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Men's Health Clinic In Pretoria, Tshwane | South Africa

Men's Health Clinic

Erectile Dysfunction

What is Erectile Dysfunction?

ED is defined as the inability to achieve and/or maintain an erection sufficient for satisfactory sexual intercourse. Studies have shown that 52% of men suffer from some form of erectile dysfunction and that number increases with age. While it is most prevalent in older men, it can be a problem for men of all ages.

What Causes Erectile Dysfunction?

There are many causes of erectile dysfunction:

  • Diabetes
  • Hypertension
  • High Blood Cholesterol
  • Cardiac Diseases
  • Low Testosterone Levels
  • Illicit Drug Use (Excessive Alcohol Consumption and Smoking)
  • Prostate Problems
  • Side Effects From Prescription Medications

Other less common causes include stress, low sex drive, guilt, anxiety, sexual boredom, or even depression. 

It is well known that penile health and overall health are closely related. Problems achieving and maintaining erections can be an early warning sign of some other diagnosed medical problems. It is important to seek medical advice as soon as symptoms first appear.

Treating Erectile Dysfunction

ED is best treated promptly. The sooner it is properly diagnosed and treated, the better the outcome and possibility of full recovery. Many treatment options exist and your ED doctor can determine the most appropriate treatment plan for you, based on your condition and personal situation.


The convenience of oral medications, like Viagra® and Cialis®, often makes them the first-line of treatment for Erectile Dysfunction. PDE5 inhibitors are effective for many men and work by relaxing the smooth muscles in the penis to help increase the blood flow. Men who take nitrates should not use these medications given the potential for an unsafe drop in blood pressure. Other potential side effects have been reported such as sudden vision or hearing loss, congestion and headaches.


Considered a very effective treatment for Erectile Dysfunction, ICP involves an injection of a combination of FDA-approved vasodilators into the spongy tissue of the penis, using an auto-applicator. This combination causes an expansion of the penile arteries and penile tissues, resulting in increased blood flow to the penis.  An erection typically develops within minutes and studies have shown it works in up to 95% of men. Because ICP is non-systemic, it is often recommended for men with diabetes, heart conditions and high blood pressure.


A VSD is a battery or manually-operated cylindrical pump that slides over the penis. When activated, it sucks air out of the sealed chamber, which draws blood to the penis. An elastic ring is placed around the base of the penis which helps keeps the penis firm enough for sexual penetration. This process can be time consuming and interfere with spontaneity. Sometimes the elastic ring can cause skin irritation or discomfort. VSDs are valuable when used in conjunction with other Erectile Dysfunction medications.


MUSE contains a vasodilator known as Alprostadil prepared in the form of a pellet that is inserted into the urethra, via an applicator. The medication is absorbed through the urethral wall into the erectile chambers known as the corpus cavernosa.


While effective in a small number of extreme cases a penile implant surgery should only be a treatment of last resort. The surgery involves placement of an implant, prosthesis, into the penis.  There are two types of implants, malleable and inflatable but both help restore rigidity to allow for penetration. Once an implant is inserted it must always be used to get an erection. Complications can include infection, bleeding, pain and discomfort or mechanical failure.


A very small percentage of patients are candidates for vascular reconstructive surgery. Additionally, this procedure is costly and not always effective so it is rarely recommended. Risks include those related to other major surgical procedures. This treatment is most effective for younger patients whose condition is caused by a pelvic or genital injury.


Low Testosterone levels is not a common cause of Erectile Dysfunction but in cases where inadequate production or testosterone does lead to ED, testosterone replacement therapy can be effective.  More often Low Testosterone is a contributing factor and is better used in conjunction with a more direct treatment for ED.  For many men, TRT can also be valuable in improving their sex drive which helps in achieving and maintaining erections.

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