What is ED?
Erectile dysfunction (ED) is when a man cannot get or keep an erection. The condition prevents the man from having sex or finishing sex. This condition used to be called impotence. ED can occur at any age, but it is more common in men older than 75 years of age.
It is a common problem. Studies conducted in China, the US, Germany, and Brazil show that erectile dysfunction affects 16 to 40% of the adult male population with approximately 150 million new cases reported every year.
Although older men are more likely to develop erectile dysfunction, the condition can develop at any age. Research conducted in Italy showed that one in every four patients seeking help for erectile dysfunction is under the age of 40.
ED doesn’t have to be a part of getting older. As a man ages, he may need more stimulation (stroking and touching) to get an erection. He might also need more time between erections. Older men should still be able to get an erection and enjoy sex.
Do I have erectile dysfunction (ED)?
Complete our 1-minute online questionnaire to establish if you have ED. We use the International Index of Erectile Dysfunction Test (IIEF-5) to determine if you have ED and to what extent. Complete our 1 minute test to see if you suffer from ED which is free and no personal information is required.
What causes erectile dysfunction?
Erectile dysfunction is a complex issue that’s linked to a number of different health conditions. It can develop as the result of conditions like cardiovascular disease, hypertension, or multiple sclerosis, but it can be caused by poor lifestyle, lack of exercise, overconsumption of alcohol, performance anxiety, or weight gain.
Erectile dysfunction can be caused by:
- Diabetes (high blood sugar)
- Hypertension (high blood pressure)
- Atherosclerosis (hardening of the arteries)
- Stress, anxiety, or depression
- Alcohol and tobacco use
- Some prescription medicines. This includes antidepressants, pain medicine, and high blood pressure medicine
- Fatigue
- Brain or spinal cord injuries
- Hypogonadism (a condition that leads to low levels of the male hormone, testosterone)
- Multiple sclerosis
- Parkinson’s disease
- Radiation therapy to the testicles
- Stroke
- Some types of prostate or bladder surgery
Can erectile dysfunction be prevented or avoided?
If you’re worried you may have erectile dysfunction, or you’re having problems maintaining an erection, see a doctor. They will be able to discuss the problem, assess any medication you may be taking and do a physical examination.
A doctor may arrange some tests to identify or rule out any underlying causes. These tests may include looking for risk factors for cardiovascular disease, such as a blood sugar level test and a blood test for cholesterol and other fats (lipids).
If your erection problems are linked to a lifestyle factor or psychological condition like performance anxiety, you may be able to improve erectile problems – or stop them getting worse – by making positive changes to your diet and lifestyle.
There is some evidence that altering lifestyle factors can improve erectile function, though more studies are needed in this area.
Because erectile dysfunction shares many of the same risk factors as cardiovascular disease, making positive changes to your diet, lifestyle, and exercise regime can improve your cardiovascular health as well as your general health.
Shockwave Therapy and ED
Shockwave therapy is the latest treatment modality for patients suffering from erectile dysfunction due to poor vascularisation, and it is one of the few treatment options that improves natural erections and can potentially rejuvenate the erection mechanism. In addition, shockwave therapy has the following advantages:
- Non-invasive treatment lasting 20 minutes in a treatment room – walk in and walk out within 30 minutes
- No medication required
- Fewer complications than other treatment modalities
- Significant clinical benefit often experienced 6-8 weeks after treatment
Will losing weight help ED?
There is a strong link between erectile dysfunction and obesity. The exact reasons for this link are not fully understood. Weight loss is also associated with a number of related benefits, including a reduced risk of type 2 diabetes and atherosclerotic heart disease.
Healthy weight loss is important, however. Fad diets and rapid weight loss regimes are rarely effective, and many carry their own health risks. For best results, aim to lose between 1lb and 2lb per week by:
- Cutting down on junk food, or foods high in sugar
- Eating more fruit and vegetables
- Eating more whole grain foods, like brown pasta or brown rice
- Exercising for at least 150 minutes per week
- Making sure you’re eating regular meals to reduce the temptation to snack
Will giving up smoking help reduce ED?
