What Is Erectile Dysfunction?
Erectile dysfunction (ED), sometimes referred to as impotence, is the persistent difficulty in achieving or maintaining an erection firm enough for satisfactory sexual intercourse.
Occasional erection problems are common and may be linked to tiredness, alcohol, stress or anxiety. However, when symptoms become regular or ongoing, this may indicate an underlying health condition that requires medical assessment.
Erectile dysfunction is a common sexual health concern affecting men of all ages. While it becomes more prevalent with age, it is not simply a normal part of ageing. In many cases, it can be treated effectively once the cause is identified.
How Does an Erection Occur?
An erection depends on healthy nerves, hormones, blood vessels and psychological wellbeing.
When a man becomes sexually stimulated:
- Signals travel from the brain to the penis
- Blood vessels relax
- Blood flow increases
- The penis fills with blood and becomes firm
If blood flow is reduced, nerve signals are disrupted or hormone levels are low, it may become difficult to produce an erection or maintain it during sexual intercourse.
Common Causes of Erectile Dysfunction
Erectile dysfunction often has more than one contributing factor. Causes can be divided into physical and psychological.
Physical Causes
The most common physical causes involve the circulatory system. Conditions that affect blood vessels can limit the ability to increase the blood supply required for an erection.
These include:
- High blood pressure
- High cholesterol
- Heart disease
- Diabetes
- Obesity
- Smoking
These conditions can damage blood vessels and restrict blood flow, making erections weaker or more difficult to maintain.
Other physical causes include:
- Low testosterone
- Neurological disorders
- Side effects of certain medications
- Previous pelvic surgery
- Excessive alcohol use
In some men, erectile dysfunction can be an early warning sign of cardiovascular disease. Because the penile arteries are smaller than coronary arteries, symptoms may appear earlier.
Psychological Causes
Emotional and psychological wellbeing plays an important role in sexual health.
Stress, anxiety, depression and relationship problems can all contribute to ED. Performance anxiety may create a cycle in which fear of difficulty leads to further erection problems.
In many cases, both physical and psychological factors are involved.
When Should You Seek Medical Advice?
Many men delay seeking help due to embarrassment. However, persistent erectile dysfunction should not be ignored.
You should consider medical assessment if:
- ED occurs regularly
- Erections are less firm than previously
- You struggle to maintain an erection
- You have risk factors such as high blood pressure or high cholesterol
- ED is affecting your confidence or relationship
Early evaluation allows us to identify any underlying health issues and begin appropriate treatment. Addressing ED promptly may also help prevent progression of associated cardiovascular disease.
How Is Erectile Dysfunction Diagnosed?
Diagnosis begins with a detailed discussion and review of your medical history.
During consultation, we will assess:
- General health
- Current medications
- Lifestyle factors
- Sexual symptoms
- Psychological wellbeing
Blood tests are often recommended to check cholesterol, blood sugar and testosterone levels. These investigations help identify underlying causes and guide treatment decisions.
In most cases, extensive testing is not required unless specific concerns arise.
Treatment Options for Erectile Dysfunction
The best way to treat erectile dysfunction depends on the cause. Treatment is tailored to the individual.
Lifestyle Changes
For many men, improving overall health can significantly improve erectile dysfunction.
Recommended changes may include:
- Stopping smoking
- Reducing alcohol intake
- Increasing cardiovascular exercise
- Managing weight
- Taking steps to reduce stress
Improving heart health often improves erectile function, as erections depend on healthy blood vessels and good blood flow.
Oral Medications
Medications such as sildenafil (Viagra) and tadalafil belong to a group known as PDE5 inhibitors. They work by increasing blood flow to the penis during sexual stimulation.
These medications are effective for many men but must be prescribed carefully, particularly in those with heart disease or those taking certain medications.
Additional Medical Treatments
If tablets are ineffective or unsuitable, other options may include:
- Vacuum erection devices
- Injectable treatments
- Topical therapies
- Shockwave therapy
In cases where other treatments have failed, penile implants may be considered. These surgically placed devices provide a long-term solution for men with severe erectile dysfunction.
The Importance of Treating Underlying Conditions
Erectile dysfunction is often a symptom of a broader health issue rather than a standalone condition.
Managing high cholesterol, high blood pressure and heart disease can improve erectile function. In some cases, treating these conditions alone may improve symptoms without further intervention.
ED provides an opportunity to assess overall cardiovascular health and reduce long-term risks.
Emotional Wellbeing and Relationships
Erectile dysfunction can affect confidence and self-esteem. It may also place strain on relationships if not discussed openly.
Seeking help early reduces anxiety and prevents ongoing stress from worsening symptoms. In some cases, counselling or therapy may be helpful alongside medical treatment.
It is important to recognise that ED is a medical condition, not a personal failing.
How Dr Edward Calleja Can Help
Dr Edward Calleja is a Consultant Urologist based in Sussex with extensive experience in diagnosing and managing erectile dysfunction.
He offers:
- Comprehensive assessment
- Discreet and confidential consultations
- Investigation of underlying causes
- Personalised treatment plans
- Access to advanced medical treatments
If you are experiencing erectile dysfunction, early assessment can lead to effective treatment and improved sexual health.
To arrange a consultation, use the online booking system or contact Dr Calleja’s secretary on 01424 757 458. Appointments are available in person and online for patients across Sussex and the UK.
