Erectile dysfunction is a very common illness especially among men aged 40 to 70. Also known as impotence, it affects around half of men at some point in their life. It is nothing to be embarrassed about and if you speak to your doctor they will be able to advise you on what medication will help you to overcome your problem. There are a variety of drugs you can buy to help manage erectile dysfunction, such as Viagra and Cialis. Erectile dysfunction pills are also available for less money if you choose to buy the nonbranded, generic version. There is no chemical difference and they have exactly the same effect.
Impotence can be cause be a variety of reasons. Sometimes it is simply a case of getting older, but it may be your medication affects your ability to get an erection, or there is an underlying health issue, which a doctor can help you to identify and resolve.
The erectile dysfunction treatment that is right for you will depend on your medical history and any other medicines you're taking. There maybe certain circumstances in which one type of pill is not correct for you and your doctor may recommend one you have not heard of before. Erectile dysfunction is a well researched area of sexual health, and there are a variety of medicines to help you solve your problem.
"Erectile dysfunction is a common condition which affects half of men at some point in their lives. There is no shame in talking to your doctor about it, as we are trained to help you with any kind of sexual problem you have. It may be a problem caused by another medication you are on, or it may be due to something else in your life, such as stress or mental-health conditions. There are a variety of treatments so don't be put off if one of them doesn't work for you."
What is erectile dysfunction?
Erectile dysfunction, sometimes known as impotence, is a condition where a man fails to get or maintain an erection either once or repeatedly. It is a very common condition which affects around half of men aged 40-70 and becomes more likely as you get older. You are twice as likely to suffer from erectile dysfunction in your 60s as you are in your 40s, but can affect you at any age. Almost all men experience short term erectile dysfunction at some point, usually after consuming too much alcohol. Impotence is usually nothing to worry about or be ashamed of and you should only be concerned if it begins to affect your life and relationships. There are no long term side effects of erectile dysfunction, but in some cases it can be a symptom of an underlying condition.
Despite the huge amounts of people suffering from erectile dysfunction, very few people speak to their doctor or seek help to fix the problem. Your doctor is trained to talk to you about this kind of problem, but if you would rather not discuss it with them, you can talk to someone at a sexual health clinic, sometimes known as a GUM (genitourinary medicine) clinic who will deal with this kind of problem on a daily basis.
What causes it?
There are dozens of reasons why men suffer from erectile dysfunction, but they can be divided roughly into two categories: physiological (physical) and psychological. The reason behind why you cannot get or maintain an erection may affect the type of medication or therapy you need to cure or fix the problem. Erectile dysfunction, sometimes known more simply as ED, can sometimes be a symptom of an underlying condition, and when you speak to your doctor about the problems you have been having, they may want to do some tests to make sure there is no bigger issue to be treated. This could be a hormonal issue such as hypogonadism, better known as suffering from a lack of testosterone, a problem which can usually be resolved quite easily with a testosterone gel applied daily to the skin, such as Testogel. Impotence may also be a symptom of an underlying condition which affects the blood circulation to the penis, such as blocked blood vessels (medically known as atherosclerosis).
In a large amount of cases, reversible lifestyle changes such as an unhealthy diet, drinking too much or smoking may be the cause of your erectile dysfunction, and the problem can be resolved by adopting more healthy lifestyle habits. There is also a link between cycling more than 3 hours a week and suffering from erectile dysfunction.
Some of the major illnesses which cause erectile dysfunction for physical reasons include:
- Cardiovascular disease (CVD), any illness which relates to the heart or blood vessels
- Blocked blood vessels (atherosclerosis)
- High cholesterol or blood pressure
- Metabolic syndrome, the collective name for the combination of high blood pressure, diabetes, obesity and high cholesterol
- Parkinson's disease
- Multiple sclerosis
- Peyronie's disease, a disease which affects the shape of the penis due to scar tissue
- Sleep disorders
Sometimes other medications you are taking may impair your ability to get or maintain an erection. Such medications include (but are not limited to):
- Radiation therapy in the pelvic region
- MAOIs (monoamine oxidase inhibitors) or SSRIs (selective serotonin reuptake inhibitors) which may be taken to treat depression
- Medication taken to control high blood pressure
- Some heart medications
- Opioid painkillers
- Some cancer treatment drugs
- Prostate treatment drugs
- Some types of diuretics, drugs taken to increase the amount of urine you pass
- Sleeping pills, amphetamines, and other drugs with act on your central nervous system
- Medication taken to treat anxiety
- Medications which alter your hormones
- Anabolic steroids
If you are taking one of you above drugs and think it may be the cause of your erectile dysfunction, you should not stop taking the drug as way to fix the problem as this can be very dangerous. Instead, speak to your doctor and they may choose to change your medication to work around the problem if possible. Do not do this without your doctor’s guidance.
