Erectile problems: what are the treatments?
When should I consult a doctor?
IMPORTANT: before consulting a doctor it is important to know the difference between a brief sexual let-down and a persistent erectile problem. All men experience problems getting an erection at some point when they are stressed or tired. You do not get a satisfying erection as often when you are a bit older, which usually starts to happen in your 50s.
You should talk to a doctor if:
- Your erectile problems last longer than 3 months
- You experience these problems after you have been injured, whether physically or psychologically
It can be intimidating to talk about this with a doctor at first, so you should find a doctor who is comfortable with. Do not panic! Doctors are used to talking about this problem and know how difficult it is for men to talk about their issues. They are trained to know a lot about erectile problems, which are a very common reason for consultations. If a doctor does not feel they can treat erectile dysfunction they will refer you to a colleague who is suitable, whilst staying informed about any treatment you are given.
Should I go alone?
The first consultation can be done alone, but it is advised that your partner is involved. Being supported by a partner is one of the most important elements in finding a long-term solution.
What will the doctor prescribe?
A doctor will normally prescribe an oral treatment the first time round, such as:
These four molecules work by releasing the smooth muscles of the corpora cavernosa to help blood flow to the penis, aiding an erection. These medications are erectile facilitators and are only effective when combined with sexual stimulation (e.g. caresses). They are only available on prescription (beware of fake medications on the internet!) and are not reimbursed by social security.
WARNING: these drugs such as Cialis, Viagra or Levitra can all cause serious side effects and will interact with other drugs (such as nitrates, for example). You should not take them with grapefruit juice, either, or any other medication that you take on time. You should always consult a doctor or pharmacist.
You can take these drugs short term (for a few weeks) to help regain your confidence, especially for men who have been alone for a long time and need to regain some confidence to find a new partner (taking medication for psychological problems).
They can also be used long term if you suffer from a proven vascular disease (diabetes, hypertension, heavy smokers), but also depending on your age.
You might be advised to take a hormonal treatment if a medical test indicates that you have low testosterone levels as well as clinical signs such as fatigue and gaining a large amount of abdominal weight. Testosterone can help reinstall some sexual desire and increase your muscles. This treatment is only temporary and should depend on testosterone levels in your blood.
Non-prescription treatments for erectile dysfunction
You can also use a topical treatment such as injections into the corpora cavernosa of the penis. These contain substances that can help you get a good erection quickly, even without sexual stimulation. They are only available on prescription and are reimbursed by social security if your erectile problems are linked to serious, diagnosed physical damage (for example, following a prostatectomy after prostate cancer; paraplegia or tetraplegia; multiple sclerosis, etc.)
A doctor could also prescribe injections if you cannot take an oral treatment, or if other methods have been unsuccessful.
Men are often scared of this treatment because of how it is administered, however, it is not painful and the doctor will accompany you as long as necessary to explain and show how it should be done. Injections are made easier using an auto-injector pen: after you put the product together, all you have to do is take the protective cap off the needle and place it upon the skin for it to inject automatically.
Penile prosthetics through surgery are also available as a last resort. This option might be suggested to patients who have found no success with medical treatments, or whose health does not permit them to take them.
It is very important that you make a decision carefully, especially if you are opting for an implant so that you are well informed of the operation’s risks. Prosthetics are most popular with patients suffering from cardiovascular diseases and diabetes, for whom medical treatments are ineffective. There is no age limit for prosthetic insertion, but obviously, this should be a decision made by the patient, his partner and an experienced medical team.
Medical review on 6 August 2021 by Dr. Martin Trudeau