance anxiety that keeps it going.
What is the best vitamin for erections?
No vitamin resolves erectile dysfunction, and the supplements sold for it have no evidence behind them or contain undeclared drugs. What does work is treating the cause: cardiovascular control, quitting smoking, exercise, reviewing your medication and the appropriate medical treatment.