When to see a doctor for erectile dysfunction: A guide for men

While occasional difficulty maintaining an erection is normal, frequent or persistent erectile dysfunction can have a significant impact on quality of life and signal a more serious health problem.

Mr Zeb Khan, leading consultant urological surgeon, explains what is erectile dysfunction, its potential causes, when to see a doctor, and the treatment options available that can help.

What is erectile dysfunction?

Erectile dysfunction is the inability to achieve or maintain an erection that is firm enough for sexual intercourse. The condition is more common with ageing, but it can affect men of all ages. While it’s normal for erections to occasionally be more difficult, if erectile dysfunction is persistent or recurrent, it’s important to see a urological surgeon.

What are the causes?

Erectile dysfunction can result from a range of physical, psychological, and lifestyle-related factors:

Physical causes

Cardiovascular disease, such as high blood pressure, heart disease, and high cholesterol, can restrict blood flow to the penis, making it difficult to achieve or maintain an erection. Diabetes, due to prolonged high blood sugar levels, can damage the blood vessels and nerves responsible for erections, leading to dysfunction.

Obesity also contributes, by increasing the risk of diabetes and heart disease. Hormonal imbalances, such as low testosterone, can reduce libido and contribute to erectile dysfunction.

Additionally, prostate problems, including the effects of prostate cancer treatments like surgery or radiation, can cause nerve or blood vessel damage, further contributing to erectile dysfunction.

Psychological causes

Mental health issues can also have a major impact on erectile dysfunction. Stress, anxiety, depression, and relationship problems can all interfere with the ability to achieve or maintain an erection. Performance anxiety, in which the fear of not being able to perform sexually causes more difficulties, is also a common psychological trigger.

Lifestyle-related causes

Certain lifestyle habits can increase the risk of erectile dysfunction. Smoking, for instance, damages blood vessels, which limits blood flow to the penis. Excessive alcohol consumption can also impair nerve function and disrupt blood circulation.

Additionally, lack of exercise contributes to a sedentary lifestyle, which can lead to obesity and poor cardiovascular health.

When should I see a doctor for erectile dysfunction?

It’s important to see a urological surgeon if you experience persistent or recurrent difficulties achieving or maintaining an erection.

This includes:

• If your difficulty with erections occurs frequently or has been persistent for several weeks or months.
• If you experience pain during erections.
• If you experience a sudden inability to maintain an erection, especially if it occurs after an injury or surgery.
• If you experience accompanying symptoms, such as chest pain, shortness of breath, or dizziness.
• If your mental health, self-esteem, or relationships are being affected due to erectile dysfunction.

What treatment options are available?

The treatment for erectile dysfunction depends on its underlying cause. In many cases, erectile dysfunction can be treated effectively with a combination of:

Lifestyle changes

For men with erectile dysfunction caused by lifestyle factors, making healthier choices can improve symptoms. This includes regular physical activity, a balanced diet, and quitting smoking.

Medications

Oral medications like sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra) work by increasing blood flow to the penis, helping to achieve and maintain an erection. They are taken 30 to 60 minutes before sexual activity and are effective for most men.

Psychological therapy

If psychological factors are contributing to erectile dysfunction, psychotherapy or counselling can be helpful. Cognitive behavioural therapy (CBT) and couples counselling can help addresses performance anxiety, stress, or relationship problems.

Medical devices and surgery

For more severe cases of erectile dysfunction, other treatment options include:

• Penile injections or urethral suppositories to deliver medication directly to the penis to improve blood flow.
• Vacuum erection devices to help draw blood into the penis to create an erection.
• Penile implants, surgically-implanted devices, to help achieve and control an erection.

In some cases, surgery may be necessary to repair damaged blood vessels or nerves, especially if erectile dysfunction is caused by a vascular issue.

If you would like to book an appointment with Mr Zeb Khan, head on over to his Top Doctors profile today.