Erectile Dysfunction

Erectile Dysfunction?

I have many years experience in helping men and their partners with this distressing condition. It must be said that all men who have sex have at some time in their lives experienced erectile dysfunction.  So, you are not alone!

Below you will find brief and generalised information however individual advice is very important.

Some definitions of erectile dysfunction:

  • Impotence

The penis is regularly not hard enough to penetrate (vagina, anus etc according to preference.)

  • Premature Detumescence

The penis loses its erection once you are in but have not ejaculated.

  • Premature Ejaculation 

When ejaculation happens regularly under a minute after penetration.


                        An individual assessment is really important in order to successfully manage ED. 

Causes can include one or several of the following:

  • Blood Supply

Blocked arteries from things such as cholesterol, smoking and obesity.

  • Nerve Supply

Damaged nerves from prostate and bowel surgery and from the effects of diabetes.

  • Overthinking too much

Thoughts such as:

  • "Should I be doing this" (guilt)
  • " I really want to impress" (performance anxiety)
  • "It didn't work last time, I wonder if I can do it this time", "I'm tired", "this is a bit ho hum these days", " I really can't be bothered" (libido).

 

Drugs

A range of common drugs can interfere with performance and cause ED.

  • Alcohol,
  • Antidepressants and anxiolytics
  • Some blood pressure medications
  • Some antihistamines
  • Some anti Parkinson drugs (some anti Parkinson drugs can cause sexual aggression too).


Treatments

There are a range of medical treatments available.  The best treatment for you  can only be determined after an individual assessment 

PDG-5 Inhibitor Drugs (These drugs help the smooth muscles of the penis to relax and increase blood flow).

  • Sildenafil -marketed as Viagra, Avigra, Vedafil
  • Tadalafil- marketed as Cialis
  • Vardenafil- marketed as Levitra

Taken prior to expected sexual activity these cause erection with appropriate sexual stimulation.

If you take the drug then get distracted with other activities, you will not get an erection.  Which of these drugs is better for you will depend on your circumstances and expectations.

Alprostadil

Marketed as Caverject, this is an injection into the penis itself, usually used after a poor response to PDG-5 Inhibitor drugs. It is a different drug to the PDG-5 inhibitor drugs.

Only one side needs injecting as the drug spreads rapidly through the penis.

An erection is usually achieved without stimulation and detumescence only occurs only when the drug has been metabolised so if the phone goes, the neighbours turn up or your partner has a headache, the erection stays.

It is a medical emergency if the erection lasts 3 to 4 hours as the penis tissue looses oxygen supply and can become damaged.  Before seeking medical help, it is worth trying running up and down stairs or applying cold compresses.  A drug is available to reverse the erection should medical help be sought.

Apomorphine 

Marketed as Apokyn, Ixense, Spontane and Uprima, this drug is not registered for use in New Zealand.  It is not related to morphine or its derivatives.

It is available online or at some Men's Health Clinics. It is taken as a nasal spray or dissolved under the tongue.

It works by stimulating dopamine in the brain so enhancing the sexual response, but works poorly when used alone compared with the other medications.

I would like to see it made available here as I see it useful to possibly increase libido and desire so be a useful adjunct with the oral medications, should this be needed.

The vacuum pump 

The chamber is applied to the penis and the apparatus is hand pumped.  A band is placed over the base of the penis and the pump removed once an erection has been achieved.

Surgical options

When all else has failed, a surgical implant can placed in the penis with a pump placed inside the scrotum.  This is a specialist urological surgery procedure only.  I can refer you to a specialist surgeon if this surgery is required.

 

How to maintain?

The most important things to maintain erectile function are:

  • Do not smoke tobacco or cannabis
  • Drink alcohol in low to moderate amounts or not at all
  • Exercise regularly
  • Eat a healthy diet
  • Maintain ideal body weight
  • Relax your brain regularly
  • Avoid inter personal conflict
  • Communicate with your sexual partner
  • Seek early help if you are experiencing ED issues regularly.

Costs

An initial individual assessment is up to $71.

Booking

Please phone reception at Broadway Medical Centre  to enquire about booking.

Phone:   03 477 4335

Fax:       03 477 4337

E-mail: enquries@broadwaymed.co.nz