Erectile dysfunction treatment

What is erectile dysfunction?

An erection happens when blood flows into the penis and stays there. Anything that reduces that blood flow, interferes with the nerves involved, or lowers desire can cause ED. An occasional off night is normal and not ED. We look at it when the difficulty is persistent — typically present for three months or more — or when it is affecting your confidence or your relationship. ED is very common: roughly half of men experience some degree of it by their fifties, and effective treatment exists for the large majority.

What causes ED?

ED usually has a physical cause, a psychological one, or a mix of both. Identifying which is the key to treating it properly rather than just masking it.

• Vascular: narrowed or stiff blood vessels from high blood pressure, high cholesterol, or atherosclerosis — the most common physical cause
• Metabolic: diabetes and obesity, which damage both blood vessels and nerves
• Hormonal: low testosterone, thyroid problems, or raised prolactin
• Neurological: nerve damage from diabetes, pelvic or prostate surgery, or spinal injury
• Psychological: stress, anxiety, depression, performance worry, or relationship strain
• Lifestyle and medication: smoking, heavy alcohol, lack of exercise, and certain blood-pressure or antidepressant medicines

How we assess it

A good ED consultation is more than a prescription pad. We take a focused history, check the things that point to an underlying cause, and only then agree on a treatment with you.

• A confidential conversation about your symptoms, general health, and any medications
• Blood pressure and cardiovascular risk assessment
• Blood tests where indicated: blood sugar, cholesterol, testosterone, and others
• A review of drug interactions, especially nitrates and alpha-blockers
• A clear explanation of what we find and what your options are

Treatment options

Oral medication is the proven first-line treatment, and it works well for most men. We match the tablet and dose to your routine and your other medicines, and we treat the things that make ED worse. If tablets are not enough or not suitable, we look again at the cause and refer you to a specialist for options we do not provide in-house.

• Oral medication (PDE5 inhibitors): sildenafil and tadalafil improve blood flow so you can get an erection with stimulation. Sildenafil is short-acting; tadalafil lasts longer and has a low-dose daily option.
• Choosing your regimen: we help you decide between on-demand dosing and daily low-dose tadalafil, based on how often you want to be ready and how your body responds.
• Treating the root cause: managing blood pressure, blood sugar, weight, smoking, and stress, which improves erections and your wider health.
• Referral when needed: if medication is not the right answer, we refer you to a urologist or other specialist for further assessment or treatment.

Discretion, start to finish

Private entrance and consultation room, no medication labels on display, prescriptions in plain packaging on request, and a refill process by phone or LINE so you do not need to repeat the consultation each time. Nothing is shared with employers, family, or insurers without your written consent.