Keeping it Up

By Dr Yaman Tal, Consultant Urological Surgeon & Consultant in Sexual Medicine

Studies have estimated that Erectile Dysfunction (ED) may play a role in as many as 20 per cent of failed marriages. ED has nothing to do with manhood, it’s a medical condition and could be an early sign of heart disease. 

A man’s sexual dysfunction is a group of disorders

that include:

1. Erectile dysfunction (difficulty getting or keeping

    an erection)

2. Premature ejaculation (reaching orgasm too quickly)

3. Orgasmic disorder (reaching orgasm too slowly or

     not at all)

4. Low libido (reduced interest in sex)

It is not uncommon for men to experience short-term  Erectile Dysfunction (ED) in their lifetime, especially in times of stress and illnesses. ED can affect men at any age but is more common in men over 40.

Keeping it up: how erection works

The penis is composed of two chambers that contain small cavities surrounded by contracted muscles. During sexual stimulation, these muscles relax, opening the cavities and allowing blood flow, resulting in an erection. Any disease that affects blood vessels, hormones or nerves can lead to erectile dysfunction.

Causes of ED

There is a long list of causes:

Clogged blood vessels (atherosclerosis), diabetes, high cholesterol, smoking, raised blood pressure, obesity, surgeries (prostate and pelvis), stroke, Parkinson disease and son on

Depression and anxiety, for example 

Dysfunctional relationships and poor communication between a couple are also risk factors 

A wide range of medications are associated with ED, such as many blood pressure tablets, prostate medications and antidepressants

How to deal with ED

Unfortunately, many men, due to false pride, avoid talking about the problem, distance themselves from their partner and refuse to seek medical help for years. By the time they may seek help, their relationship is severely damaged.

So the first step to manage ED is communication. Do not delay talking to your partner in open discussion and attend doctor appointments together.

What the doctor will do

After a review of your medical history and examination, your doctor will ask for a routine blood test, including cholesterol and blood sugar as these are common causes of ED. What many men do not know is that ED is often a warning sign of heart disease – decreased blood flow to the penis can be caused by clogged arteries) or high blood pressure.

After the blood test, the doctor will advise the  patient to try some tablets to enhance blood flow to the penis- it’s important to follow the advice of your doctor.  The most important fact about ED medication is that they are not magic pills; they require adequate foreplay to work effectively. Keep in mind that only medication can treat ED – herbal supplements don’t work and pose hidden dangers to your health. If you do not respond to mediation, the doctor may prescribe injections which are not favoured by most patients because they require planning and kills the spontaneity of sex.

The ultimate solution for ED is penile prosthetic surgery where small silicone rods are inserted into the penis. This will bypass any physiological erection and provide permanent solution with extremely high satisfaction rate. Some of these rods are inflatable and come with a small pump to inflate and deflate the penis.