Erectile Dysfunction Treatment

Erectile dysfunction (ED) can occur at any age, but is more common as you get older. There are physical and psychological causes of ED. The cause can be related to a combination of these factors listed below.

The main physical cause of ED is the narrowing of the blood vessels supplying the penis. This prevents adequate blood flow to this area to get or maintain an erection. Diabetes, high blood pressure and high cholesterol are all causes of ED as they cause narrowing of the blood vessels. These are by far the most common causes of ED in men over 40 years of age.

ED can be an early warning sign of these conditions, and others such as heart disease, which is why men are advised to have a physical check-up with some routine blood tests.

Other physical causes of ED include:

• Obesity.
• Hormonal abnormalities.
• Smoking, alcohol and drug use (especially with long-term or heavy use).
• Some Medications (e.g. steroids, including anabolic steroids).
• Nerve damage (Such as can occur in Multiple Sclerosis).

In most cases that are due to a physical cause, the symptoms develop gradually and you may have intermittent symptoms for a while before they become more persistent. Your libido (sex drive) is likely to be normal if the cause is not related to hormones or psychological reasons

Psychological causes include:

• Stress.
• Anxiety (including performance anxiety).
• Depression.
• Relationship problems can also play a role.

If the cause is due to psychological factors, the symptoms will often develop suddenly. They may improve spontaneously as your psychological state improves.

Medications can help you to achieve and maintain an erection. However, ED medications will not treat any underlying medical conditions that are causing or contributing to this problem. We strongly advise that you consult with a doctor for advice on assessment and management of any underlying cause. This is a good opportunity to review your general health, including cardiovascular risk factors.

This service is suitable for you if you are:

• 18 years of age or older.

• Male.

• Experiencing erectile dysfunction (difficulty getting or maintaining an erection satisfactory for sexual intercourse).

This service is not suitable for you if you:

• Are less than 18 years of age.
• Are female.
• Have experienced erectile dysfunction since the onset of sexual activity.
• Have been advised to avoid sexual activity by your doctor.
• Have had a heart attack or stroke in the past 6 months.
• Have any of the following heart problems:
  • Unstable angina
  • Uncontrolled High blood pressure. Low blood pressure and prone to fainting
  • Irregular heart rhythm
  • Heart failure, heart valve problems, cardiomyopathy
• Have significant liver or kidney disease.
• Have a history of:
  • Decreased vision due to optic nerve damage
  • Retinitis pigmentosa
• Have a blood disease:
  • Sickle cell anaemia
  • Leukaemia
  • Multiple myeloma
• Have a coagulation disorder e.g. haemophilia.
• Have a physical deformity of the penis.
• Are using ‘poppers’ (amyl nitrate).
• Are taking certain medications
  • There are several potentially serious drug reactions with ED medications. There is more information on this below. Please check this carefully.

It is important that you understand this information and how it relates to you. If you are not sure send us an email to info@webdoctor.ie  and we can help.

There are some drugs that should not be taken together because of potential adverse interactions, making the risks outweigh the potential benefits.
It is VERY important that you let us know exactly what medications you are taking so that we can safely prescribe a treatment for you.

We can provide a range of erectile dysfunction medications, both branded and generic, subject to clinical suitability.

A 6-month prescription for up to 16 tablets per month will be issued. These medications should be used as per the instructions on the prescription. Do not take more than the recommended dose.

These medications work by relaxing the blood vessels in the penis, allowing increased blood flow to help you to get and maintain an erection when you are aroused. (You will need to have sexual stimulation to help with this medication).

They all belong to the same group of medications but have a different active ingredient. There is a slight variation on how each tablet works, and they each have individual time frames for the onset of action and duration of action.

You may need to vary the timing and the dose, or type of medication to get the best individual result.

Your medication may not work the first time you try it, and you may need to take it on 4 to 6 separate occasions to assess the full effect. If it has not helped after this, you can contact us for advice.

These medications are usually tolerated very well.
You are less likely to experience side effects with lower doses of medications, and we recommend that you try the standard dose first – this can be adjusted depending on your response to the treatment and side effects if they should occur.

If side effects occur, they can include:

• Headaches.
• Dizziness.
• Flushing.
• Stuffy nose.
• Stomach upset/and indigestion.
• Visual disturbance can occur, such as blurred vision, increased sensitivity to light and a blue/halo around bright light.

For full details of the potential side effects of these medications, please ensure that you read the patient information leaflet that comes with your medication before you start to use it for full details on potential side effects.

If you are concerned that you are developing side effects, we advise that you stop your medication and seek medical advice.

Yes! 

There are lots of lifestyle changes you can make to help improve your symptoms:

• Drinking alcohol within the recommended limits (< 17 units per week).

• Stop smoking (smoking causes narrowing of all blood vessels in the body).

• Maintain a healthy weight: ED is more common if you are overweight or obese and losing weight has been shown to help.

• Regular exercise.

• Manage stress (sometimes easier said than done!).

When completing the questionnaire, please ensure you let us know exactly what medications you are taking (prescribed and over-the-counter), herbal remedies or recreational drugs as erectile dysfunction medications can have significant interactions with some drugs. This will enable us to advise you on appropriate treatments and prescribe them safely for you.

Do not take more than one tablet in 24 hours and do not combine it with other erectile dysfunction medications.