Erectile Dysfunction

Erectile dysfunction (ED) is the persistent or recurrent inability to achieve or maintain an erection sufficient for sexual activity. It is sometimes known as 'impotence'.

It's a very common problem, particularly affecting men past the age of 40, and around 1 in 10 men overall.

ED can be triggered by psychological issues such as depression, stress or relationship difficulties. However, in about 75% of cases of ED, the cause is physical. Most men with ED have a combination of physical and psychological causes.

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Erectile Dysfunction symptoms

If you have ED you will be unable to get an erection, or you cannot keep an erection for a long enough period to penetrate your partner or achieve climax. Some men are unable to get a desired erection for sexual activity, but notice that they still wake up with an erection.

Erectile Dysfunction diagnosis

In most cases, a doctor will only become aware of your erectile dysfunction if you tell him or her. It won't show up on standard medical checks.

Your doctor may discuss the possible causes of your condition. At this stage, be prepared for questions of a very personal nature concerning your sex life.

The doctor will also conduct a physical examination, looking at your genitals, pulse, and your reflexes. Your blood sugar, cholesterol, blood pressure, hormonal levels and your nerves may all be tested to try and establish the underlying cause of your ED.

In some cases, you will be referred to a urologist for further tests. Further investigations may be carried out that measure the blood flow and pressure in your penis.

Erectile Dysfunction treatment

There are many different types of treatment for ED, including:

Oral treatments

  • Usually the first line of treatment.
  • A pill is taken up to an hour before you are planning on having sex. Usually, you will still need some form of sexual stimulation in order for the pill to work.
  • Once you have an erection, you should be able to have sex as normal. The next time you wish to have sex, you will have to take another pill, although one type of pill works for 24 hours.

Vacuum constriction device

  • A mechanical way of getting an erection.
  • You place your penis into an empty cylinder. A pump removes the air, creating a vacuum.
  • This draws blood into the penis, giving you an erection.
  • A rubber ring is slipped around the base of your penis to maintain your erection. This ring can stay on for up to 30 minutes, while you have sex.

Intracavernosal injection therapy

  • The patient or partner is taught to inject a special drug into the shaft of the penis when an erection is required. Erection usually follows 15 minutes after the injection.

Transurethral therapy

  • A needle-free form of the injection treatment.
  • A small pellet of the drug is placed in the urethra using a special applicator. The drug is then absorbed through the wall of the urethra and an erection follows in five to ten minutes.
  • Has a lower success rate than other treatments.

Hormone treatment

  • Only a small number of ED cases are caused by hormone problems.
  • The most common is low testosterone levels, which can be restored with testosterone replacement therapy.

Penile prosthesis

  • A penile prosthesis is when a rod is inserted into the penis so that an erection can be manually achieved. In some cases, this involves using a small pump to 'inflate' the penis.
  • This is usually a last resort, if all other treatments have not worked.

Surgical treatments

  • In a few isolated cases, surgery can be performed to correct abnormalities of blood vessels affecting blood flow.

Need more information?

Speak to your GP or a consultant if you notice any symptoms or want to discuss erectile dysfunction treatment options.

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