Dr Sean Cummings  
London, United Kingdom

Specialties: STD/STI HIV prevention

Interests: Hepatitis C, Men's Health, HIV Prevention
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London, United Kingdom
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Erectile Dysfunction (Impotence) Treatments

Oct 06, 2010 - 24 comments

Erectile Dysfunction (Impotence) Treatments

This used to be called impotence until the rather more sensitive erectile dysfunction or “ED” phrase was coined. It actually is a better term because there is a range of ways in which your penis mail fail to live up to expectations, causing embarrassement and disappointment.

Very technically, ED is defined as the inability to develop or keep an erection long enough for the desired sex to occur. This might include masturbation, public sex, penetration and oral sex. It really doesn’t matter why the erection is desired – but if you can’t reliably get one when you need one, then you have ED.

ED is probably the most common sexual problem that a man can experience. Overall, probably around 1 in 4 men have problems. Younger men tend to have more in the psychological problem area with negative embarrassing experiences being reinforced each time the erection fails. Older men have a much higher rate of ED with around 50% plus of men in the 50 to 70 age group in at least one US study reporting it. Remember that ED is a range of conditions – it’s not simply a “dead or alive” condition. Partial erections; erections which start off strong and then fail; erections which are fragile in the sense that it doesn’t take much to make them collapse, are common.

As I say, younger men generally have less physical reason to develop erectile failure. They usually will have strong erections but occasional psychological problems like “performance anxiety” where they worry whether an erection will occur will kick in and cause erectile collapse. Older men, sadly in my age bracket of 40 plus, will tend towards more physical causes with around 5% of us being totally unable to develop an erection of any sort at all.

The reasons for erectile dysfunction have become much clearer over the last 20 years or so. In fact, I’m so old that I can remember the days when as students we were taught that the majority of men with erectile problems had physical disease causing it. We then went almost full circle with the psychological argument taking precedence and suddenly all men with ED had “issues” which you could solve with a jolly good chat with a psychologist.

Luckily things really have changed and mainly with the meteoric arrival of the drug Viagra and then its relatives Cialis and Levitra. These drugs heralded the notion that although there might be a physical or a psychological problem, it was solvable and reliably so, by taking the medications.

The arrival of these medications also opened the box of shame and enabled men to discuss the issues rather more openly. As a GP in NHS practice I would frequently have female patients come to talk to me about their sexual problems and their male partner’s lack of erection.

What finally did become really very clear was that there was a range of interacting physical and psychological elements, all having impact on each other. Physical difficulty caused by disease and or medications would be compounded with realising that once you’d started there had to be the expected outcome which usually involved penetration and ejaculation. Consequently a combined medical and gray-haired psychologist lady approach would often help tease everything out. Unlike women, few men can fake sexual arousal because if the erection isn’t there, well, it’s a difficult one.

There are a number of well-known conditions that will cause or worsen ED. The main ones I’m afraid are self-induced. If you suffer from ED its is worth while having a medical examination and also some blood tests for hormone and sugar levels.

Stress is something that’s often talked about and is a very powerful damper of sexual functioning. It is an awkward one to get around though because its 2010 and life is a blur of work and getting to work and family and responsibility and money etc etc – you know the picture. If you can sort the stress out then its probable that your sexual functioning will return to normal.

Alcohol and recreational drugs are for lots of people the major culprits. I do love a drink but the painful fact is that alcohol, except in very small amounts is very toxic. It’s also very seductive, so that one drink which might just calm the nerves before a potential sexual encounter, will frequently become plenty of drinks, leaving your erection something only to be dreamed of. Depressive illnesses also encourage people to drink far too much alcohol and the combination of the two together really is not a good one.

Recreational drugs – ecstasy, cocaine, crystal meth are widely used. I saw a recent press release saying that cocaine had become the UK drug user’s drug of choice in 2010. The problem with these drugs is that they will often increase sexual desire and feeling of “sexiness” but they equally often will destroy the mechanism so your hydraulics don’t match up with what you’re experiencing in your head. As a result, especially with crystal meth people will become fantastically desperate to achieve firstly an erection and secondly ejaculation. Even if they do, this isn’t enough and as soon as they’re done they’re off on another sexual quest. The result is often unsafe very risky sex, genital injury and sometimes such complete disinhibition that STI’s or STD’s including the blood borne variety HIV and 2010’s new infectious darling, Hepatitis C become a routine.

Diseases such as diabetes, heart disease and high blood pressure also have a marked impact on erectile dysfunction rates. This happens via a combination of routes including the disease process itself and also the medications used to treat the conditions. Very many medications will have an adverse effect on both libido and erectile capability.

Luckily there are now a variety of devices and medications used to treat ED. Although using medications etc is not ideal, it does virtually guarantee an erection.

The medications fall into two main groups – oral and injectable/insertable.

