Erectile Dysfunction (ED)

Men who cannot get or maintain an erection that lasts long enough, or is not rigid enough, to complete sexual intercourse are considered to have erectile dysfunction.   

Normal physiology of an erection: 

An erection occurs when blood fills into two chambers known as the corpora cavernosa. This causes the penis to expand and stiffen: much like a balloon as it is filled with air. The process is triggered by impulses from the brain and the genital nerves. Anything that blocks these impulses or restricts blood flow to the penis can result in ED.

Apparently cyclists suffer more ED than other athletes as their seats are often not designed well enough to protect the perineum ( the area between the anus and scrotum) that contains arteries and nerves vital to sexual arousal.

Erectile dysfunction is reported by 1 in 5 men and that number increases with age. This does not mean growing older is the end of your sex life! 

Your GP will conduct a physical exam to establish if there are any signs of abnormalities or poor circulation or nerve trouble. The GP will organise blood tests to check testosterone levels, blood cell counts, blood sugar levels, cholesterol levels, and liver function.

You GP might also look into signs of cardiovascular disease as studies suggest that ED is a strong predictor of heart attack and stroke. Researchers suggest all men diagnosed with ED should be evaluated for cardiovascular disease but that this does not mean every man with ED will develop heart disease.

Changing life style factors

• Give up smoking 
• Lose weight 
• Exercising more often but do not cycle for a while (if you cycle for more than 3 hours a week)
• Do not drink more than 14 units of alcohol a week

Referral 

Your GP might recommend sex therapy, either on its own or in combination with other psychotherapy.

There's usually a long wait for these services on the NHS.

Medication 

Sildenafil (Viagra) is often used by doctors to treat erectile dysfunction. It is also available from chemists. Due to changes in regulations you no longer need a prescription to get Sildenafil but you must always remember to have a consultation with the pharmacist to make sure it's safe for you to take it.

There are other similar medicines called Tadalafil (Cialis), Vardenafil (Levitra) and Avanafil (Spedra) that work in a similar way. You will still need a prescription to get these medicines. Your GP may also prescribe Alprostadil (as a cream, as a pellet or as an injection). 

If ED is caused by a blockage in an artery leading to the penis then surgery can often restore blood flow.

Side effects

• Headaches        
• Flushing
• Dizziness
• Indigestion
• Drop in blood pressure
• Direct injection is invasive and involves an infection risk

  It's natural to feel angry or embarrassed when dealing with ED but don't forget that your partner is also affected. Talking openly about ED will help your partner understand the diagnosis and treatment options. This can reassure a partner that you haven't lost interest.

ED is more common in those with a history of obesity, or who have smoked, or to those who endure high levels of (work or domestic) stress, or those with a history of prostate or bladder cancer or benign prostate hyperplasure (that can sometimes damage nerves and blood vessels near the penis). Tiredness, anxiety, drinking too much alcohol, high cholesterol, the side effects of medication (including certain blood pressure drugs), antidepressants or tranquilizers can also be factors. 

Among men, with erectile dysfunction, those with diabetes may experience the problem as much as 10 to 15 years earlier than men without diabetes.  With the increase of the aging population, the worldwide prevalence of ED has been predicted to reach 322 million cases by the year 2025, making it a major health problem!

Other conditions that may cause ED include cardiovascular disease, atherosclerosis (hardening of the arteries), kidney disease and multiple sclerosis. These illnesses can impair blood flow to the corpora cavernosa and to the nerve impulses throughout the body.

Carbon dioxide is colour and odourless gas that is heavier than air. When bathing (to chest height) in a “dry carbon dioxide” the gas is absorbed through the hair follicles and skin into the capillaries and connective tissues. This (vasodilation) expands the blood vessel’s diameter which improves blood flow and the removal of waste products as well as increasing the transport of oxygen, nutrients and glucose to the tissues.

Effects:

Within the first couple of minutes  a client experiences pleasant heat and perspiration.

Blood pressure is decreased typically by 15-20mmHg Systolic and 10-15mmHg Diastolic

Benefits last up to six months:

Improves micro-circulation in the blood vessels of the penis and restores erection