What is ED and how common is it? Erectile Dysfunction (ED) is the persistent or recurrent inability to achieve and/or maintain an erection sufficient for satisfactory sexual activity. This occurs when men are unable to get and maintain an erection. Many men live with ED for years (at least 2-5 years)without seeking medical advice, because of embarrassment or a belief that ED cannot be treated. However, in most cases ED treatment is straightforward and effective. In addition, ED may be an early warning sign of other conditions. So it makes sense not to allow embarrassment to get in your way -if you are worried about ED, go to your doctor without delay to get it checked and treated. What causes ED In many cases, ED is caused by a combination of both physical and psychological factors. A proper medical assessment is important as ED could be caused by an underlying illness, medication side effects, or be related to psychological issues - see some common causes below:       Diabetes Heart Disease High blood pressure Nerve conduction problems e.g. multiple sclerosis and Parkinson’s disease Following prostate surgery Medication side effects: Some medicines used to treat conditions such as high blood pressure or depression may have ED as a side effect.  Stress  Excess alcohol  Smoking The earlier a health problem is attended to, generally the easier it is to treat. So if you are worried that you may have ED, go to your doctor without delay. What treatments can I get for ED Counselling All men with sexual dysfunction may benefit from some type of supportive counselling If your doctor feels you will benefit from specialist counselling, your doctor will be able to recommend one known to them Tablets There are currently 3 different oral tablets available These products are called PDE-5 inhibitors They are now the most commonly-prescribed treatments for ED They are not all exactly the same, and their differences are important If your doctor decides to prescribe one of these for you, they may discuss those differences with you Depending on the treatment, they need to be taken between 25 minutes and 1 hour before sexual intercourse The period of time over which they work can vary from 4–5 hours up to 36 hours. i.e. during these time periods, providing you have sexual stimulation, an erection may be achieved In order for these medications to work, sexual stimulation is required Alcohol may affect erections Avoid excessive alcohol with oral treatments Some of these treatments may have their onset of effect delayed if taken after food If your doctor thinks an oral treatment may be suitable for you, then they will discuss side effects and contraindications* with you as part of reaching a prescribing decision The most common side effects include: headache indigestion flushing pounding heartbeat nausea nasal congestion effects on vision dizziness back pain muscle aches abdominal pain * Contraindication: To advise against or indicate the possible danger of a drug or treatment Injections or insertions These are injected into the penis or inserted using a special applicator This usually takes place just before sexual intercourse to produce an erection You should discuss all possible side effects with your doctor There are currently 3 different products available These products contain alprostadil The product is either injected into the body of the penis or inserted down the tube of the penis (urethra) using a special applicator They work approximately 5–15 minutes after administration If your doctor thinks an injection or insertion may be suitable, they will discuss side effects and contraindications* with you as part of reaching a prescribing decision Side effects may include: pain in the penis, testicles and (rarely thighs) urethral (in the wee tube) burning after long-term use the penis may become scarred or you might notice a slight bend and pain on erection Tell your doctor if this happens as you may need to stop using the product Above are guidelines only. Always consult your Doctor if you have any concerns If your penis is scarred, not straight, or abnormally formed, you should NOT use these products Vacuum pumps These work by creating a vacuum around the penis, helping to cause erection A constriction ring is placed around the base of the penis to maintain the erection Various types of vacuum pumps are available Vacuum pumps should be used just before sexual intercourse They take a few minutes to work The constriction ring should not be worn for longer than 30 minutes (remove ring) They may be used as often as required Some products advise a break of at least 60 minutes between each treatment