What are the available oral treatments?

Unfortunately there are some unscrupulous people willing to cheat the public. Advertised herbal tonics remain largely unregulated and are to be avoided except from a reputable UK based supplier. Tragedies have occurred from substitution by more dangerous herbs and even by poisonous drugs from some overseas herbal suppliers. Only EU certified medication is recommended or dispensed by askthedoctoruk clinic. The main current options, PDE5 phosphodiesterases, all act on a common pathway to open the circulation.

What other drugs interact adversely with oral Erectile Dysfunction medications?

HIV medication (Proteases) can intensify the action of the drug unpredictably. Commonsense suggests avoiding this drug combination completely. Similarly the Macrolide class of antibiotics Erythromycin, Clarithromycin, Azithromycin also can increase toxicity of these drugs, as can Cimetidine (an older class of peptic ulcer drug, less used currently). The Alpha Blocker class of medication used for benign prostate disease (eg Tamsulosin/ Flomax) as well as for blood pressure control also can drop the blood pressure dramatically if taking PDE5 medications and should not be taken together.

What non drug options do I have?

Common sense: reduce drinking to a sensible level and do not smoke. As an Australian doctor used to say “the more you smoke, the less you poke”. While we in UK are more polite, the message remains the same. Deal with stress. Many men lose sight of the fact that our recent ancestors spent a lot of time fighting for their territories. Look at an uncastrated tomcat to get the idea. When we stop exhibiting the aggression quite natural to us, largely to avoid legal and personal difficulties, we may then direct the anger inwards. This does us no favours. I suggest that patients join a gym and name the punching bag. If they are gardeners, to name the weeds as they dig them out. The practice of Martial Arts similarly permits a controlled used of this part of our masculinity.

Running or cycling achieves a fitter body and of course a sense of well being but does not address this warrior part of our natures.