What is Erectile Dysfunction?

Erectile dysfunction (ED) is a common type of male sexual problem. It is when a man has trouble getting or keeping an erection sufficient for sexual intercourse. Achieving an erection is a complex process involving the brain, hormones, nerves, muscles and blood circulation. ED becomes more common as you get older.

Some people have trouble speaking with their doctors about sex. But if you have ED, you should talk to your doctor. ED can be a sign of health problems such as cardiovascular disease or diabetes.

Who gets Erectile Dysfunction?

ED affects approximately 5% of men in their 40s, and 15-25% of men over the age of 65. Transient erectile dysfunction can affect up to 50% of men between the ages of 40 and 70. It is distressing and frustrating for both patients and their partners.

What causes Erectile Dysfunction?

Erectile dysfunction can have a range of causes, both physical and psychological. Physical causes include: narrowing of the blood vessels going to the penis – commonly associated with high blood pressure (hypertension), high cholesterol or diabetes, hormonal problems, surgery or injury. Psychological causes of ED include anxiety, depression and relationship problems.

Sometimes erectile dysfunction only occurs in certain situations. For example, you may be able to get an erection during masturbation, or you may find that you sometimes wake up with an erection but you are unable to get an erection with your sexual partner.

Sorry Cyclists! -- Men who cycle for more than three hours per week may be recommended to try a period without cycling to see if this helps improve erectile dysfunction. Riding in the correct position with a properly fitted seat may also help to prevent regular cycling from leading to erectile dysfunction

Treatments

First of all we should talk about treating any underlying conditions. If your erectile dysfunction is caused by an underlying health condition, such as heart disease or diabetes, that should be addressed first. In some cases, treating this may also resolve the problem.

If you are taking medication that can cause erectile dysfunction, there may be an alternative. It is best never to stop taking a prescribed medication unless you are advised to do so by your GP or another qualified healthcare professional responsible for your care.

Improving Lifestyle factors such as losing weight if you are overweight, giving up smoking, cutting back your alcohol consumption, not taking illegal drugs, exercising regularly, reducing stress will all help. As well as helping to improve your erectile dysfunction, these changes can also improve your general health and may help to improve your quality of life.

Yes, yes, what about the pills?

There are treatments available. Phosphodiesterase-5 (PDE-5) inhibitors are one of the most widely used and effective types of medication for treating erectile dysfunction. These are better known as Viagra (sildenafil - which is also available as brands Avigra, Vedafil and Silvasta) and Cialis (tadalafil). They work by temporarily increasing the blood flow to your penis.

Sildenafil works for about eight hours and they are designed to work 'on demand'. Tadalafil lasts for up to 36 hours and is more suitable if you require treatment for a longer period of time, for example, over a weekend.

Depending on the type of PDE-5 inhibitor you are taking and the dose, it should take about 30-60 minutes before it starts to work. With sildenafil you should be able to have sex from one to 10 hours after taking the medicine. After taking tadalafil, the effects will last for up to 36 hours.

It may take longer to notice the effects if the tablet is taken with food, so it's best to take it on an empty stomach. You can then eat after an hour without affecting the medicine.

Are there any reaons I can't take Erectile Dysfunction meds?

There are several contraindications to ED meds. If you use a GTN spray, multiple blood pressure tablets, have a low BP, or have recently had a stroke or heart attack, these tablets may not be for you. Please discuss your other meds and conditions with your doctor.

Want to talk?

Book an appointment for a video consultation with a qualified New Zealand GP, who can discuss all this with you. If appropriate, we can arrange for the medications to be precsribed and delivered to you.



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