Erectile Dysfunction

The Centre for Men’s Health offers expert diagnosis and treatment and advice for erectile dysfunction (ED) and related conditions. 

What is Erectile Dysfunction?

Erectile dysfunction (ED), also known as impotence, is a term covering a range of difficulties with sexual function causing a man to be unable to get and maintain an erection that is sufficient for satisfactory sexual intercourse.

However, although a wide term, ED does not cover cases where a normal erection is possible but there is a problem with orgasm or ejaculation. The most common of these is premature ejaculation, where although an adequate erection is possible, arousal and ejaculation occur too rapidly for satisfactory sexual intercourse. 

Why ED matters and seeking early advice and help is important?

ED can have a major negative impact both on man’s self-esteem and on his intimate relationships. It is often hard for the man to admit that he is suffering from erection problems and difficulty with talking to a sexual partner about the situation can easily lead to a worsening relationship and an unfulfilling sex life for both parties. In such cases, early advice and help can prevent problems becoming entrenched and can pave the way to a return to a happy and healthy sex life for the couple.

However, in addition to the possible personal esteem and relationship consequences, it is important to get proper medical advice about ED as the problem can also be an early warning sign of underlying medical problems, such as diabetes and cardiovascular disease.

What causes erectile dysfunction (ED)

The cause or causes can be medical or psychological (mental) or a combination of both.

Medical: ED can be the result testosterone deficiency, when a man’s level of total or active testosterone becomes too low (deficient), or their body is unable to make effective use of the testosterone in the blood (testosterone resistant). Erectile dysfunction, together with loss of sex drive, are common and distressing features of testosterone deficiency.

ED can also be the result of narrowing of the blood vessels going to and in the penis. This can be due e.g. to cardiovascular disease or diabetes. ED can provide an important early warning marker for underlying medical issues, enabling preventive action to be taken to deal with any associated lifestyle or other risk factors. ED can also be caused by surgery or injury to the penis.

Psychological: where problems with erections only happen in certain situations or with particular sexual partners, it is likely that the cause is psychological and connected to stress, anxiety, depression or relationship issues.


How is erectile dysfunction diagnosed and treated at the centre?

Diagnosis will be based on a careful assessment of symptoms, medical history, current physical and mental health, lifestyle factors, a physical examination, and a blood test.

This will enable the doctor to assess whether the likely causes of the erectile dysfunction are medical, psychological, or a combination and to decide on the best course of treatment, if required.

The treatment will depend on whether the underlying cause of the erectile dysfunction is medical or psychological.

Where the cause is medical there are a range of proven medications, such as sildenafil (sold as Viagra). Research undertaken at the Centre for Men's Health has shown that in around two thirds of cases, treating the underlying hormonal deficiency can restore both libido and potency. In the remaining third, our studies have shown that combining testosterone replacement therapy (TRT) with erection enhancers, such as Viagra (sildenafil), Levitra (vardenafil) and Cialis (tadalafil) brings our success rate with erectile dysfunction to over 95%.

For those few patients where erectile function is not fully restored by testosterone replacement in combination with erection enhancers, the Centre for Men's Health can provide other erection inducing treatments.

In cases of psychologically induced ED, talking based therapies such as sex therapy and cognitive behavioural therapy may be used. The Centre can provide referral to expert practitioners in these therapies as part of a treatment package.

What causes erectile dysfunction (ED)?

How is erectile dysfunction diagnosed and treated at the centre?