Treatment of Erectile Dysfunction
The treatment offered will depend on the cause of your ED. Many men experience ED associated with a psychological cause such as Performance Anxiety. Some men will have ED related to a physical cause, such as diabetes. Men with ED as a result of diabetes and cardiovascular disease are referred to Urology by their GP. Often there is a psychological element to ED as well as a physical cause. Talking with your doctor will help inform what type of treatment would suit you best. Medication can be a useful tool for treating ED. The most effective way of treating ED is usually a combination of talking therapy and medication. If you are experiencing symptoms of erectile dysfunction, you can speak to your GP about a referral to the Sexual Problems Service and discuss a trial of medication.
Viagra, Cialis and Levitra
These belong to a group of drugs called Phosphodiesterase Type 5 Inhibitors (PDE5I). They work to improve blood flow to the penis. You need to be turned on to achieve an erection with these drugs. The most common side effects are: headache, flushing, indigestion, blocked nose and visual disturbance. PDE5I drugs should not be used if you are on Nitrates as it may result in very low blood pressure.
Alprostadil Alprostadil is a PDEI5 drug which can be administered in several different ways:
- Muse is a fast acting PGE5I (5-10 minutes) pellet which contains Alprostadil. It is gently inserted into the urethral meatus (where urine comes out of at the penis tip) and the penis is gently massaged to help its absorption.
- Vitaros is the same medication in a cream form.
- Cavaject is an injectable form of Alprostadil that you give yourself. It is injected into the side of your penis. This treatment requires a referral to Urology to be taught how to safely perform this.
A VED is a closed-end clear plastic cylinder with a vacuum pump and constriction rings. The cylinder is placed over the penis and the vacuum pump is used to remove the air from the cylinder. The vacuum reduces the pressure in the cylinder, causing blood to be drawn into the penis resulting in an erection. Once the penis is fully engorged a ring is placed at the base of the penis preventing the blood from draining away. The erection produced using a VED is slightly different to a normal erection. The penile skin is a lower temperature, the veins appear distended and the penile circumference can be increased.