Even though erectile dysfunction is very common, it remains a difficult topic for most men to talk about. It can be caused by a number of different reasons, including psychological and physical ones.
The good news is that there is a variety of possible treatment options available to you. These can range from medications, injections to surgery. However, sometimes even a simple change in your lifestyle or diet is enough to improve your erections and get you back to your best.
However, before getting started, make sure to speak to your GP to get advice on which is the most suitable treatment for you. See below for a quick guide we have compiled so you can read up on the different options out there. We’ll dive into more detail into the following ones.
- Lifestyle Changes
- Prescription Medication
- Vacuum Penile Pump
- Penile Implants
We mention this one first, not only because it is the easiest or cheapest solution, but also because we believe that medication should not be the first solution you should be seeking. We have actually written a blog post about how changes in your lifestyle can help you combat your ED.
Diet: Having high cholesterol levels in your arteries can slow down the flow of blood to your penis when you want to get an erection. Recent academic research has actually found that obesity is a bigger contributor to erectile dysfunction than age. A good way to start is replacing saturated fats in your diet with healthy fats and avoid sugar or processed carbohydrates.
Physical Exercise: Being active helps to increase blood circulation and reduce your cholesterol level. At the same time, it reduces the production of stress hormones cortisol and adrenaline and makes your body produce endorphins, helping the psychological part of your arousal process. Make sure to find an exercise which you enjoy. Options could be walking, running, yoga, boxing, cycling or any other team sports.
Porn: Porn-induced erectile dysfunction is a common problem, particularly amongst young men. The accessibility, affordability, and anonymity of consuming porn has materially increased over the last years. The best way to start is to try to break the habit of masturbating to porn and potentially even go a set time (i.e. 10 days) without masturbating.
Smoking: Smoking narrows your arteries, slows circulation and increases the risk of respiratory and heart diseases. There is also strong academic evidence supporting that smoking can cause erectile dysfunction. Stopping smoking has shown to reverse the impact significantly. You can try going cold turkey, replacing with a nicotine e-cig, switching to a nicotine-free one, or using cognitive behavioral therapy (CBT)
Alcohol or Drug Consumption: Although alcohol can help you lose your inhibitions, it’s difficult to get an erection when you had too much to drink. In the long term, heavy drinking also contributes to obesity and high blood pressure, which make you more likely to suffer from erectile dysfunction. Avoid having more than 2-3 units of alcohol per day, and go a few consecutive days in the week without any if you can.
As with all lifestyle changes they take time, so you need to be persistent and determined, as ED will not be cured overnight.
Even though the cause of erectile dysfunction can be physiological (or physical), the majority of cases have a psychological component. However, often it is not easy to pin down the cause to a single reason and can also be a combination of both factors.
Psychological reasons can include stress, performance anxiety, depression, traumatic sexual experiences or relationship issues. Speaking to a therapist can help understand the nature of your problems and help address these.
Psychotherapy can be done alone or together with your partner and usually involves a deep-dive into identifying the emotional, psychological and sexual issues which may be the cause of ED.
Given psychotherapy can take quite some time to work it is important to set expectations from the beginning and not expect things to improve overnight. Research has shown that the effectiveness increases when both partners approach the therapy with an open mind and a strong willingness to change things. Often couples find that a partner-therapy leads to a deeper, understanding between each other and the increased communication can strengthen a more trusting relationship with positive effects on their sexual life.
Sildenafil (Viagra) was introduced into the market in 1998 and still remains the most commonly prescribed treatment for erectile dysfunction. Since then other medications like Tadalafil (Cialis), and Vardenafil (Levitra) have been approved. They all belong to the same group of drugs known as PDE5-inhibitors and work in the same way, namely increasing blood flow to the penis, helping you in getting or maintaining an erection.
Prescription medications should be taken about 30 to 60 minutes before sexual activity and their effects can last up to 4 hours. A number of factors such as dosage, your age or what you had eaten before can influence the effectiveness of the drugs. Make sure to consult a GP to figure out the recommended dosage as it can vary from one drug to another.
It is not uncommon for men to suffer minor side effects from taking ED prescription medication.
Common side effects include headaches, dizziness or digestive problems.
Alprostadil, also known as Prostaglandin E1, works in a very similar manner to Sildenafil (Viagra). It enhances blood flow to the penis and makes the blood vessels expand allowing the penis to become erect. However, Alprostadil is either injected directly into the penis or placed via an intraurethral suppository.
The medication usually starts to work after 5 to 20 minutes and the erection lasts for about one hour will actually remain post ejaculation. It was found to be effective in about 64% of men, however, given the high risks associated with this treatment option it is usually only considered after other treatments have failed.
Vacuum Constriction Devices
Also known as vacuum constriction devices (VCD), can help men creating an erection using a vacuum pressure pump. The VCD is a cylinder-like device which is placed over the penis and an attached pump (manual or run on batteries) creates vacuum pressure inside the cylinder. The vacuum draws blood into the blood vessels of the penis and causes it to become erect.
A constriction band or ring is placed around the base of the penis to prevent blood from flowing out of the penis and to maintain the erection.
About 70% of men have reported a positive outcome by using a VCD. The band or ring can be left on for about 30 minutes to allow for sexual activity.
Penile implants are devices placed surgically inside the penis and scrotum to help men with erectile dysfunction (ED) to get an erection. Penile implants are the most invasive alternative to treat ED and are typically recommended only after all other treatments have failed.
During surgery two cylinders are placed in the penis and an inflatable pump in the scrotum. Squeezing the pump in the scrotum causes fluid to move into the cylinders and hence creating an erection. When inflated the penis acts and feels like a natural erection.
Surgeries for penile implants take about 60 minutes and the patient can resume sexual activity within six weeks after the surgery. Penile implants see satisfaction rates of over 90% after 2 years of use.
Which ED treatment option is the most suitable for you?
While changing your lifestyle is the easiest and quickest one you can start, it is important to consult your GP to understand the underlying causes of why you may be experiencing ED.
Sometimes ED is just a symptom of a more serious condition, which a GP can help you identify.