The chemicals in cigarette smoke can damage your heart. Several studies have shown that smoking significantly increases the risk of erectile dysfunction because smoking limits the blood supply to the penis.
If you’re serious about giving up cigarettes, you could:
- Write a list of the reasons you want to quit
- Develop a plan to cope with your cravings, including ways to distract yourself
- Explore nicotine replacement therapies, such as patches, tablets, lozenges, gum and a nasal spray
- Exercise more, to combat cravings
- Enlist the help of family members or friends who can keep you on track
Will reducing alcohol consumption help with ED?
Heavy drinking can interfere with your nervous system and may prevent you from getting an erection.
Drinking too much alcohol can also cause other problems, such as disrupting your hormone levels, which could hinder your ability to get or maintain an erection. To keep your health risks from alcohol as low as possible, you should aim to consume less than 14 units per week.
You can make the process of cutting down on alcohol easier by:
- Setting yourself a daily limit
- Setting yourself a weekly budget for alcohol
- Choosing lower strength drinks
- Making smaller drinks
Will reducing anxiety and stress help with ED?
Stress and anxiety are linked to erectile problems. This can include worries about work, money, your relationship or family matters.
If you find you’re experiencing occasional erectile problems, or that your erectile dysfunction seems to come and go depending on the situation, it’s more likely to be caused by stress or anxiety.
You can’t always prevent stress, but there are some things you can do to manage your emotions and reduce the impact that stress is having on your life. This includes:
- Exploring mindfulness which can help to improve your mental wellbeing
- Exploring mindfulness which can help to improve your mental wellbeing
- Talking to your friends or family members about your problems
- Taking regular exercise
- Making sure you are eating healthily
- Making sure you get enough sleep
Tackling performance anxiety
If you feel pressure to perform during sex, worry about your ability to please your partner, or find you’re nervous about having sex, you may struggle to get or maintain an erection.
This issue may pass as you and your partner get more comfortable with each other, but performance anxiety can be a self-perpetuating problem.
If you fail to perform once, you may feel anxious the next time you engage in sexual activity. Over time, this problem can sometimes lead to persistent erectile dysfunction.
If you fail to perform once, you may feel anxious the next time you engage in sexual activity. Over time, this problem can sometimes lead to persistent erectile dysfunction.
Talking to your partner may help to reduce your anxiety. Pick a time when you are both relaxed to engage in an honest and open discussion about your anxieties. You may find this helps to put your mind at ease.
Sometimes, counselling for couples or sex therapy can be useful. Alternatively, you could try cognitive behavioural therapy (CBT).
CBT is designed to help you stop negative thinking patterns, which can change the way you feel about situations and the way your body responds to scenarios that you find stressful or hard to manage.
CBT can be delivered in different ways. It can be done one-on-one, in a group, online or through a self-help book.
Do medication, implants and shockwave really work for ED?
For the treatment of erectile dysfunction, there is not one solution that works for everyone and quite often it is a combination of treatment, lifestyle and psychological changes that helps to resolve this frustrating condition.
Medications like Sildenafil (Viagra) and Tadalafil (Cialis) can work really well for some men, but the side effects can be unacceptable for many. Injection therapy and implants can also be very effective with resolving ED, but not necessarily appealing procedures and not without their risks.
Shockwave therapy cannot resolve all causes of ED, but patients who have been appropriately screened for this treatment will experience a pain free and quick (20 mins per session) process, and when effective after 6-12 treatments, further medication, injections or implants should not be required. Improvements with erections are normally long lasting (at least 12 months and much longer in many cases) and should erections eventually start to reduce, then shockwave treatment is repeatable.
Patients with severe chronic ED may be finding medication ineffective. This is where shockwave therapy can help improve the effects of medication and therefore improve the ability to gain an erection.
Team
Meet Phill
Phil is a highly experienced MSK Physiotherapist and prides himself in offering truly personalised care and delivering results. He has specialised in Men’s Health conditions and has been providing Shockwave Therapy treatment for ED for the past 5 years.
