Understanding the issue
Understanding the issue
There are both physical and psychological causes of ED and most men will experience a combination of these causes, with one type affecting the other and vice versa.
When to refer
- Anyone under 18 years of age
- Anyone taking any other medication
- If they have had a stroke or heart attack in the last six months
- If they have any other medical conditions – e.g., sickle cell anaemia stomach ulcers
- Those taking other medication for erectile dysfunction
- Any concerns about heart health, physical fitness or breathlessness
- If they are uncertain of their diagnosis or describing symptoms of premature ejaculation
- If the customer answers 'yes' to any questions on the Viagra Connect Pharmacy Checklist.
Remember
- Many people find it embarrassing to talk about sexual health so try and put them at ease by offering privacy and having a non-judgemental approach
- Think about what you say and how you say it. Tone of voice and gestures are as important as the words you use
- Explain why you require information to avoid them feeling defensive or intruded upon, for example by saying: “I need to ask you some questions to make sure this is going to be the right thing for you”
- Remember to protect confidentiality
- Highlight the risks of buying drugs over the internet and encourage customers to always visit a pharmacy to purchase them safely.
Causes
Men whose ED is due to a physical cause often experience a gradual onset of erectile problems. These physical causes can include:
- Cardiovascular disease (CVD)
- Diabetes
- Raised blood pressure (hypertension)
- Hormone problems
- Drinking alcohol
- Smoking
- Lack of exercise
- Using illicit drugs
- Some prescription medicines – e.g., some diuretics, antidepressants and hormone modifying drugs.
ED can be an early warning sign of future cardiovascular problems, appearing up to five years before a cardiovascular event, such as a stroke or heart attack. Future heart problems may be prevented if treatment for ED is undertaken soon after symptoms start, particularly if lifestyle changes are undertaken.
A psychological cause is more likely if a man has erection problems some of the time. This can include:
- Performance anxiety and the fear that ED will keep occurring
- Depression – ED may be a symptom of depression. The emotional stress commonly associated with loss of sexual function may also lead to, or aggravate, depression
- Lack of arousal and/or inhibition, e.g., premature ejaculation
- Major life stress such as money worries or a bereavement.
Typically, ED develops quite suddenly if it has a psychological cause. It may resolve when the person’s mental state improves – for example, if their anxiety or depression eases. For some men, ED can exacerbate such conditions, leading to a vicious circle of a worsening mental health issue and persisting ED.