The oral meds began with Viagra or sildenafil. This was the first of a group of drugs called phosphodieterase inhibitors or PD5 inhibitors for short. They work by allowing an increase of blood into the penis and maintaining the erection for longer. It’s a bit like filling a bath – if you turn the taps on full the bath will fill, even though the plug is out. Other drugs like Cialis and Levitra are variations on the same theme but with their own characteristics. Levitra and Viagra are very similar medications being prompt acting with a relatively short duration of action.

Cialis has a longer onset and longer overall effect – in some men up to 3 days. Doctors will try to tailor the medication according to your needs. So for the man who needs an erection in an hours time, Levitra or Viagra are the appropriate drugs. For the man who wants a more normal sexual response over time, then maybe twice weekly Cialis is the way forward.

Other drugs include the injectable Caverject – yep, you have to inject your penis – but the upside is a fantastic stiff erection that you can hang your hat on. Muse is a little pellet which you insert into the urethra – the pipe you pee through – and then massage your penis. Gives a reasonable injection, but stings and burns a little. Also, someone sucking you may end up with a rather medicinal taste…..

Finally, vacuum pumps. These are rigid penis shaped devices slipped over the penis. You vacuum extract the air and suck blood into the penis, then slipped a tight **** ring over the base to keep the blood in. Surprisingly popular, though gives a cold, unattractive blue penis with frequent interruptions to re-inflate it. Not the most magical of moments.

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139792 tn?1498585650
by Dalubaba, Apr 17, 2011
A good informative article. A similar article on holistic medicine may also be prepared, coverin kegel esercises, Sat kriya, kundlini yoga, Zen etc.Yoga locks can help to vitalize genital area.Taoist yoga also gives some helpful rechniques. Exploring all these with neutra attitude can give us well rounded method to treat there sexual proble to enhance the charm of overall life.....

Avatar universal
by harraj, Apr 19, 2011
I am 24 yrs male, i problem is when i talk yo my girlfrnd or whenever i see little bit pornography or romantic scene the i got aroused and my penis leaks sperms. while mastrubuting i got discharge in in few seconds.. is this problem have any cure my medicines. i m in trouble. plz help me out.. i m totally depressed... plz help me.

139792 tn?1498585650
by Dalubaba, Apr 28, 2011
when one is excited, there is slight wetness on penis glanse and in vagina. this is normal and necessary as it works as a natural lubricant to fecilitate the penitration of penis into vagina. so you need not worry about pre-***. It is not ejeculation.
Try to calm down. Over excitement leads to premature ejeculation. you may try few things suggested in the above comments.Don't worry, you will be ok.

Avatar universal
by Me288, May 06, 2011
I'm 22, I have a problem while intercourse I can't stay erected. It's been happening for about two weeks now. What can it be

Avatar universal
by NOHARD, May 10, 2011
Why does this not mention DHEA, as a way out ED, its worked for me, after 7 months looking for an answer for my ED, see I'm an epat living in Greece, and the doctor at our clinic just put it down to anxiety and gave me Viagra as a way out, no check to see if I could take it, sorry Viagra is not me, made me fill like a machine.
So I kept looking around tell I read about DHEA and all of its side effects, but there a lot of people who, rate this product with very high merit, OK for me so far its working with no side effects.

Avatar universal
by geoalfonsino, May 29, 2011
i have diabetes but erection is low i take cialis 20mg but i canot good erection my sugar is low  please help me

139792 tn?1498585650
by Dalubaba, Jul 25, 2011
I found an exercise which is called deer exercise. It is meant for male and female. Deer exercises are different for male and female. Google Deer exercise for man or woman. There are many websites on the subjects.

Avatar universal
by mod915, Jul 30, 2011
         hi when my penis once leeks it doesn't erect again even i am in mood to do more sex plz help me

139792 tn?1498585650
by Dalubaba, Aug 04, 2011
Normally it takes half an hour to one hour to get the penis re-erect. You have to wait for some time before you start again. Massaging testicles( with mild pressure) or massaging perineum( muscle between legs, may help.

Avatar universal
by dodgings, Aug 17, 2011
hi,ma penis is curve 2the left side n i want it 2b straight again cz wenever i sleep wit a gal they make fun of me,plz help...

139792 tn?1498585650
by Dalubaba, Aug 27, 2011
Spinal rotation ; This exercise is rotation from the base of the spine. Google'spinal rotation for sexual stamina. you will get the details in many website. you may also google sexual reflexology.
Some tips for those who cannot leave masturbation; It is an ideal situation if you do not masturbate. However if you cannot remain without it, here art tips that makes your masturbation much less harmful.
Do not masturbate with dry hands. Do not stop breathing,Do not over visualize. Do not masturbate when you are over excited.Empty your bladder before maturation.Each tip has some scientific base.Do not masturbate if you are in a hurry. Keep 30 minutes time for mb. Thanks.

