Erectile Dysfunction: Thinking Beyond Just a ‘Little Blue Pill’

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Given the advent of the internet, and most especially search engines such as Google, there is a plethora of information available at a person’s disposal. Every possible question that you could ask has an answer.

By Dr Dawid Mouton

The problem is that tools such as these bombard us with information without sound professional advice. These seemingly wonderous creations can easily lead to confusion through misinformation, ultimately causing dissatisfaction and frustration. This is especially true when dealing with complex medical conditions.

Whilst writing this article the top search suggestion when typing ‘erectile dysfunction’ into Google, related to medicated treatment. Unfortunately, most webpages are trying to sell you a magical or “natural” cure – sometimes even illegal ones! 

As a Urologist, I often see patients who are either completely unaware of the vast treatment options available for erectile dysfunction, or have only tried the proverbial ‘little blue pill’ to no avail. Rarely do these patients follow up with a medical professional, opting to rather suffer in silence. 

So what options are available for men suffering from erectile dysfunction? The short answer: Lots! Treatment options range from more conservative measures to surgery. The best angle of attack is to approach each case individually, usually starting with something less invasive and increasing the potency (pun intended!) as required. 

Since the basic pathophysiology of erectile dysfunction is based on vascular disease, it is important to start with improving your lifestyle. Weight loss, stopping smoking, exercising regularly and maintaining a healthy diet will not only make you feel better, but also improve your erections! New onset disease should be screened for diabetes, high cholesterol and underlying cardiovascular disease. 

Medication will be the next step. There are various drugs on the market, all with different pro’s on cons. If medication fails it might be due to poor technique (timing, dose, etc) or an individual’s response to a particular brand. Different types of medication can be tried after a medical professional review. There are also injectable solutions that can be attempted. Some men might be sickened by the idea of injecting something directly into their penis, but with the correct training this can be a very effective treatment option.

Vacuum devices can also be tried as an alternative to medication. This device sucks blood into the penis, leading to an erection, with constrictor band preventing the blood from flowing back out of the penis. When using this method of treatment, it is important to know exactly how to use this device to prevent injury, but if used correctly it can be very effective. 

One of the best, but most invasive methods of treatment is a prosthesis that is implanted into the penis. There are two broad categories, a malleable and an inflatable device. The malleable is a rigid implant that is bended downwards when an erection is not required. The inflatable device is activated with a switch in the scrotum, which allows cylinders implanted into the penis to fill with fluid causing an erection. This is an excellent “on demand” option to achieve a good, sustained response, with a very high patient (and partner) satisfaction rate. Although most men with erectile dysfunction will never need such invasive treatment, this is an excellent option for a disease that’s refractory to the more conservative treatments.  

A healthy sex life is key to any grounded relationship; something that is not simply about your partners satisfaction, but also your own. Erectile dysfunction should not be the reason that you decide to stop being intimate with your loved one.

Erectile dysfunction is also not something to be ashamed or embarrassed about. Although often not curable, it is almost always manageable. A Urologist can provide insight into the treatment options available and to help you to decide which is the best option for you.  


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