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American Association of Clinical Endocrinologists. American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for the Evaluation and Treatment of Male Sexual Dysfunction: A couple’s problem – 2003. Update Endocr Pract. 2003;9(No. 1). Accessed at https://www.aace.com/sites/default/files/2019-06/sexdysguid.pdf on January 31, 2020.

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Erectile dysfunction can be caused by many factors and may have a gradual or sudden onset. It can be very upsetting and result in a lot of stress and worry. It can feel embarassing to discuss this with your doctor but it is important that you do, so that you can receive the appropriate help. Erectile dysfunction can also be a sign of other illnesses such as heart disease or diabetes, so it is important that you seek medical advice. What are the facts about impotence? Erectile dysfunction becomes commoner with increasing age and is seen in 50 - 55% of men between 40 and 70 years old; It is often associated with obesity, high blood pressure, high cholesterol & diabetes which are all significant risks to health; Investigation is only indicated if both partners wish to pursue treatment; Most treatable causes can be identified by a clinical history, physical examination and routine blood tests; If there is no treatable cause, treatment with tablets is the first option for most men; Other methods of treatment are only indicated if medication proves ineffective, causes side-effects or cannot be used because of specific medical conditions. What should I expect when I visit my GP?
General good health, particular cardiovascular, is important for sexual function. Avoiding obesity and belly fat can help you avoid and treat erectile dysfunction. A good diet and exercise should be part of your daily regimen. .

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The brain plays a key role in triggering the series of physical events that cause an erection, starting with feelings of sexual excitement. These Include:
Regarding vascular etiologies of erectile dysfunction, a regular erectile function depends on adequate arterial inflow as well as venous outflow occlusion. Both arterial inflow stenosis or impaired venous outflow occlusion compromises filling of the corporeal bodies. Either problem, namely compromised arterial inflow or venous leakage, may result in vasculogenic erectile dysfunction (3).

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A hollow tube is placed over the penis and the air inside the tube is vacuumed out (manually or battery operated) using a pump. The vacuum pulls blood into the penis, leading to an erection. Once the erection is achieved, a tension ring is placed at the base of the penis to keep the blood in the penis to maintain and erection.
If your erection problems have a medical cause, your doctor can explain the treatment options, the techniques needed to make them work and their suitability for your needs based on your overall health.

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Adjustment of medications that adversely affect erectile function should be considered whenever possible.

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    Strengthening the muscles that surround and support the genital area can assist the penis in obtaining and maintaining an erection and address issues that cause premature ejaculation.

    Your doctor may switch you to another medication to see if that resolves the issue.
    In fact, one common reason many younger men visit their doctor is to get erectile dysfunction medication. Often, men with erectile dysfunction suffer with diabetes or heart disease, or may be sedentary or obese, but they don’t realize the impact of these health conditions on sexual function. Along with erectile dysfunction treatment, the doctor may recommend managing the illness, being more physically active, or losing weight.

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    You can buy extract of the bark of the yohimbe tree – long used as an aphrodisiac in western Africa -- as a dietary supplement. Its promoters claim it can help erectile dysfunction. But the science shows mixed results.

    Dr Gautam Banga, consultant and andrologist at the Sunrise Hospital New Delhi previously told indianexpress.com that in India, ED is a taboo because people don’t see it as a medical disorder but as sexual incompetence. “It does not happen because the man is not interested in or is incapable of having sex, but there are medical reasons like diabetes, high cholesterol, high blood pressure and ischemic heart disease (IHD), depression etc., that leads to ED,” he said.
    There are various ways to treat erectile dysfunction. The treatment options range from home remedies to medications and therapies.

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    It’s important to answer these questions openly and honestly, so your doctor can accurately assess your condition in order to recommend effective treatment.

    While many cases of ED are caused by medical conditions that can’t be cured, various treatment options can help restore sexual function.
    As with vardenafil, doctors do not recommend tadalafil for men with the following conditions:

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    A GP might recommend sex therapy, either on its own or in combination with other psychotherapy.

    Erectile dysfunction (ED) is a condition that affects millions of men around the world and as many as 30 million men in America. Also known as impotence, this condition impairs a man’s ability to achieve a suitable erection for intercourse. In the majority of men with ED, the condition is a physical problem caused by insufficient blood supply to the penis. However, some cases of ED are caused by psychological disruptions such as depression and performance anxiety.
    Stopping urination midstream is one way of tightening the muscles, building their strength and control. Drawing the testicles upwards is another.

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Once significant systemic diseases, such as diabetes or heart disease, are ruled out, an oral medication, such as Viagra, Levitra, or Cialis, may be prescribed. If these agents are successful, further testing is usually not warranted.

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The central nervous system is responsible for releasing nitric oxide, an essential chemical for producing and maintaining an erection, and heavy alcohol consumption depresses the central nervous system, causing it to function less efficiently. Not enough nitric oxide translates to erectile dysfunction.

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Medication can be a big help if the extent of the ED is not that considerable and a couple faces it occasionally.

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Lifestyle changes are one of the most effective treatments. Weight loss, increased physical activity, cutting out smoking, getting enough sleep and reducing alcohol can all have a big effect on erectile dysfunction. If you have obstructive sleep apnoea, make sure you are using your CPAP machine.

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