There are many factors which influence intimate relationships for a couple.
One factor is that of male erectile dysfunction, E.D. which is the inability to achieve and maintain an erection to be able to complete satisfactory intercourse. This is usually called impotence.
In order to achieve an erection, it is necessary to have blood flowing in to the penis faster than it flows out, a bit like filling a bucket which has holes in it. The single most contributing factor to cause impotence is smoking and a number of studies have shown a direct relationship between the sudden onset of impotence and heart disease within the subsequent six months.
As men age their natural level of male hormones (testosterone) decreases. They may put on weight, develop diabetes or have high cholesterol. They may need to take various medications or have other physical conditions including high blood pressure, diabetes or prostate problems or may suffer from depression all of which can contribute.
A visit to the General Practitioner is the first step in seeking treatment for this condition. The doctor will take a history, perform an examination and perhaps arrange for blood tests or other investigations.
Treatment may involve the use of tablets which may be taken before intercourse is likely to take place or alternatively, some medication can be taken daily in a low dose which allows more spontaneity, rather like being “on the pill”. It is important to note that a recent study has shown that 77% of tablets purchased on the internet have been shown to be counterfeit and that 80% contain less than half the dose of active ingredient that they claim.
Some men may find assistance with a Vacuum Enhancement Device (VED) which is rather like a bicycle pump which is placed over the penis to “pump it up” and then a rubber ring is placed at the base of the penis to prevent it going down. It is important that the ring is only left in place for about half an hour and not forgotten! These devices are somewhat cumbersome and some people find they lack spontaneity.
Another alternative is to inject a substance in to the side of the penis which increases the blood flow. It is important not to “overdose” on these substances as the erection may not go down within half to one hour as intended and permanent damage may result. The injection technique should be taught by the doctor and a test dose given to avoid that. Usually the injections are supplied as a single dose. The usual cost for a single dose on prescription is around $15.There are some companies on the internet which supply “cocktails” of medications to be injected at grossly inflated prices or have annual subscriptions for supply.
Finally, in some cases it may be necessary for the man to have a penile prosthesis inserted. This is a device which is inserted by a surgical procedure and works using a hydraulic system where the device may be inflated to create an erection and deflated when not required.