Discussing erectile dysfunction (ED) with a doctor
Written by Dr David Delvin, GP and family planning specialist, and Christine Webber, psychotherapist
Are you worried that you may have
erectile dysfunction ? Well, you ought to talk to a doctor about it. Don't suffer in silence! But first of all, let's just make clear what ED is.
It's what people used to call impotence: an inability to get an erection when you want to. In other words, your penis won't get stiff enough when you want to have sex. Or it may get stiff for a while and then you 'lose' it. Satisfactory intercourse becomes almost impossible - which is very frustrating and distressing.
However, if this only happens to you once or twice, then you probably have nothing to worry about. All men have a so-called 'failure' in this department at some time in their lives. Likely causes of an occasional inability to get (and maintain) a good, hard erection include:
- anxiety
- tiredness
-
stress
- too much alcohol.
If it's only been a very rare happening with you, you've no need to feel anxious. If you experience problems regularly, then you clearly do need advice from a doctor.
Why should you see a doctor rather than someone else?
These days, other people – for instance, those who operate private clinics which charge you a lot of money – do try and offer advice about erectile dysfunction. But you definitely need to see a properly-qualified medical doctor.
Why? For several reasons:
- only a doctor can assess your case and decide whether you have any medical problem
- only a doctor can do any tests that may be necessary
- if it becomes necessary to prescribe medication – such as oral anti-ED drugs, only a doctor can do this.
How to check
In the UK it is a strict legal requirement that all practising doctors must be registered with the General Medical Council.
You can check whether any doctor is registered by going to the GMC's website.
So which type of doctor should you consult about ED?
There are various types of doctor who you can go and talk to initially. These include:
- your own GP
- a doctor at a family planning clinic
- a doctor at a youth advisory clinic (or Brook Advisory Clinic for young people)
- a doctor at a genitourinary medicine (GUM) clinic
- a private doctor - who could be a specialist in sex medicine, or a urologist (a surgeon who deals with the genital and urinary systems).
Talking to your GP
As a starting point, there's a lot to be said for talking to your own doctor. After all, he or she has your medical records, and may already know a lot about you (and your family).
If your GP can't actually help, he or she should know the name of another doctor to refer you to. However, we are aware that some men still find their GP somewhat unapproachable (or even embarrassed) on sexual matters.
If this is the case, you should talk to one of the other types of doctor listed above.
Building up the courage to visit a doctor
You may feel very diffident or even scared at the prospect of going to a doctor. But have courage: medical men and women are used to dealing with this sort of thing. These days, ED is so common that many GPs see half a dozen cases a week. It's quite a routine matter for them.
A good idea is to plan ahead. Work out what you're going to say to the doctor. In particular, think about what words you're going to use.
A lot of men feel quite petrified about how to express the problem in words. Some guys are embarrassed because they don't know how to pronounce the terms.
Others are scared that the terminology they would naturally use, like 'I can't get a hard-on', might offend the doctor. (This is unlikely!)
There really is no need to worry. All you need say is: 'Doctor, I think I've got ED.'
In the very unlikely event that the doctor doesn't understand you, just say: 'Erectile dysfunction,' instead of 'ED'.
Questions you may want to ask the doctor
- What do you think is the cause of my ED?
- Can it be treated?
- What treatments are available?
- Would simple alteration of my lifestyle help?
- Could any pills that I'm taking be causing this problem?
- Do I need tablets?
- If so, what side-effects could there be?
- Could I get my treatment free on the NHS, or do I have to pay for it?
- Will the problem ever go away so that I can stop using the treatment?
- Would you be willing to see my partner and explain the situation to her/him?
. Don't pretend you've got something else wrong
Many men are so ashamed about their erection difficulties that they pretend they've got something else wrong instead.
They go to their GPs about some real or made-up affliction, like backache, and when the doctor has sorted out that problem - and it's time to leave - the patient stops by the exit and says: 'Oh, there's another thing, doc. I think I'm impotent.'
Skilled doctors are well aware of this ploy, which they encounter regularly, but we couldn't really recommend it! It's simpler just to tell the doctor at the outset of your consultation that you think you have ED.
What will the doctor do?
A doctor who is used to dealing with ED will make time to talk to you about the problem, even if it means you coming back on another day.
If your doctor is not used to dealing with ED, he or she should send you to someone who is more qualified in this field.
The doctor will ask you a set of frank questions about erection and sex. You shouldn't be shocked by them.
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