Erectile Dysfunction Consultation
Erectile dysfunction (ED) is considered by most men to be one of the most serious of medical conditions even though it is not physically damaging or life threatening. Erectile dysfunction, also known as impotence, is the inability of men to achieve an erection long enough to engage in sexual activity. It is more common in older men, but the condition can affect a male of any age.
Men with erectile dysfunction are either unable to achieve or unable to sustain an erection, preventing them from performing sexual activity to satisfaction. Unlike other types of sexual medical conditions, ED does not usually decrease libido or reduce the desire for sex.
The severity of erectile dysfunction varies by the individual affected. Some men are completely unable to achieve an erection. Some can achieve an erection, but only briefly. Others suffer from intermittent problems, being able to achieve and sustain an erection on some occasions but not on others.
According to worldwide research, over 50 percent of men between the ages of 40 and 70 have experienced erectile dysfunction. Of these, 10 percent have experience severe erectile dysfunction. This makes it the most prevalent of all male sexual disorders. Every year, 26 men per 1,000 report a new case of ED.
Understanding how erectile dysfunction works requires a basic understanding of the anatomy of the penis. Inside are two spongy chambers, the corpora cavernosa, that run the length of the penis. When at rest, the muscles of the corpora cavernosa are constricted, restricting blood flow to the penis. During arousal, the muscles relax and allow blood to flow into the penis. The pressure of the rush of blood then compresses the veins in the penis, making it more difficult for blood to flow out than to flow in, which keeps the penis erect during arousal.
Men with erectile dysfunction experience one or more of the following conditions: a block in the signals that normally trigger an erection, a physical inability of the penile tissues to respond to the signals or a cardiovascular condition that does not allow blood to flow into the penis.
Erectile Dysfunction Causes
Impotence can be caused by one or more physiological or psychological issues. Male sexual arousal is a complex process involving the interaction of several processes. Some of the factors required for a man to achieve an erection include psychological or emotional arousal, the travelling of sensory information to and from the brain through the nerves, hormonal interaction, a response of the tissues of the penis and the cooperation of the circulatory system.
A disruption in any part of the chain of events leading to an erection may result in erectile dysfunction. Some cases of ED are caused purely by psychological issues. Other cases are caused by physiological conditions. Many cases of ED are caused by a side effect of ingested substances, whether they are legal or illegal recreational drugs or prescribed pharmaceuticals.
Some of the most common psychological causes of erectile dysfunction include the following:
- Anxiety or Depression
- Stress
- Mental fatigue
- Low self-esteem
- Inability to communicate properly
- Guilt
- Post-traumatic stress disorder
Several physiological conditions may also be the source of erectile dysfunction. One of the leading risk factors for ED is age. As men get older, they increasingly develop age-related medical conditions that can cause erectile dysfunction. However, these conditions can be experienced by people of any age. Some of these medical conditions are as follows:
- Diabetes
- High blood pressure
- Cardiovascular disease
- Nerve damage or diseases of the nervous system
- Low testosterone
- Obesity
- Prostate cancer
A number of pharmaceutical and recreational drugs have been found to cause or contribute to ED:
- Alcohol and Nicotine
- Cocaine
- Opiates
- Antidepressants
- Tranquillisers
- Muscle relaxants
- Hormones
- Diuretics
Erectile Dysfunction Medications: Viagra, Cialis & Levitra
The Co-operative Doctor can provide a consultation specifically to determine the safe use and suitability of the medicines listed below.
Sildenafil (Viagra)
Sildenafil is more commonly known by the brand name Viagra. It was the first of its kind to be medically approved. In 60 to 80 percent of men with ED, it can produce a full and lasting erection from 20 to 60 minutes after an oral dose.
Tadalafil (Cialis)
This drug is more commonly known as Cialis. Taking Cialis can improve erectile function for up to 36 hours.
Vardenafil (Levitra)
Vardenafil is sold under the brand name Levitra. This drug can help men of all ages achieve and maintain an erection, but it cannot be used more than once per day.
