Erectile Dysfunction
Erectile dysfunction, is used to describe a situation when men cannot have or maintain an erection for satisfactory sexual activity. This can sometime be caused by treatments for male specific cancer.
There are varying degrees of erectile dysfunction which can be measured, with the help of several different assessment tools, typically questionnaires.
Treating Erectile Dysfunction
There are several treatments available for erectile dysfunction. The specilaist healthcare team can discuss these options or are often able to refer men to experts who can provide more information and an assessment.
Pelvic Floor Exercises
Pelvic floor exercises are usually reccomended for men who have prostate cancer surgery to help improve potential urinary incontinence which they may experience after the operation. However they can also be used to improve erectile function.
The pelvic floor is the name for the layers of muscle that stretch from the tailbone at the back of the body to the pubic bone in front. The pelvic floor supports the bladder and bowel. Information on these exercises can be found here
Oral Medication
There are several different tablets such as Viagra (sildenafil citrate), Cialis (tadalafil) and Levitra (vardenafil) which can often improve erectile dysfunction.
These medications may work over different periods of time and usually require some form of sexual stimulation. After orgasm, the erection will fade as it would normally. If an erection lasts for more than four hours, men must seek medical attention.
Men may not be able to take erectile dysfunction medication if you they have cardiac or heart problems. They are also unsuitable if men are on nitrate drugs to treat angina and high blood pressure.
Other Treatments
Muse
This is a small pellet that can be inserted into the urethra. It can cause an erection which will remain after orgasm and will not subside until the drug has worn off, usually after 30-60 minutes.
If practising oral sex, a condom should be worn to prevent any possibility of a partner swallowing the pellet. It can cause some tenderness and discomfort in the penis.
Vitaros
This is a cream which can be applied to the surface of the penis and works in a similar way to MUSE.
Caverject Dual Chamber or Viridal Duo
These are injections which men can inject into the base of the penis. A very fine needle is used and the injection must be done slowly. Patients describe it feeling like ‘pricking a finger with a rose thorn’.
This treatment is not suitable for men who are taking anticoagulant medications such as Warfarin.
Vacuum Constriction Devices
These are mechanical aids that can help to achieve an erection. The erection is maintained by putting a constriction ring at the base of the penis. The ring should not be in place for more than 30 minutes. As soon as this ring is removed, the erection will end.
Vacuum devices may not be suitable for men who are taking anticoagulant medications like Warfarin.
Although lots of similar devices can be bought online or in sex shops, these are not necessarily suitable. Men who have had pelvic surgery or radiotherapy to treat cancer should be entitled to a medically approved device on prescription from their GP.
Penile Implants
These can work well if the above therapies have not worked but do require surgery. They are implanted by a urologist to ensure that they are fitted correctly. The implants can be either malleable or inflatable and controlled at will.
Psycho Sexual Therapy
Being able to have an erection relies on both physical and emotional stimulus. Going through cancer treatment can make men lose confidence in their bodies, their masculinity and their identity.
Psychosexual therapy is where men and if necessary their partners can talk about their sexual problems with a professional counsellor.
If you feel this would help you, your specialist health care team should be able to refer you to a counsellor or give details of local organisations that may offer this service.
Erectile Dysfunction Nurses
The following medical company has a helpline for men who are experiencing erectile problems where they canspeak directly to an Erectile Dysfunction nurse.
*Images courtesy of Lorraine Grover.