ERECTILE DYSFUNCTION

“Erectile Dysfunction” (ED) is a rather medical-sounding name meaning ‘difficulties with achieving or maintaining an erection’. Problems can be mild, short term and intermittent, or severe and entrenched. The word “Impotence” describes the more severe end of the spectrum of ED. Most men with ED would be in the mild to moderate end of the spectrum. The quality of an erection varies anyway in normal men from time to time, and may deteriorate naturally with age. This does not however mean that sexual activity cannot be enjoyable into later life even if the man’s erections aren’t quite as good as they were when he was young.

Our approach at MenzMedical is to obtain a thorough history of the problem, and do a complete physical examination and blood tests. After careful analysis, we advise the man what the most likely cause is, and tailor a solution for him.

Prior to attending for the 1½ hour consultation, we request if possible that the man attend the laboratory after fasting for 12 hours, to have some blood taken off for analysis. If he attends at the lab at least 2 business days prior to coming for the medical, nearly all the results will be back, so we can discuss them with him (and/or his partner) during the consultation with the doctor. See below if you do not wish to have a full medical check (WOF).

TREATMENTS

TABLETS

Sildenafil is the generic name for Viagra® (registered trade mark of Pfizer Corporation). Viagra® was developed by Pfizer in their research facility in Sandwich, Kent, UK in the late 80s/early 90s. The drug was introduced to the public in 1998, and almost overnight, became very popular as the primary treatment for ED. In 2011 Viagra® was been rebranded as Avigra® in New Zealand (Pfizer). Avigra® is identical to Viagra® in all but name. There are also other brands of sildenafil available such as Silvasta® (Douglas Pharmaceuticals) and Vedafil® (Mylan). As a result of the patent expiring on sildenafil, the price of all the brands, is now a fraction of the price of the original sildenafil. The “window of opportunity” for sildenafil is approximately 3 to 4 hours. Recently, Medsafe NZ has allowed Douglas to reclassify Silvasta® from prescription to OTC (over the counter). Patients over 35 can obtain the drug without prescription if they qualify by answering a few questions about their health. Our policy is to check on the man’s smoking status and heart status ensuring that he has had a blood pressure check, diabetes check, and cholesterol check within the last year. We can do this for you. Full dosing information will be given at the time of sale.

Tadalafil (which goes by the trade name “Cialis”® and is a trade mark of Eli Lilly corporation) is a longer lasting version of sildenafil, with a window of opportunity of up to 36 hours

THE SELF-INJECTION METHOD

This method was developed by Ronald Virag in France in 1980. He discovered that injecting a vaso-dilating (artery dilating) drug into the expanding part of the penis (the corpus cavernosum) could medically induce an erection, lasting up to an hour. The success rate is extremely good with few side effects. The method has a lot of advantages apart from the fact that it needs to be administered with a fine needle at the base of the penis 10 minutes before sexual intercourse. It is quick-acting, safe for men with heart disease, and has a higher success rate than sildenafil. In a way, it bypasses the need for the brain to instruct the penis to become erect, so is more likely to work even if the man is anxious.

THE VACUUM PUMP

This is older technology which is based on the principle of applying a negative pressure (vacuum) to the outside of the penis to cause it to fill up with blood and become engorged. The subsequent erection is maintained with the use of an elastic ring at the base of the penis to retain the blood in the chambers. The ring can be left on for up to half an hour.