Effective Treatments and Medications for Impotence

Impotence can be a devastating condition, significantly affecting the quality of life and placing strain on relationships. However, in many cases it’s a very treatable condition and there’s a range of different options which can be considered.

Although some men can find the subject difficult to discuss, if you are affected it’s vital that you talk to your doctor about it. Impotence is something that they will have seen many times before and there’s no need to feel embarrassed. Don’t be tempted to simply purchase medication online; impotence can be the sign of a more serious underlying condition such as cardiovascular disease so it’s imperative you get checked out first.

There are a number of different likely causes for being impotent and the treatment which is offered will vary depending on the underlying reason.

A poor lifestyle can cause impotence so before consulting your doctor it may be worth making some changes yourself to see if there’s any change. Losing excess weight, cutting back on alcohol to less than 2 units a day, stopping smoking, improving your diet and taking more exercise can all boost your overall health and can be enough to trigger the ability to sustain an erection. If you take recreational drugs you should also try stopping these too.

Whatever the cause of your impotence, improving your lifestyle will help to increase blood flow to the penis, and prevent further damage from being inflicted on the nerve endings. By doing this you will maximise the chances of any treatment working successfully.

Medication

Most men will have heard of a treatment for impotence called Viagra; this is a medication which belongs to a group of drugs known as Phosphodiesterase-5 inhibitors (PDE-5 inhibitors).

Viagra is not the only medication which can be prescribed from this category; the three main treatments are:

Viagra – also known as sildenafil

Cialis – also known as tadalafil

Levitra – also known as vardenafil

An advert for Cialis – a popular drug worldwide

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Although all three of these drugs are PDE-5 inhibitors, they have a slightly different effect and work in different ways. Around two thirds of men can be successfully treated with one of these drugs. Your doctor should explain the differences in the medication so you can decide what’s most appropriate for you. Part of the decision will be based on whether you have tried any of the treatments before, and how sexually active you are.

Viagra and Levitra work fairly rapidly once taken and are designed to be taken on an “as and when” needed basis. Ideally they should be taken on an empty stomach around an hour before you want to get an erection; they take between 30 and 60 minutes to take effect. Once in the system, they last for approximately eight hours.

Cialis is designed to be taken slightly differently and is prescribed when a longer term effect is required, perhaps over a weekend or on an ongoing basis. Once in the system the results last for approximately 36 hours.

Regardless of which medication you take, you should only have one every 24 hours, and you should take it on an empty stomach. This makes it easier to absorb; you can eat about an hour after you have taken the drug without affecting the result.

None of the medications will produce a spontaneous and uncontrolled erection; the man must still feel aroused. The treatment simply allows the body to produce the desired effect as and when appropriate.

Levitra tablets

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If PDE-5 inhibitor medication doesn’t work for you, it could be because you haven’t had sufficient sexual stimulation, you have waited too long to have sex, you haven’t waited long enough or the dosage may need to be increased.

PDE-5 inhibitors are a very effective treatment for the majority of men but they aren’t without their side effects and they aren’t recommended for use in everyone.

Men who have cardiovascular disease or abnormalities in the anatomy of their penis – such as Peyronie’s disease – may find that their doctor is reluctant to prescribe the medication. Each case has to be considered on its individual merits and the risks and the benefits weighed up.

Sexual activity is good for the overall health so even in individuals with cardiovascular disease; if it’s possible to prescribe the medication your doctor will do so.

There are a number of other conditions where use of PDE-5 inhibitors may be contraindicated; these are as follows:

if you are taking any medication or recreational drug containing nitrates. Angina is often treated with organic nitrates, while the recreational drug known as ‘poppers’ is made from butyl nitrate. The combination of nitrates and PDE-5 inhibitors can have a very dangerous effect on the heart.

anyone at risk of priapism (a condition which results in painful erections lasting many hours)

if you are taking alpha blockers. These are a type of long acting medication often used for high blood pressure amongst other things.

you have been given advice to refrain from sexual activities due to the risk of widening your blood vessels.

you have recently suffered a stroke.

you have low blood pressure

you have had a heart attack

you have unstable angina – this is a very specific type of angina where the symptoms are more frequent and severe

you have suffered from non-arteritic anterior ischaemic optic neuropathy – this is an eye disorder which results in a sudden loss of sight

If you have suffered from any of the above conditions, it doesn’t mean that you won’t be able to take PDE-5 inhibitors; it means that you will be assessed far more closely. For example, if your heart attack occurred several months ago and your overall health is good, it may be perfectly safe for you to take PDE-5 inhibitors.

There is another type of medication available if PDE-5 inhibitors don’t work, or you are unable to take them.

Alprostadil is a type of artificial hormone which works by prompting the body to increase blood flow to the penis. It is either delivered as an injection into the penis or by inserting a pellet into the urethra (the small tube at the tip of the penis which carries urine from the bladder).

After application, Alprostadil takes around 5-15 minutes to start working but the duration of its effect varies depending on the dose.

