All erectile dysfunction is manageable. Do not give up. I will start with the commonest causes of erectile dysfunction as are presenting to me in my clinic on a daily bases. I will then mention all the other causes of ED in order of their frequency of occurrence.
(1) Performance Anxiety. This is the commonest cause for a man failing to achieve or sustain an erection of sufficient quality to satisfy the needs of either party engaged in sexual activity. It is caused by negative thoughts blocking the flow of pleasurable arousal and desire that leads to an erection. It is NOT the man’s fault. It is NOT his partner’s fault. It is NOT just in the mind and it takes time and patients to cure. Sometimes the use of a medication like Cialis, taken for a few weeks, can help return confidence. Other than that, pleasuring, without the challenge of intercourse for a few weeks, is the way forwards. This of course requires your being in a steady relationship.
(2) Arteriosclerosis. This means the narrowing of the blood vessels to the penis preventing the flow of sufficient blood to bring about an erection. Typically it effects older men and often it will have other manifestations like coronary artery disease or angina pectoris. It usually can be managed with medications like Viagra but occasionally the addition of Testosterone Replacement Therapy or penis injection may have to be considered
(3) Medications and Drugs. All illicit drugs like the opiates, cannabis and cocaine can all lead to erectile dysfunction. Alcohol and nicotine too can contribute to ED. In addition to these many prescription medications like the beta-blockers, H2 antagonists but most particularly the newer antidepressants and anti-psychotics can quickly lead to the development of erectile dysfunction. The solution to this is to discontinue all such drugs and medications. If this can’t be done then penis injection may be the only solution.
(4) Any Chronic Illness. Diabetes type 1 or 2, MS, rheumatoid arthritis, Parkinson’s Disease and so on can lead to the development of ED. The solution here will take some working out with a specialist but Testosterone Replacement Therapy again may have a role to play.
(5) History of Prostate Surgery. Surgery for BPH or so-called TURPS, prostatectomy for cancer or any aggressive pelvic surgery can give rise to erectile dysfunction. Again, the solution here will require some expert intervention but may well involve penis injection with Caverject or some such.
The bottom line is that almost all erectile dysfunction is manageable and indeed studies have shown that as much as two thirds of all erectile dysfunction will resolve itself in time and without any medical intervention. There is no such thing today as incurable erectile dysfunction. There is help for everyone no matter how young or how old. There is no such thing as a “hopeless case”. Even in men with profound performance anxiety when the medications do not work, one can always move on to intracavernosal injection when all fruit fails.
Another fall back position is the introduction of testosterone replacement therapy to augment Viagra, Cialis or Levitra. Often too, it may well be a question of simply restoring restoring a man’s confidence. It can be simply amazing how one proper erection that allow for intercourse, can lead to another. Because once a man stops worrying about it and stops looking at himself, everything else can fall into place. Who was it that said that nothing succeeds like success. When it comes to managing erectile dysfunction, never a truer word was spoken. Final words — never give up on this easy dysfunction.