Erectile dysfunction is the name for difficulty getting an erection or maintaining an erection long enough to have intercourse or penetrative sex. Erectile dysfunction can be caused by a number of factors, including underlying physical conditions or psychological causes.
Erectile dysfunction can be frustrating and challenging, but the good news is that there are treatment approaches that can help.
Erectile dysfunction isn’t uncommon and generally increases with age due to biological changes. At least one in five men over 40 has erectile issues of varying degree.
There are many reasons why men experience erectile issues, including:
Decreased testosterone levels due to androgen deprivation therapy (ADT, or hormone therapy) for prostate cancer can often lower libido and sexual function.
Your health care professional will talk to you about your specific symptoms and take a detailed medical history to determine possible causes.
Managing erectile dysfunction depends on the cause and the individual person. Not all treatments work for everyone. You may need to do some trial and error before you find a process that works for you.
The first step is to treat any underlying health conditions. If this doesn’t improve your erectile dysfunction, there are other options, including lifestyle changes, medications, psychosexual therapy, devices and surgery.
Your health care professional may suggest lifestyle changes to improve your health, such as:
Prescribed medication is usually the first line of treatment. The medications work by dilating the blood vessels to promote blood flow into the penis and generate an erection. Tablet medications for erectile dysfunction are called phosphodiesterase-5 (PDE5) inhibitors, and examples include Viagra and Cialis.
Penile injectables are another option for medication management of erectile dysfunction. These medications increase blood flow when injected directly into the penis, resulting in an erection.
Men of diverse sexualities and masculinities report experiencing psychological distress related to changes in sexual wellbeing, including erectile dysfunction. A holistic approach to erectile dysfunction takes into account both the physical and psychological challenges that can affect sexual wellbeing.
Psychosexual therapy, also known as sex therapy, involves discussions about individual expectations of sex and intimacy. Speaking with an accredited psychosexual therapist can be an important way for you (and your partner) to discuss topics such as performance anxiety, erectile dysfunction, changes in libido, premature ejaculation, intimacy and sexual pleasure.
If you would like to know more about psychosexual therapy, speak with your GP or health care professional. You can find more information about accredited psychosexual therapists from the Society of Australian Sexologists website.
Penile rings are ring-shaped devices that fit around the base of the penis. They work by occluding the veins and therefore blood flow out of the penis to help maintain an erection for longer. They can be used alone or with a penis pump.
A penis pump, also known as a vacuum device, is a device that is placed over the penis to draw blood into the shaft. Once the vacuum creates an erection, the retaining band is slid down to the lower end of the penis, and the pump is removed. An erection typically will last long enough for intercourse.
Penis pumps can be battery or hand-operated and are effective for most men. Before using a penis pump, speak to your health care professional.
A penile implant is a device that is placed into the penis to help get an erection and maintain it for sex. The device is implanted into the penis during surgery, usually by a urologist.
There are several types of penile implants, including inflatable pumps and malleable rods. Whichever option you choose will be custom-fitted to your penis. Speak with your GP or urologist for more information.
If you are having prostate cancer treatment, your experience of sex may change. While everyone’s situation is different, some of the common changes to expect can include:
