Ask a doctor; Your erectile dysfunction questions answered 7 years ago

Ask a doctor; Your erectile dysfunction questions answered

We asked for your erectile dysfunction queries the other week and now we have the answers for you.

Erectile dysfunction (ED) or premature ejaculation (PE) can damage the self-esteem of even the most confident and self-assured of men. But guess what? The inability to maintain an erection affects 1 in 10 men in Ireland.  ED and PE aren’t selective or exclusive, they can be persistent or fleeting, but their effects can have a devastating and long-lasting impact on a man’s life.

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There is also a lot of confusion about the difference between ED and PE. ED is the inability to maintain and sustain an erection, and ejaculation is considered premature if it happens within two minutes of penetrative sex. We know that where bedroom troubles begin, relationship stress and confidence issues often follow so read on because Dr Gigi Taguri from Lloyds Online Doctor is here to put your mind at ease.

I'm a fit guy who exercises, however, I do have problems getting it up. Sometimes I can't get hard and other times it doesn't last for long. How can I improve the firmness and the length of my erection? It's effecting me having sexual relationships. JR, Age 21

This can be particularly upsetting and several of you wrote to me explaining that you have trouble obtaining or sustaining an erection despite the fact that you are otherwise fit and healthy and/or are in a committed relationship. There could be several underlying reasons for this.

For many men, the inability to maintain an erection can knock your confidence which is perfectly understandable, but unfortunately, you can then get yourself into a psychological cycle which is difficult to break even if you think you’re ok. If you are able to have a morning erection and an erection when masturbating and are otherwise young, fit and healthy it’s likely the root of the problem is more psychological, and in such cases an assessment to see whether ED medication is suitable for you would be best as this can help break the cycle.

However, it is important to remember that ED can be the first sign of other conditions such as high blood pressure, cholesterol, diabetes or other hormonal problems and even though you feel you are fit and health it is worth also getting tested for these conditions.

I sometimes have difficulty in maintaining and erection, I have spoken to my Doctor who gave me Levitra tablets which worked initially but now I can’t get hard no matter how much my girlfriend does? RK, Age unknown

There are several possible reasons - one being that your underlying cause of ED may have got worse. If you’re under an increasing amount of stress, drinking more alcohol, or have an undiagnosed or poorly condition such as high blood pressure, cholesterol or diabetes, then you could find this manifests itself in the bed room. I would recommend getting tested for these conditions and also trying a higher dose of the drug you’ve been prescribed or switching to a new medication such as Viagra (Sildenafil) or Cialis as it’s important to find the best one for you. My colleague Dr Tom has written a piece uncovering the differences between Viagra and other ED pills, which may be useful.

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What are the best tips you have to last longer in the bedroom? CS, Age 28

PE and ED are really common problems which can affect your ability to have an enjoyable sex life. Here are my top three tips to help you get your confidence back in the bedroom:

1.Ease off on the alcohol, and stay away from recreational drugs as these all affect your ability to last a long time.

2.Exercise and eat well since there are significant links between diabetes, high blood pressure and both ED and PE.

3.Try the ‘squeeze technique’. When you are just about to ejaculate, squeeze your penis with at the point where the head joins the shaft and your impulse to ejaculate will be reduced. With time, you should recognise this impulse and be able to build control without squeezing. Maintain the squeeze for several seconds until you feel your impulse to ejaculate pass. After you release the squeeze, wait for around 30 seconds, then go back to foreplay. You may find that your penis becomes less erect during this period – this is normal.

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And remember: Never buy medication from an illegal or untrustworthy online pharmacy. Irish registered doctors at Lloyds can issue paper prescriptions and a free online assessment so you can work out what treatment is suitable for you before you commit.

If you found this useful, don’t forget that in two weeks Dr Gigi will be answering your questions on weight loss to help you get healthy this summer. Here's the link to the confidential question form and don’t forget to follow @LloydsOnlineDoc

Lloyds Online Doctor provides men with consultations and prescriptions for a range of treatments including erectile dysfunction, weight loss, stop smoking and home STI test kits. Launched in July 2013, the service has treated over 20,000 Irish patients so far. To find out more about the service visit www.lloydsonlinedoctor.ie