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Is there a treatment for ED?

Fri, 05 Mar 2021 03:17:00 GMT

Shockwave therapy treatment

Is there treatment for my ED?

Yes . So: you have been seen by your doctor, have given a good account of your ED in your story and in the questionnaires you filled out, have been examined and have had your blood samples sent to the lab. There are no obvious ‘reversible’ reasons for your ED but you would like it sorted. Your blood pressure is normal as are your cholesterol, your blood sugar and your testosterone, you don’t smoke or drink alcohol to excess, don’t ‘do drugs’ and you are not stressed or depressed. Your testicles and penis appear normal. There are plenty options.

If your testosterone is low, your doctor might treat this with patches, gels, tablets or a once every 14 week injection. There a currently 4 oral (tablet form) medications licenced as first line treatment for ED. These drugs help dilate the arteries which leads to relaxation of the muscles in the penis, swelling of the veins and erection. These drugs are very safe but the first dose should be prescribed by a doctor.

Always tell your doctor or pharmacist if you are taking and over-the-counter medications or herbal remedies as there might be possible interactions with the ED medications. They can interact with some heart medications and should definitely not be taken if you are prescribed medication for angina (chest pain caused by heart disease) or amyl nitrate (poppers) or if you have low blood pressure. The drugs are not affected my moderate alcohol use and need sexual stimulation to get an erection. Possible side-effects include flushing of the face, nasal stuffiness, headache and blurred vision. As with almost all drugs, nausea can occur and these side-effects are generally short lived.

Other medical treatments include injections into the side of the penis. Pain at the injection site is usually minimal and short-lived. There might be a tiny amount of bleeding or bruising. This would not be recommended if you are taking anticoagulant medications (blood thinners). Another way to help with an erection is to put a small medicated suppository into the opening of the penis. You might experience some burning in the penis that lasts for a few seconds.

Are there any other treatments apart from medicines available to treat my ED?

Yes : If tablets, injections and suppositories don’t work, all is not lost. You might like to use a battery-powered vacuum pump to pull the blood into the penis. Once you have an erect penis, you can put a band on the base of the penis until after sex. Implants of rods into the penis might suit you but this is a surgical procedure and would only be recommended if other treatments are not clinically indicated or failed.

If you or your doctor feels that your ED is stress, anxiety or depression related or if you feel it is due to alcohol or drug misuse, you may benefit hugely by referral to psychological services with a professional interest in dealing with ED or addiction.

Are there any newer treatments available to treat my ED?

Yes : There is a novel treatment for ED which we offer at Harold’s Cross Surgery. It is called Extra-Corporeal Shock Wave Therapy (ESWT).

Extracorporeal means outside the body so the procedure is not invasive. No injections.

ESWT was first licenced for use in the 1980s for the treatment of kidney stones. A beam of shock waves was focussed on the stones which shattered and were passed by the patients in their urine. Later, its use became popular with physiotherapists for treating bone and joint complaints.

Low intensity shock waves have recently been shown to stimulate new blood vessel formation in the penis by causing mechanical stress and local trauma to the penis. Since poor blood flow in the penis is strongly implicated in ED, it was believed that ESWT would improve blood flow to the penis and improve or even reverse ED.

Recent studies appear to back up this belief. Low intensity ESWT has been shown to increase the rigidity of the penis and duration for the erection. Where measured, penile blood flow increase significantly following sessions of ESWT and this correlated well with patients reports and the questionnaires used to measure your erectile function or psychological well-being as mentioned earlier in the article. Success with ESWT might mean that you won’t need to take any more ED medications.

We offer this revolutionary treatment at Harold’s Cross Surgery.

Does ED last forever?

ED is very treatable and in many cases, reversible. We at Harold’s Cross Surgery, where we specialise in Sexual Health, would be happy to see you, to discuss lifestyle changes and treatments that can greatly improve sexual function.

ED. What it is, and what causes it?

Wed, 03 Mar 2021 03:17:00 GMT

What Erectile Dysfunction is, and what causes it?

