Why You Can’t Get It Up & What To Do About It

How common is erectile dysfunction? 
“Recent research done by King’s College London found that nearly half of men under the age of 50 suffered with erectile dysfunction (ED). They found ED was especially common in those under the age of 40 and that 11.7m British men specifically were regularly suffering with ED. Their research also found one in eight men worldwide said they had problems with their erections every time they tried to have sex. Meanwhile, sales of the popular ED drug Viagra have trebled in the last ten years. While statistics do suggest the prevalence of ED has been increasingly rapidly, it’s hard to be sure what the figures really mean. ED is an embarrassing problem, and many men have traditionally been reluctant to come forward for treatment. Now that Viagra can be bought over the counter and there is increased marketing of the condition, it could be that more men are feeling encouraged to speak up about it.” – Dr Deborah Lee, GP, Dr Fox Online Pharmacy 

How do you define ED? 
“Erectile dysfunction is the inability to obtain or maintain an erection sufficient for penetration and for the satisfaction of both sexual partners. ED should not be confused with impotence, which is the inability to ejaculate.” – Dr Shirin Lakhani, private GP

Why might someone be struggling?
Experts agree ED can be triggered by a wide range of physical and psychological factors, and often it’s a combination of the two. These include:

Poor Lifestyle Habits: “The main causes of ED are poor lifestyle habits: eating too many calories, not enough exercise and being overweight. Drinking too much will also take its toll – alcohol negatively affects every aspect of sexual performance. Smoking is also strongly linked to ED.” – Deborah 

Diabetes: “Having type-2 diabetes also puts you more at risk – in fact, studies show that nearly three-quarters of men with type-2 diabetes will suffer from ED.” – Deborah 

Stress: “Living under the cloud of the pandemic for the last 18 months will have undoubtedly taken its toll on men’s intimate health and resulted in an increase in ED. Lockdown meant many men were forced to adjust to new home-working environments, to being furloughed or made redundant, not to mention being forced to cope with the added stress and worry that these changes in circumstances have brought. Nervousness and anxiety undermine attaining an erection by pulling blood away from your digestive system and penis to your muscles.” – Shirin 

Inefficient Blood Flow: “The penis is a vascular organ, and the same things that clog your arteries will also affect blood flow to the penis. Any medical condition that reduces the blood supply or disrupts muscle function will likely result in poor erections – think high blood pressure and raised cholesterol, as well as atherosclerosis, the process that takes place when cholesterol deposits are laid down in your arterial walls. By narrowing the lumen of the artery, the blood supply to the vessel is reduced – this can happen in your heart and your penis.” – Deborah 

Taking Some Medication: “There is a long list of medications that can cause ED, including antidepressants. If you are struggling with ED, speak to your GP about switching to an alternative that doesn’t have ED listed as a side effect.” – Deborah 

Can taking a pill help with ED?
“One popular form of medication is a PDE5 inhibitor, which helps to control blood flow. Viagra (sildenafil) is the best known of these inhibitors. There are other types, which differ in how they are taken and how long they take to work and are effective for, but the principle behind their mechanism of action is the same. These all have two names – a generic name, which is the active ingredient, and the brand name, which is the drug company name. Alongside Viagra, these include Cialis (active ingredient tadalafil), Levitra (vardenafil) and Stendra (avanafil).” – Deborah 

Do you need to be sexually aroused for it to work?
“Always read the instructions on how to take Viagra. If you don’t, it may not have the desired effect. The usual starting dose is 50mg, although some people need 100mg and others need only 25mg. Take Viagra on an empty stomach – not after a fatty meal, as this delays absorption into the bloodstream. At the same time, do not take with alcohol as the combination can lead to low blood pressure and make you feel faint. It takes a good 30-60 minutes to work, then when the time is right, you will need sexual stimulation. An erection won’t just pop up in front of you. One tablet is said to be effective for up to four hours. If, however, it doesn’t work, try again. Manufacturers recommend trying up to six times before seeking an alternative.” – Deborah 

How often can you take it?
“Medication such as Viagra is a treatment, not a cure, meaning that many men choose to use it for an extended period. In one study which tracked men taking it for four years, at the completion of each year, at least 94% of participants reported satisfaction with the effect of Viagra treatment on their erections. Almost all these men reported improved ability to engage in sexual activity. Many men do choose to take it for an extended period and, unlike people taking medications such as painkillers or sleeping pills who gradually develop a tolerance for these drugs, the same has not been observed with Viagra when taken according to a doctor’s instructions.” – Shirin 

Is there any benefit to taking Viagra if you don’t have ED?
“No. Viagra and other ED medications are indicated only for men who suffer with problems getting or maintaining an erection and were not designed for recreational purposes. Anyone not struggling with ED won’t notice much of a difference taking these medications.” – Dr Babak Ashrafi, Superdrug Online Doctor 

What are your other options?
“The first step to dealing with ED is to correct lifestyle measures that may be contributing to the problem. This includes addressing any relationship and mental health issues. Viagra may be prescribed in the interim to help restore erections and improve confidence. Often, once erections start to happen regularly and there is less anxiety, Viagra can be tailed off. If Viagra isn’t working, one of the other PDE5s may help – Cialis is a good option. This can be taken every day, meaning it doesn’t have to be taken before intercourse, so sex can be more spontaneous. If PDE5s aren’t effective, you could try swapping to alprostadil, which is available as a cream, an injection or as a pellet inserted into the urethra. This needs to be prescribed by your GP.” – Deborah 

Are there any non-medical treatments to try?
“Pelvic floor exercises aren’t just for women. In fact, there was one case study published in 1998 of a man who practised Kegel exercises and accidentally became multi-orgasmic, having six orgasms during a 36-minute period in lab testing. To perform Kegels, tighten your pelvic floor muscles (the same muscles you use to stop your flow of urine when you pee) and hold the contraction for three seconds, and then relax for three seconds. Be careful not to tighten your bum muscles, thighs or abs – you shouldn’t see any visible muscles moving. Aim for at least three sets of ten repetitions per day.” – Megwyn White, certified clinical sexologist, director of education at Satisfyer

Any other alternatives worth mentioning?
“The P-Shot is a pioneering treatment which can help improve erectile tissues. A non-surgical procedure, it involves injecting the penis with the patient’s own platelet rich plasma, which helps improve the health and vitality of the penis and naturally stimulates penis rejuvenation. The treatment costs around £1,200. Invicorp is another treatment that can help with erectile dysfunction. A combination of two ingredients is injected into the penis, which can help boost blood flow.” – Shirin

The bottom line?
“Viagra is one of the most popular drugs on the market. In fact, a Google search brings up 4m references – far more than for the likes of Botox or Prozac. Many men swear by it and say it has saved their marriages. However, for the best results, your other half needs to be aware you are taking it and should do their bit to help. When both parties are committed to making it work, you are far more likely to get a better outcome. Also remember that simply obtaining an erection won’t necessarily result in a happy sexual outcome for both parties. Don’t overlook the benefits of seeing a specialist in psychosexual medicine. Many couples who have been down this route have found it highly effective and wish they had done it long before.” – Deborah 
  

For more information, head to DoctorFox.co.uk, Elite-Aesthetics.co.uk, Superdrug.com and Satisfyer.com.
   

DISCLAIMER: Features published by SLMan are not intended to treat, diagnose, cure or prevent any disease. Always seek the advice of your GP or another qualified healthcare provider for any questions you have regarding a medical condition, and before undertaking any diet, exercise or other health-related programme.