Erectile dysfunction: Causes, treatments, and seeking help

Written by: Professor Rakesh Heer
Published:
Edited by: Kate Forristal

In his latest online article, Professor Rakesh Heer gives us his insights into erectile dysfunction. He talks about the common causes, how to determine if its physical or psychological, medical conditions or lifestyle habits that contribute to erectile dysfunction, treatment options and when to seek help.

 

 

What are the common causes of erectile dysfunction, and how can I determine if my ED is related to physical or psychological factors?

It is not unusual for men to occasionally fail to get or keep an erection.

 

Most commonly, this can be related to tiredness or drinking too much alcohol, which can be easily addressed. In other cases, this may be caused mental or psychological factors, including stress, depression, relationship conflicts or anxiety about performance. In these cases, the issues with erection problems can occur suddenly, or be intermittent and/or situational.

 

If erectile dysfunction happens occurs often or all the time, typically progressing slowly over time, it may be caused by condition such as high blood pressure, high cholesterol, diabetes, depression or anxiety, heart and vascular disease and hormone problems. We can also see erection problems occur as side effects of some medicines and smoking.

 

If you have a recurring or persistent problem with erections, it is important to seek advice as it may be a sign of more significant disease. In most cases your doctor can prescribe medicines to help.

 

 

What medical conditions or lifestyle habits may contribute to erectile dysfunction, and are there any changes I can make to improve my erectile function?

The key is to lead a healthy life. Lifestyle changes that may be relevant include:

 

  1. Stopping smoking
  2. If overweight, weight loss
  3. Eating a healthy diet
  4. Regular exercise
  5. Where possible, minimising stress and anxiety
  6. Reducing alcohol intake

 

 

What are the available treatment options for erectile dysfunction, and how effective are they in restoring sexual function?

Treatments can be very effective in improving erectile dysfunction.

 

For many, treatment with tablets is sufficient. These tablets include sildenafil (Viagra), and related drugs tadalafil (Cialis), vardenafil (Levitra) and avanafil (Spedra). Each drug has slightly different actions, and the choice of tablet can be tailored to individual needs.

 

Other approaches include the use of vacuum pumps, especially in those men where tablets are not suitable. There are drugs that can be delivered into the urethra or injected directly into the penis using small needles.

 

If there are identifiable causes of erectile dysfunction, then switching medicines and treating high blood pressure, high cholesterol and hormone deficiencies may help. Also, counselling and therapy can help if your erection problems are linked to emotional or mental health problems.

 

 

When should I seek medical help for erectile dysfunction, and what can I expect during the evaluation and diagnosis process?

There will be questions about your lifestyle and relationships, and any problems you might be experiencing. There will be a detailed enquiry about the nature of erectile dysfunction, including intimate questions that may feel embarrassing to talk about. These sensitive questions are handled in a professional, discrete and compassionate manner. An examination of your genitals is useful to consider physical causes. Some men may also have urinary symptoms, and a digital examination of your prostate may be advised. Blood tests are typically done to assess hormone function. You can expect a management plan at your first review in most cases.

 

 

Professor Rakesh Heer is a highly esteemed urologist with over 25 years of experience. You can schedule an appointment with Professor Heer on his Top Doctors profile.

By Professor Rakesh Heer
Urology

Professor Rakesh Heer is a highly esteemed consultant urologist based in London. He has extensive experience in general and specialist urology. He is renowned for his expertise in urinary problems, prostate concerns, men’s sexual health and penile and scrotal conditions. His specialist interests include all aspects of prostate cancer and bladder cancer diagnosis and management.

Professor Heer qualified in medicine from the University of Nottingham in 1997, before pursuing further training in Newcastle. In 2006, he completed a PhD at Newcastle University, receiving the European Urology Association’s prize in 2008 for best urological paper published in international literature. In 2010, he was also awarded a highly-sought-after Hunterian Professorship from the Royal College of Surgeons of England and a highly prestigious clinician scientist fellowship from Cancer Research UK for his cutting-edge research. In this time, his work focused on ground-breaking studies into prostate cancer. In 2011, he was appointed as a consultant urologist in Newcastle, where he ultimately became professor. He recently moved to a new professorial position at Imperial College London as Chair of Urology. In 2021, he received a National Clinical Excellence award from the Department of Health in recognition of his dedication to patient care, expertise and leadership in the field of urology. Professor Heer sees private patients at The Cromwell Hospital in central London.

Additional to his clinical responsibilities, Professor Heer is a highly respected educator in the field of urology. He was co-director of the annual UK cadaveric robotic course for several years, training many consultants from the UK and worldwide. He also previously held a senior role as Newcastle University's Associate Dean and is currently also Director of MD studies.

Professor Heer is also a globally renowned leader in urology research, helping shape current, patient-centric, and high-quality clinical practice. He is chief investigator in a number of important trials, including those conducted by the National Institute for Health and Care Research (NIHR). He holds a number of important national leadership roles, including chairman for clinical guidelines, writing for the National Institute for Health and Care Excellence (NICE), as well as chairman for the National Cancer Research Institute (NCRI) localised prostate cancer subgroup. He remains actively involved in research and has published numerous academic papers in esteemed peer-reviewed journals.

For further information please visit: rapidurologylondon.co.uk and https://www.cromwellhospital.com/

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