Erectile dysfunction (ED) is medically defined as the ‘persistent inability to attain or maintain an erection sufficient for sexual performance’. In layman’s terms, this means that the penis does not get stiff enough for penetrative sex. Studies have shown that as many as 52% of men will develop some degree of ED at some time in their lives. The best study to date on the prevalence of ED, in my opinion is the Massachusetts Male Aging Study, 01 5385515.ED increases as we get older and recent study in 2013 has shown that ED is common in men under the age of 40 affecting 1 in 4.

How does a man get an erection?

Getting an erection is a complex bodily process involving dilatation (swelling) of the arteries bringing blood to the penis, relaxation of the muscles in the penis and the turning on of the system that allows for the temporary blockage of the veins that take the blood away from the penis. All this is under hormonal control, mainly testosterone and the nerves that supply the penis and ensures that an erection happens when desired or required. This means that blood gets trapped in the penis which becomes hard until the blood leaves the penis, for example after ejaculation.

What causes ED?

ED happens when there is a breakdown in this bodily process and can be due to problems with the arteries, veins, muscles, nerves, hormones or even the penis and testicles themselves. This can be a very worrying and distressing problem for men and their sexual partners resulting depression and low self-esteem. It can also cause feelings of unattractiveness, undesirability, and unworthiness. The risk factors that have been most identified for the development ED are increasing age, lack of exercise, being overweight, smoking, high cholesterol or something called metabolic syndrome. Metabolic syndrome is the medical term for a combination of diabetes, high blood pressure (hypertension) and obesity. You may have noticed that these are the same risk factors that are commonly implicated in the development of heart disease. This is very important. ED can be a good predictor of future heart attack or stroke if these risk factors are not addressed. The penis can get ‘blockage of the arteries’ like many other arteries in the body. This is the commonest cause of ED and may be more apparent to you earlier than heart disease so take this seriously and see a doctor.

ED can also be a side-effect of certain medications such as some anti-depressants and some drugs used to treat high blood pressure. It can also be linked to ‘recreational’ drug use such as cocaine or marijuana or heavy drinking. There are also strong links between psychological illness and ED. Depression and stress can cause ED and probably more commonly, prolonged ED can lead to depression and anxiety. Psychological causes of ED might include gender identification issues or unclear sexual preference. Furthermore, you might just not find your sexual partners attractive or worse still, they do not particularly fancy you!

Certain conditions that affect the nerves in the penis such as multiple sclerosis can cause ED and structural problems with the penis such as Peyronie’s disease which causes curvature of the penis can too. Spinal injury or prostate surgery are also potential causes of ED.
Young men in particular are often slow to visit their GPs for routine check-ups. A consultation for ED is an ideal opportunity for a doctor to intervene, to discuss heart disease risk factors including lifestyle, such as lack of exercise, smoking and drinking and to treat the reversible risk factors such as high blood pressure, cholesterol or diabetes. The GP can uncover untreated medical conditions, treat the ED and ideally prevent possible future heart disease.

How is ED diagnosed?

Mon, 01 Mar 2021 03:17:00 GMT

ED is reliably diagnosed on clinical history where you can tell your ED story, by examination and investigations.

The doctor will ask about the ED, when it began, how frequent it is and of anything makes it better. Your relationship with your sexual partners may also be explored. A morning erection is common for most males and if that happens for you, it suggests that the machinery is intact and that the cause may be psychological, stress or drug related. Similarly, if you can masturbate successfully, this is a good sign.

The doctor may ask you to fill in some questionnaires, related to your erectile function or psychological well-being, such as depression. Your doctor might examine you. Your doctor would check your blood pressure and do a genital exam to check for testicle size and for any curvature of the penis. This may warrant a referral to a urologist, a surgeon specializing in this area. In some circumstances your doctor might also like to check your prostate. If you appear overweight, your doctor might work out your body mass index (BMI). This may be something that you might need to address, as well as your smoking, drug or alcohol use.

A sample of your blood would be sent to the laboratory to check for signs of heart disease, diabetes, high cholesterol and low testosterone. The testosterone check should be done in the morning while fasting so don’t be surprised if your doctor suggests a morning clinic appointment. If your testosterone is low, replacing this hormone might well sort out your ED.