Just like PDE-5 inhibitors, Alprostadil won’t be appropriate for all men and should be avoided or given careful consideration in the following cases:

anatomical abnormalities

infections

with other drugs to treat impotence

if you have a penile implant

if you have been advised to avoid sexual activity

if you are at an increased risk of suffering from priapism (a long lasting painful erection)

Some methods may be more appropriate than others; for example with anatomical abnormalities or infections, insertion into the urethra may be ruled out but injections may be viable.

Statistics suggest that amongst men where PDE-5 inhibitors were unsuccessful, around 85% of men responded well to Alprostadil injections. In cases where urethral insertion is used, the success rate is around two thirds of men.

Hormone therapy

This route is only appropriate if it’s determined that the impotence is being caused by a hormonal problem, such as hypothyroidism.

In these cases, a referral to a specialist consultant, an endocrinologist, will be made.

Sometimes asking an Endocrinologist can be a good idea

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Hormones are a type of chemical which is produced naturally by the body but there are a number of synthetic hormones which mimic their action. Hormone levels in the body can be brought back into balance by injecting synthetic hormones, thereby curing the impotence.

Vacuum pumps

If you aren’t able to take medication or else are keen to try a non-medicinal route, a vacuum pump may provide the solution.

Effective in approximately 90% of men who master the technique, regardless of the underlying cause, a vacuum pump can provide an erection which lasts for approximately half an hour.

Comprising of a plastic tube and a pump, hand or battery operated, the man places his penis into the tube and begins the pump. This removes all of the air from the tube, creating a vacuum which causes the penis to fill with blood and swell.

Once fully erect, the tube is removed from the penis and a band placed around the base, preventing the blood from flowing back out.

It can take a bit of practice to get the technique spot-on but it is a simple and very effective technique for the vast majority of men that try it.

The main limitations are that a vacuum pump may not be suitable for any man who suffers from a bleeding disorder, or where anti-coagulant medication is being taken.

Pain and bruising are the primary side effect, occurring in just under one in three men.

Counselling and therapy

If there is a psychological element either contributing or causing to the erectile dysfunction, there are various forms of counselling and therapy which can help.

The three main types of therapy used are Sensate Focus, psychosexual and cognitive behavioural therapy (CBT).

Sensate Focus

Useful for when there’s an underlying psychological cause other than simple anxiety or depression, Sensate Focus is a type of sex therapy which puts intercourse of the agenda in the short term.

For weeks or possibly months, depending on what’s agreed with the therapist, the couple do not have sex or touch each other in the genital regions, or on the woman’s breasts. Instead, time is set aside for non-sexual exploration such as massage, touching and stroking. The idea is that both partners will become familiar and intimate with each other’s bodies, without the pressure of having sex.

After the allotted time has passed, the contact gradually builds up to being of a more sexual nature, leading ultimately back to penetrative intercourse.

Psychosexual counselling

Approaching sex therapy from a different angle, psychosexual counselling offers the chance for individuals to discuss emotional or sexual issues. This is designed to deal with any anxieties which could be causing the impotence.

The counsellor will also provide the couple with practical tips about foreplay as well as treatments for impotence to allow the issue to be tackled comprehensively.

Speaking to a Counsellor could certainly help

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Psychosexual counselling has been shown to be effective in some cases but the results tend to take some time to work.

Cognitive Behavioural Therapy (CBT)

CBT is a type of therapy not specifically designed for problems of a sexual nature, but can be used to great effect particularly if there are underlying issues with your relationships, your self-esteem or your sexuality.

The fundamental principle of CBT is that unhappiness is caused by our mental thought process rather than events themselves. Therapists therefore work to address the internal mental dialogue and help patients learn to think more positively and react spontaneously in a more helpful way.

Surgery

A very radical option, surgery for impotence is not normally considered unless the problems have been caused by pelvic trauma or serious injury, such as that which could be sustained in a road traffic accident, or where the penile anatomical abnormalities warrant intervention.

Before considering surgery all of the other treatment possibilities for impotence must have been fully explored and dismissed.

If surgery is being considered as an option, you might be offered either semi-rigid or inflatable implants. Neither of these are typically available on the NHS and the latter can be very costly.

Semi-rigid implants are typically suggested for older men who may not be seeking regular sexual intercourse. The inflatable implants usually provide a more natural result and have two or three separate parts which can be inflated.

Around three quarters of men who have surgery to treat their impotence are happy with the outcome and the erection they are able to sustain.

Infection is a risk with penile surgery and around 5% of cases develop mechanical failure with the implant within 5 years.

Be careful there are risks associated with surgery

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Take care

No matter how tempting it may be to order drugs online it’s essential to get checked by a doctor first to ascertain the underlying cause.

In addition, these type of medications bought online are unregulated and the quality and content of the treatment may vary. Some may contain more active ingredients than others.

Always check with your GP that you aren’t entitled to NHS prescriptions; medication for impotence is available on the NHS in some circumstances. If you decide to buy online, make sure that the pharmacy you use is registered in the UK and any doctors are registered with the General Medical Council.

Image Credits: Surtr, Wikipedia, TCOYD, Downtown Ad Agency and West Midlands Police