Erectile dysfunction resources

In 1998 the first treatment for ED was released, Viagra®; a phosphodiesterase-5 inhibitor (PDE-5) which became known as the ‘little blue pill’. This simple pill was a game-changer for many men like you that had previously relied on treatments such as injections and vacuum pumps. In recent years other similar medications have been released, and more recently as the original patents have expired, the generic versions have also become available and are a popular choice among prescribers and men alike.

Branded	Generic
Viagra	Sildenafil
Cilais	Tadalafil
Levitra	Vardenafil
Spedra	Avanafil – Not yet available as generic

The first-choice treatment, for the majority of men, are oral tablets. They are usually very well tolerated and effective in about 80% of ED cases.⁶ Other treatments for ED are available through your GP if you cannot take the tablets or would prefer to use an alternative. These include creams that you apply to your penis, penis pumps, penile implants or injections, exercises or lifestyle changes, such as weight loss and reducing your alcohol intake. If the cause of your ED may be more psychological than physical, then counselling can be very effective.

All PDE-5 inhibitors work in the same way. These include Viagra, Sildenafil, Cialis, Tadalafil, Levitra, Vardenafil and Spedra.

When you are aroused your tissues release a chemical called nitric oxide (NO), this, in turn, causes the release of a second chemical called cyclic guanosine monophosphate (cGMP). cGMP causes the muscles at the sides of your penis to relax allowing blood to rush in. The veins that drain the blood from your penis also get compressed trapping the increased blood in your penis resulting in an erection.

An enzyme called phosphodiesterase-5 (PDE5) breaks down the cGMP and your penis returning it to its original state. PDE5 inhibitors such as Viagra/Sildenafil, work by blocking the action of PDE5, so your levels of cGMP remain high, the muscles at the side of your penis relax, more blood rushes in, and you can achieve a firmer and longer lasting erection. It is important to remember that PDE5 inhibitors only exert their action when you are sexually aroused, it does not increase your sexual desire, and it will not resolve any underlying physical causes of your ED.

If you measure your blood pressure at home, make sure you use a validated blood pressure monitor. Read the instructions thoroughly before you begin. It’s best to take your blood pressure when you are sitting down, with your back supported and legs uncrossed. Remove any clothing from your upper arm, if you cannot roll up your sleeve high enough, you should remove your top.

Hold out one of your arms so that it is at heart height, supported by a table or chair arm, and place the cuff snuggly around your upper arm. The tube that connects to the machine should be towards the inside or the centre of the arm. Try to relax and avoid talking while the test is carried out. You will feel the cuff expanding around your arm and a short squeezing feeling that may be a little uncomfortable. The pressure is then slowly released while the monitor ‘reads’ your results.

Your results will be shown on the digital display e.g.

People refer to their blood pressure as ‘120 over 80’. This means that the systolic pressure as your heart pushes blood out is 120mmHg and the diastolic pressure as your heart fills with blood is 80mmHg. P75 means that your pulse (heart rate) is 75 beats per minute.

Before taking your blood pressure, it’s important to avoid the following factors that may cause your blood pressure to rise temporarily:

• Cold temperatures
• Exercise
• Caffeine
• Stress
• Smoking
• Certain medications (check the label on your device)

Take at least two readings, 5 minutes apart. Enter the lower of the two readings during your online visit.

There are things that you can also try to help to improve your ED symptoms, aside from taking medications or alongside your medication. Men who are overweight are statistically more likely to experience difficulties with getting and maintaining an erection.⁸ So, if you’re carrying a few extra pounds, then you could look to improve your diet and increase the amount of daily activity that you do. We wouldn’t recommend crash dieting or diet fads. Instead, aim to eat a healthy, balanced diet by reducing ‘bad’ foods, such as processed foods, high sugar and high fat foods, and increasing your intake of ‘good’ foods like fruits and vegetables, lean meats and whole grains. Smoking and alcohol have also been associated with ED⁹, and by cutting back you may find improvements in your symptoms.

Stress, tiredness and anxiety can all be possible causes of ED but reducing your stress or take time out is much easier said than done. You could try giving yourself some ‘me’ time. Whether it is a cup of tea in a quiet room to collect your thoughts, a walk on your lunch break, relaxing past times such as yoga or simply sharing your worries with your friends and family, finding a way to lower your stress levels could improve your ED symptoms.