If you are able to get and maintain an erection sometimes, for example in the morning, but not when you are with your partner, your problem may be a psychological one and not a physical one. This is less common, but can be easier to fix. Psychological causes of erectile dysfunction include:
- Mental health disorders such as depression or anxiety
- Relationship problems
- “Performance anxiety” - when you have previously been unable to get an erection and are scared, worried or feel guilty that it may happen again, thus making you more stressed and making the problem worse
- What treatments are available?
The treatment for your erectile dysfunction depends greatly upon the cause of it, and you should always begin with altering and improving your lifestyle habits. Not only will this be the easiest and generally most effective way to get results, but it will benefit your whole life and general wellbeing, and could help clear up other health problems you may have. Lifestyle changes you can make to treat erectile dysfunction include:
- Losing weight if you are overweight or obese. You will be classified as overweight or obese is your BMI is over 27 or 30 respectively. You can find out your BMI by using an online calculator and inputting your age, height and weight.
- Stopping smoking. Smoking can be detrimental to your health and the health of those around you and choosing to give up can improve your health in all kinds of way. If you need assistance in giving up smoking, read our smoking cessation page.
- Taking more exercise. As well as being a great way to lose weight, taking more exercise is good for your cardiovascular system and general health, and increasing blood flow around the body. Exercise is also a great way to relieve stress and the endorphins released after exercising can help you to tackle depression naturally, making it a great solution if you think your erectile dysfunction may be caused by psychological or emotional problems.
- Eating healthily. This is another solution which goes hand in hand with losing weight, but increasing the amount of healthy food you eat and water you drink can help your body function better in all kinds of ways.
- Drinking less alcohol. As well as the commonly experienced short term effects of too much alcohol causing impotence, on a more long term basis giving up drinking can be extremely beneficial. If you are drinking more than 14 units of alcohol a week, consider cutting back to reduce the effects it can have of you sex life.
- Cycling less. This may seem like a backwards suggestion after suggesting that exercise is a good way to ease impotence, but there is evidence to suggest that cycling more than three hours’ cycling a week is linked to erectile dysfunction. This is because the position in which you sit whilst cycling is found to constrict certain blood vessels necessary to maintain an erection.
- Reducing stress. If you are under a lot of pressure at work or home, this could be hindering your ability to get an erection. Try cutting back on work or having an honest conversation with your partner about what is bothering you to try and overcome this problem.
If you have tried all of these solutions and think your problem may be an emotional or psychological one, seeing a qualified sex therapist may help you to help you overcome stress and emotional difficulties you may be having, such as anxiety or depression. Sometimes talk to a professional about the problem and confronting it can be enough to come to terms with it. This understanding of your problems can make them more manageable. If you think the problems may stem from relationship difficulties, you and your partner may choose to see a couples therapist to overcome the difficulties.
There are also a variety of medications which can help you to overcome erectile dysfunction, the most well known being Viagra. These medications are known medically as PDE-5 inhibitors, and work by increasing blood flow to the penis.
Viagra, of course, is the best known of these medications, and the most widely used and oldest one of these PDE-5 inhibitors. It is also available under its generic name Sildenafil, named after the active ingredient in Viagra. These products are exactly the same, and you only pay extra for Viagra because it is a brand. But these are not the only pill based solutions.
Another brand of PDE-5 inhibitor is Cialis (also available under its generic name of Tadalafil). This is one of the longest lasting types, and the effects can last for up to 36 hours. There is also Levitra (also available under its generic name of Vardenafil), which is similar to Viagra/Sildenafil, but has less chance of adverse side effects. Spedra (also available as Avanafil) is one of the newer brands of PDE-5 inhibitors, and also one of the fastest acting. In some cases, it can be effective as quickly as 15 minutes after taking the pill. These medications can be taken with or without food, but will take longer to have an effect if they are taken after a heavy or fatty meal. Taking them with alcohol will also impair their effect.
Who is it suitable for?
Although PDE-5 inhibitors are suitable for use by most men, certain conditions may mean that you should steer clear. The following is not an exhaustive list and you should speak to your doctor about your medical history before taking any PDE-5 inhibitor to resolve erectile dysfunction. As a general rule, you should not take these kinds of medication if:
- You are a woman
- You are allergic to any of the ingredient
- You are taking nitrate to treat angina (chest pain)
- You are taking nitric oxide donors (poppers)
- You are taking riociguat for high blood pressure in the lungs
- You have a severe heart or liver problem
- You’ve recently had a heart attack or stroke
- You have low blood pressure
It should also be noted that may be side effects of using PDE-5 inhibitors, and you should read the relevant patient information leaflet to be informed of these before taking them. If you find the side effects too much, you can speak to your doctor about getting a prescription for another type of medication. Remember that erectile dysfunction is a very common illness that most men experience at some point in their lives, and your doctor will be trained to listen and understand your problem and assist you in getting help in a way that works best for you.