Erectile dysfunction is not something you can hide. If you are attempting sexual intercourse, whether you have an erection hard enough to penetrate is obvious. If you fail to maintain the erection, this brings events to an unexpected end. So, unlike other diseases and disorders, no tests are necessary to prove you have the problem. The only point of tests is to find out why and, then, what to do about it.
Because erectile dysfunction can be a symptom of some serious diseases and, if you are to offer effective treatment, you have to treat the underlying cause. For example, if you are showing the first sign of a build-up of deposits on the walls of your arteries, this is a high risk symptom of possible heart disease. Preventative measures can reduce the risk of strokes and heart attacks (and restore sexual activity).
What’s the main treatment strategy?
There’s a simple rule when it comes to treating sexual problems. You start with the simplest and least invasive options and, only if there’s clear evidence of failure, do you move on to more invasive options. In this, the active support of your partner is essential. This needs to be both physical and emotional support if the problem seems likely to be long term.
What to try first?
The first step is to review lifestyle. If you quit smoking, drink less alcohol and lose some of those extra pounds, some sexual function may return. This is encouraged if you also begin to exercise and build up stamina. Then review the medications you are taking. Some drugs cause erectile dysfunction as an unwanted side effect. Changing the drug or its dosage may solve the problem. Now it grows more challenging. The use of Viagra is convenient. Pills are easy to take and work in the majority of cases. But sexual performance is partly driven by the mind and it can be appropriate to consider psychological or behavioral therapy before you begin using Viagra. This helps you to a better understanding of relationships and sexual intimacy. Where the problem is aggravated by performance anxiety or low self-esteem, counseling with both partners is very helpful.
Viagra was the first and remains the best-selling drug. There are also injectable drugs that produce stronger erections, but injections are far less convenient and more prone to side effects.
The mechanical approach
Vacuum and other devices are inconvenient and have largely fallen out of fashion. There are surgical approaches to implant devices or to reconstruct arteries and remove blockages, but this is a last resort for younger men when drugs have proved ineffective. Reconstructive surgery rarely works for older men.
The most promising possibility is the use of gene therapy to persuade the body to rebuild damaged blood vessels and nerve endings. This is now going through first-stage trials and we await the results.