Differences between Viagra, Cialis & Levitra
While essentially all working in a similar fashion, there are some differences that you should be aware of.
|
CIALIS |
LEVITRA |
VIAGRA |
| Manufacturer |
Lilly Icos |
Bayer |
Pfizer |
| Introduced |
Feb 2003 |
April 2003 |
March 1998 |
| Dosage |
10mg,20mg |
5mg, 10mg,20mg |
50mg,100mg |
| Repeat |
Dose cannot be repeated for up to 2 days |
Dose can be repeated daily |
Dose can be repeated daily |
| Absorption Rate |
15-20 Minutes |
40 Minutes |
40-60 Minutes |
| Duration |
24-36 Hours |
5-6 Hours |
3-5 Hours |
| Side Effects |
Headache, Myalgia, Heartburn (dyspepsia), Mild Back Pain |
Headache, Facial Flushing, Heartburn (Dyspepsia), Nasal Congestion |
Congestion, Diarrhoea, Facial Flushing, Headaches, UTI's (Urinary Tract Infection), Bluish Vision, Heartburn (Dyspepsia) |
| Contra-indications |
Nitrate-Based Medicines, Angina, Hypertension, Hypotension |
Nitrate-Based Medicines |
Nitrate-Based Medicines |
| More Information |
Lilly |
Bayer |
Pfizer |
PDE5 inhibitors are contraindicated for use by many people. These drugs are not recommended for patients with heart disease, abnormal blood pressure, liver disease, kidney disease or one of several other conditions. In such cases, other treatments are available.
Erectile Dysfunction Treatment
When a person suffering from erectile dysfunction cannot take Viagra, Cialis or Levitra to treat the problem, doctors will recommend one of the following other treatments:
Vacuum constriction devices – This type of device is more commonly known as a penis pump. It is a hollow tube that fits over the penis. A pump is then used to pull the air out of the tube, creating a vacuum. The vacuum causes blood to flow into the penis, which can be held inside with a constriction ring at the base of the penis.
Penile implants – This treatment involves the surgical implantation of inflatable rods into the penis. A device is then attached that can inflate the rods when an erection is wanted.
Arterial surgery – In some cases, a surgical procedure can be used to improve the functioning of blood vessels to help men achieve an erection.
Alternative treatments – Some patients have experienced relief from ED through alternative treatments such as acupuncture, hormone-replacement therapy and herbal supplements.
Investigating the causes of erectile dysfunction
While The Co-operative Doctor is a safe and effective way to obtain treatment for Erectile Dysfunction, it should not act as a replacement for your own doctor. Impotence can be a symptom of underlying medical conditions such as blood pressure problems, diabetes or circulatory problems. There may even be emotional/psychological causes. Your own doctor can do some simple tests, so please consider this. This is particularly important if symptoms develop over a period of weeks or months, or even suddenly, without an emotional event to set them off. Erectile dysfunction can be a complication of previous operations or a side effect of medicines.
Starting Treatment
It is impossible to say which treatment will work best for you. Like any medication it can be a case of trial and error.
While you are free to order any of the medications our doctors prescribe, it may be best to start off with a lower dosage first. One type of tablet sometimes works better than another, but it depends on the individual. You can order more than one type of medication, but it is important that you do not take Viagra, Cialis or Levitra together. Ideally you should leave at least 24 hours ( 36 hours in the case of Cialis ) between different medications.
Erectile dysfunction can be distressing and lead to relationship difficulties and emotional problems. It may be worth considering a course of counselling (via your doctor). Often breaking the cycle of "failure" can lead to improved sexual function.
We provide online consultations with UK GMC registered doctors. If you are suitable, a prescription will be issued online. The Co-operative Doctor will then arrange for your order to be delivered to your chosen address by overnight delivery.
Genuine medication is dispensed by The Co-operative Pharmacy. Deliveries are in discreet packaging and sent by your chosen method.
