Treatment & counselling for Erectile Dysfunction – 2024 Guide

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Physical impotence is therefore usually caused by an insufficient blood supply to the penis, or a too rapid drainage of the supplying blood. Rarely is a nerve injury the cause.

Mental impotence, on the other hand, usually stems from fear of failure, apt not to be able to at the moment

If the impotence is related to the intake of certain drugs, then one can try to replace these drugs with others that do not cause erectile dysfunction.

Diabetic patients often see their erection improve after adjusting the sugar level in the blood.

A decrease can often be improved by taking certain drugs. However, it is dangerous to take these medicines on your own: sometimes these medicines contain male hormones. Such treatment can even be dangerous: a hormonally sensitive prostate cancer can start to grow!


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For many people, a physical examination and answering a variety of questions (medical history) is all that is needed for a doctor to diagnose erectile dysfunction and recommend treatment. If you have chronic conditions or your doctor suspects a pre-existing condition, you may need to undergo additional tests or see a specialist.

Tests for pre-existing conditions may include the following:

  • Physical exam. It may include a thorough examination of the penis and testicles, and monitoring of the sensation of the nerves.
  • Blood test. A blood sample may be sent to a lab to check for signs of heart disease, diabetes, low testosterone, and other health conditions.
  • Urine analysis. Like blood tests, urinalysis is used to look for signs of diabetes and other pre-existing conditions.
  • Ultrasound. Typically, a specialist performs this test in an office setting. It involves the use of a rod-shaped device (transducer) that rests on the vessels that supply blood to the penis. This creates a video image that allows the doctor to see if you have problems with your blood flow.

Sometimes this test is done along with an injection of drugs into the penis that stimulate blood flow and produce an erection.

  • Psychological examination. Your doctor may ask you questions to see if you have depression and to look for other possible psychological causes of the dysfunction.


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The first thing your doctor will do is make sure that you are receiving the proper treatment for conditions that could cause or worsen your erectile dysfunction.

You may have several treatment options, depending on the cause and severity of your erectile dysfunction and pre-existing health conditions. Your doctor can explain the risks and benefits of each treatment, and you will decide which one you prefer. Your partner’s preferences may also influence your treatment, know about more treatment

Oral medications

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For many men, oral medications are an effective treatment for erectile dysfunction. For example:

  • Sildenafil (Viagra)
  • Tadalafil (Adcirca, Cialis)
  • Vardenafil (Levitra, Staxyn)
  • Avanafil (Stendra)

This increases blood circulation and allows an erection to be achieved in response to sexual stimulation.

First, there needs to be sexual stimulation for the nerves in the penis to release nitric oxide. Oral medications to treat erectile dysfunction are not aphrodisiacs, do not cause arousal, and are not necessary for men who do not have erection problems.

The dose, duration of action in the body, and side effects vary depending on the drug. Some of the possible side effects are flushing, nasal congestion, headache, visual disturbances, back pain, and an upset stomach.

Your doctor will take your unique situation into account to determine which medication is best for you. These medications may not immediately solve the problem of erectile dysfunction. You will need to cooperate with your doctor to find the right medication and dosage for you.

Before taking any medications to treat erectile dysfunction, such as over-the-counter supplements and herbal remedies, get your doctor’s approval. Medications to treat erectile dysfunction do not work for all men and may be less effective in certain cases, such as after prostate surgery or if you have diabetes. Some medications can also be dangerous in the following cases:

If you take nitrate medications, which are often prescribed for chest pain (angina pectoris), such as nitroglycerin (Nitro-Dur, Nitrostat, others), isosorbide mononitrate (Monoket), and isosorbide dinitrate (Dilatrate-SR, Isordil, Bidil )

Other medications

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These are other medications for erectile dysfunction:

Alprostadil self-injection.

In some cases, drugs that are generally used for other conditions are used for injections into the penis, alone or in combination. Examples include alprostadil and phentolamine. These combination drugs are often referred to as bimix (if two drugs are included) or trimix (if three are included).
Each injection is dosed to create an erection that lasts no more than an hour.

Side effects may include light bleeding from the injection, prolonged erection (priapism), and, rarely, fibrous tissue formation at the injection site.

Alprostadil urethral suppository

Intraurethral therapy with alprostadil (Muse) involves placing a tiny suppository of alprostadil inside the penis in the urethra.

An erection usually begins in 10 minutes and, when effective, lasts between 30 and 60 minutes. Side effects can include a burning sensation in the penis, slight bleeding in the urethra, and the formation of fibrous tissue within the penis.

Testosterone replacement

Some people have erectile dysfunction that can be complicated by low levels of the hormone testosterone. In this case, testosterone replacement therapy could be recommended as a first step or given in combination with other therapies.

Preparation for the consultation

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You will likely see your GP first. Depending on your particular problem, you can go directly to a specialist, such as a doctor who specializes in male genital problems (urologist) or a doctor who specializes in hormonal systems (endocrinologist).

Since appointments can be short and there is usually a lot to talk about, it is advisable to be well prepared.

What can you do

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Ask what you should do ahead of time. When you make the appointment, be sure to ask if there is anything you need to do ahead of time. For example, your doctor might ask you not to eat before taking a blood test.

Write down any symptoms you’ve had, even those that seem unrelated to erectile dysfunction.

Make a list of all the medications, vitamins, herbal remedies, and supplements you take.

Attend with your partner, if possible. Your partner can help you remember a detail that you missed or forgot during the date.

Write questions to ask the doctor