Erectile Dysfunction
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Accredited and Experienced Physiotherapists
Personalised Treatment
What is Erectile Dysfunction?
Erectile dysfunction (ED) is a mans inability to develop or sustain an erection that allows sexual activity with penetration. ED itself is not a disease, but a symptom of something else.
If you have ED, you might experience:
- Difficulty getting hard enough for penetration
- Difficulty maintaining an erection
- Losing your erection throughout intercourse
- Loss of confidence during sex
There are many reasons why you may experience erectile issues, including:
- Performance anxiety
- Stress and relationship issues
- Reduced blood flow or blood vessel function, due to conditions such as diabetes, sleep apnoea and heart disease.
- Urological problems, including Peyronie’s disease
- Consuming illicit substances, high alcohol intake and smoking.
- Prescription medication side effects
- Pelvic surgery including radical prostatectomy. The specific mechanism through which ED occurs following radical prostatectomy is not fully understood. It is thought to be due to damage to the penile nerves, vascular supply and smooth muscle.
- Radiation therapy (bowel, bladder, spinal, prostate) which can affect penile nerve function resulting in erectile or ejaculatory issues
- Nerve function symptoms related to certain medical conditions, such as spinal cord injuries and multiple sclerosis
- Hormonal conditions, such as thyroid disease and testosterone deficiency.
- Testosterone which has been lowered due to ADT/ hormone therapy for prosate cancer can often lower libido and sexual function.
How is Erectile Dysfunction treated?
Managing erectile issues depends on the underlying cause and varies for each individual. Not all treatments are universally effective, so finding the right approach often involves some trial and error.
The initial step involves addressing any underlying health conditions. If managing these conditions doesn’t resolve erectile issues, other options include lifestyle adjustments, medications, psychosexual therapy, devices, and surgery.
- Lifestyle changes recommended by a physiotherapist may include adopting a healthy diet, reducing alcohol consumption, quitting smoking, exercising regularly, losing weight, and managing stress.
- Pelvic floor exercises guided by a physiotherapist (using a real-time ultrasound machine) has been shown to improve erectile function. High quality contractions are more likely to produce better outcomes and each program will be tailored to an individuals circumstances to assist them with achieving optimal results.
- Medication such as phosphodiesterase-5 (PDE5) inhibitors like Viagra and Cialis, are typically the first-line treatment for erectile dysfunction. These medications work by dilating blood vessels to increase blood flow to the penis, facilitating an erection. Penile injectables are another medication option administered directly into the penis to achieve the same effect.
- Psychosexual therapy, also known as sex therapy, addresses psychological factors contributing to sexual issues. It involves discussions about individual expectations around sex, performance anxiety, changes in libido, intimacy, and sexual pleasure. Consulting with an accredited psychosexual therapist can be beneficial for both individuals and couples.
- Devices such as penile rings and pumps offer non-invasive methods to maintain erections. Penile rings restrict blood flow out of the penis, while penis pumps create a vacuum to draw blood into the shaft. Both can be used independently or together to facilitate and maintain an erection. Your physiotherapist can help prescribe the most suitable device for you.
- For more invasive treatments, penile implants are surgically placed devices that help achieve and sustain erections. These implants, available in inflatable pumps or malleable rods, are custom-fitted and require consultation with a urologist to determine suitability and discussion of options/ risks.
Overall, the choice of treatment depends on individual circumstances and preferences, and consulting with a healthcare provider is essential to find the most effective and appropriate solution for managing erectile issues.
Rest assured, our team has extensive experience in this field, so there’s no need to feel awkward or uneasy discussing erectile issues. We’re here to support you in enhancing your quality of life and rediscovering enjoyment in your sexual experiences. Feel free to reach out to our physiotherapists to explore options and develop a treatment plan.