Avatar universal
by mrcork675, Oct 14, 2011
I have been reading your reply for other peoples, my problem now is this. I am have been having sex for the last 3 months and just last two weeks my erect organ couldn't stand up to perform his normal duty, i wasn't disturbed at the first time, but the second time it repeat again, so my problem is what may be the cause?? how do i solve this problem?? i met doctor and he prescribed Viagra for me with other peels, i don't like taking peels and i only want to treat it in natural way. I smoke and at thesame time i drink very well, but since i notice this problem i decided to keep away from drink and smoking. Please your reply is required urgently

Avatar universal
by gelatinous, Oct 26, 2011
Great article, clear, concise and informative. Don't forget there are other options. You stopped with vacuum pump. If you had more room to type, you may have included a prosthetic penis and an inflatable penis. You can get a bladder (air or fluid) surgically installed into your penis, that you literally pump up prior to sex and deflate after sex http://bionicme.com/forums/bionic-or-prosthetic-penis

And to your readers, ED is a very sensitive topic for every man. Some more so than others. You are not alone. Millions of men are in the same boat as you. Be honest and open with yourself and your partner. Having ED does not make you less of a man. Admitting there is an issue and seeking treatment makes you MORE of a man!

139792 tn?1498585650
by Dalubaba, Nov 19, 2011
To Mrcork,
I have narrated different exercises for sexual disorders. holistic treatment will help. Yoga, kundllini yoga, taoist yoga and Tantric yoga specially deal with sexual disorders. Male deer exercise appears to be the best one.

Avatar universal
by marvin323, Apr 18, 2012
For all of those who suffers from  erectile dysfunction, I would like to have something to say.. so please read.

Unfortunately there are drugs out there that say “may cause sexual side effects.” taking one of these drugs could ruin your body and lose your  ability to do the deed without assistance and may even worsen your condition,

like you may have to start using pumps and other devices just to get an erection.

The worst case scenario is that you will reach the point of  having to consider surgical options, I hope we will never have to.

It's very upsetting that this happens, but not being able to get any erection is not the fault of the person nor does it make them less of a man, It’s a unfortunate that a lot of people do not use to go to the doctor for these kinds of problems.  

Erectile dysfunction is a very serious medical case and should not be taken lightly..there are many reason for this condition but, mostly it is  because of physiological problems or medical reasons or even psychological reasons.

if you're  unable to enjoy your sexual life. please look for help and don’t be afraid to ask for advice.

for more information go here

Avatar universal
by JavedK, Jul 29, 2012
Hi Doctor,
My name is Javed Karim. My age is 33 years.
From past few years I am suffering from Erectile dysfunction. My Testosterone level is high. According to the report it should be 241-827, however mine is 887.81. I have high blood pressure.
I would like to know, is it possible to cure my Erectile Dysfunction???

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by keerthi108, Aug 07, 2012
hi my name is keerthesh, i am 24 years old,
my penie is getting vibrate like a cell vibrating in pocket,
i got feared form this so please any one can help ,
can i know the reasons and solution?

Avatar universal
by dob1986, Nov 21, 2012
I'm 25 years old, I never had sex in my life .  But I really want to atleast after marriage
2012 Nov- I wore a condom, the moment I pulled the condom down I ejaculated. I was so embarrassed in front of a girl, she was like 'what a loser' . Yes I am . Please help me .
2011 Nov - I wore a condom for trying it out to feel what it would be like I ejaculated after 1 min. exactly.
2010 Nov - I had a healthy erection but ejaculated after 20 strokes during masturbation.
2004 - after I masturbated I went toilet for pissing at the end I had 4-5 drops of blood .

I used to be very addicted to masturbating  during my teenage. None in my family explained about the bad effects of it.
Now if I masturbate once in 10 days I have serious veins sticking out on my penis. And I have repeated nightfall  almost every alternate days .

Please help me .... I don't know whom to meet even what specialist ? I don't know anything.
Suddenly I had a doubt what if my sperm count is less,whom should I meet ?

Please help me......

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by sundre, Feb 08, 2013
i am 23 year old i did mastrubaion last 7 year know i am gatting a problam my for skin out of my penies hed and week reation only 1 ments  sex emosational is not there plz help me what to do sir

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by JacquiOlliver, Apr 24, 2014
An occasional instance of ED is normal. This is because ONE distracting thought during sex (or when you are masturbating) can make you lose your erection or lose control. The problem arises next time you go to have sexual activity. If your mind is focused on the problem, it is likely the problem will occur again. This is because the conscious mind can only focus on one task at a time - and your thoughts activate your muscle programs.

If you worry and imagine yourself losing your erection, unless you immediately change your focus, your penis will start going soft. Same with premature ejaculation. If you worry and imagine yourself ejaculating, you will ejaculate early. Correct mental focus during sex is paramount, to ensure you only ever initiate the correct sexual programs.

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by Dipzzz, May 17, 2014
my age is 23. my problem is my penis  not getting full length .

this problem im facing from three weeks.

what may be the problem?

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by juan231, Oct 23, 2015

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by Misbah123, Nov 02, 2015
I am 23 years old . I don't get power on my penis . How I will get my penis energy. When I feel sexual emotions my penis not bigg and straight. I am facing this problem since 6monts.

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by Ladydi7646, Apr 01, 2017
My boyfriend use to use meth. Now he can get an erection but he cant come while having intercourse. Is there anything to help?

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