What you need to know about erectile dysfunction.




Mr Paul Erotocritou

Consultant Urological Surgeon of Highgate Private Hospital on Erectile Dysfunction


What is erectile dysfunction (ED)?

Erectile dysfunction sometimes called impotence, is when a man is unable to get or maintain an erection that is firm enough for sex. Whilst ED becomes more common in men after 40 years of age, it is not unusual for a man to have difficulty maintaining or getting an erection on an occasional basis when tired, stressed, anxious or having drunk too much alcohol. Age alone is not a cause for ED and a number of other factors are involved.

Diabetes (high blood sugar), heart disease, and sometimes treatments for prostate cancer can raise your chance of having ED. The good news is there are many safe and useful treatments to help men improve their sexual function.


What causes ED?

ED can be caused by a number of factors both physical and psychological. There are three mechanisms by which ED can occur. The first is that not enough blood flows into the penis. Smoking, heart disease and high blood sugar can impact the blood flow and lead to ED.

The second cause of ED is nerve signals from the spinal cord and brain don’t reach the penis. Certain illnesses, injuries or surgeries in the pelvic area can cause damage to the nerves.

A third cause is that the penis is unable to store blood during an erection, meaning that the penis is unable to become firm, as blood cannot be stored in the penis long enough.

ED can also happen as a side effect from medications taken to treat medical problems, such as blood pressure medications.

Even when there is a physical cause for ED, psychological factors may make the ED worse. For instance, anxiety about being able to sustain an erection can then exacerbate ED. Depression and past sexual traumas can also lead to ED.

Treatment Options for ED

Depending on the cause for ED a range of treatment approaches are available. For a number of men, lifestyle changes can make a difference. Stopping smoking, reducing drug and alcohol use, increasing physical activity and maintaining a healthy weight are all known to have an impact.

A medication review with your GP if it is a side effect of a medication you are taking may be of benefit, to ensure it is safe to stop the medication and an alternative prescribed. Medications prescribed should not be stopped without consultation.

Psychosexual counselling may also be of benefit, allowing one to explore their feelings around ED and sex. This can be done alone or with your partner.

If treatment is needed for ED. The first line is oral medication, these tablets work well for the majority of men and work by allowing better blood flow into the penis, this increased blood flow creates a firmer erection. Second-line treatment options if oral medications fail are injectable medications. These are administered by the patient prior to intercourse, either through injecting medication into the base of the penis or a small pellet/cream into the urethra. Another option is the use of vacuum erection devices these help to pull blood into the penis to create an erection. Once an erection is gained an elastic ring is pulled around the base of the penis, to keep blood in the penis. It is important the ring is not left on for more than 30 minutes as irreversible tissue damage can occur. If these different options are not effective the final option would be consideration of a penile implant. These inflatable implants allow for a man to pump fluid into the implant making the penis rigid.



ED is a common problem for which there are solutions, it may also be the first sign of needing a check-up. Research has shown that there is a strong link between heart disease and ED. Don’t be afraid to visit your GP or a specialist for help.


Mr Erotocritou has a clinic every Tuesday and Thursday

Evening at Highgate Private Hospital. Call 02081087031 to make an appointment.

Date: 29/10/2019
By: mhunter