Treatment for Erectile Dysfunction

There are now many different kinds of treatment for erectile dysfunction -- everything from counselling to medication. Because there can be so many different factors leading to erectile dysfunction, a man should look at all the choices.

See your doctor

A visit to your family doctor is an important first step in getting treatment. Often erectile dysfunction is treatable, but many men are too embarrassed to talk to their doctor openly about the problem. As well, some doctors are uncomfortable introducing the topic, so it’s important to ask specific questions about erections if that is why you are seeing the doctor. By reviewing your medical history, prescription medications, your lifestyle and use of recreational drugs, a doctor can determine what kind of therapy is necessary. As well, he or she may be able to change your prescription if the medications you are taking could be causing erectile dysfunction.

Speak to your partner

Men are often ashamed or embarrassed to talk to their partners about sexual problems. Instead of talking, they may distance themselves from their partner or stop initiating or responding to sex. This can increase tension and hurt feelings in a relationship. Open communication helps reduce the tension and pressure that may surround your sex life. Undoubtedly, your partner will want to help you and the relationship you share.

Expanding the range of sexual play

When we think of “sex” in our culture, we usually think of intercourse. However, there are many other ways to be sexually intimate with a partner. You and your partner may wish to explore other ways to have sex--like oral sex, massage, using sex toys--to reduce the pressure you may feel to become erect. While you may hope that the erectile dysfunction will be treated and intercourse will resume, it can be helpful to include other types of sexual behaviour. You might find that it adds a whole new dimension to your sex life that is just as enjoyable!

Counselling

Even if there is a physical cause, men who are dealing with erectile dysfunction, especially if it has gone on for a long time, may have personal issues which can be addressed in counselling. As well, sexual difficulties can be the cause of or the result of other relationship problems. Couples often find it helpful to seek sexual counselling together. In fact, some doctors are suggesting that relationship counselling should automatically be included as part of a prescription for Viagra or any other medication to treat erectile dysfunction.

Oral medications

There are several oral medications to treat ED, sildenafil (Viagra), Cialis, Levitra and yohimbine (Yohimbine, Yoco). They can be quite helpful, depending on the cause of erectile dysfunction; however, there are some side effects. Please ask your doctor about any of these oral medications. 

Self-injection

Using a short needle, a man can inject medication into the side of his penis, producing an erection that lasts from 30 minutes to a few hours. Prostaglandin (alprostadil, Caverject®, Edex®), and phentolamine (Regitine®) produce results similar to Viagra but are localized in the penis after injection. The injections are claimed to be relatively painless, and many men claim that the erections they produce feel natural. However, there are side effects (infection, bleeding, and bruising at the injection site, dizziness, heart palpitations, and flushing), and it is recommended that an injection be used no more than once every 4 to 7 days.

Urethral suppositories

Contain prostaglandin (the same medication in an injection), but instead of injecting yourself, you can put the medication into the opening of the penis.

Vacuum devices

These work best for men who are able to achieve partial erections on their own. “The penis is inserted into a plastic tube, which is pressed against the body to form a seal. A hand pump attached to the tube is used to create a vacuum that draws blood into the penis, causing the penis to become engorged. After 1 to 3 minutes in the vacuum, an adequate erection is created. The penis is removed from the tube and a soft rubber O-ring is placed around the base of the penis to trap blood and maintain the erection until removed. The ring can be left in place for 25 to 30 minutes.” (Source: Urology Channel)

Surgery

Usually has one of three goals:

To insert a penile prosthesis into the penis. This prosthesis can either be a semi-firm rod or an inflatable tube.

To reconstruct arteries to increase the blood flow to the penis.

To block off veins that may allow too much blood to flow away from the penis. This helps the penis to stay erect.

Surgery is an invasive procedure and there are risks associated with any surgery, such as infection. Often men will try other treatments before resorting to surgery. Of course, any surgical procedure should be discussed with a doctor.

A consultation with a specialist

If you do not wish to discuss your situation with your family doctor or your family doctor is not able to help you, you may wish to find an urologist (a penis specialist). You can be referred to a urologist by your family doctor or any doctor at a community health centre or walk-in clinic.

Prevention

Although psychologically rooted erectile dysfunction is most common in younger men, healthy lifestyle choices can go a long way in preventing the onset of physically related dysfunction. Regular exercise and a balanced diet will help prevent high cholesterol, blood pressure problems and other risk factors that could contribute to erectile dysfunction later in life. Not smoking, moderating ones alcohol and recreational drug intake and making otherwise responsible lifestyle choices are a good idea for a number of reasons beyond maintaining the ability to achieve erections.

(Sources: WebMDClinique médicale l’Actuel, MedlinePlus, National Kidney and Urologic Diseases Information Clearinghouse)