The Mail on Sunday

The HOT topic

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TODAY THERE ARE SO MANY OPTIONS FOR MEN

LORRAINE Grover is a psychosexu­al nurse specialist based in London and Buckingham­shire and a trustee of the Sexual Advice Associatio­n (sexualadvi­ceassociat­ion.co.uk). SHE says: ‘ One man in ten suffers from erectile dysfunctio­n and many say Viagra has been fantastic for them. But this family of drugs, known as PDE5 inhibitors, which al so i nclude Cialis (tadalafil) and Levitra (vardenafil), only works for between about 70 per cent of men.

‘Those who tend to get little or no effect after taking it often have nerve problems.

‘Men with severe or uncontroll­ed diabetes can really struggle, as do those with low testostero­ne, particular­ly if they are on hormone treatment for prostate cancer.

‘ Then there are those who can’t take it for health reasons.

‘ Many people also don’t realise a man must be sexually aroused in order for Viagra to work. You don’t suddenly spring into life an hour or two after taking it while reading the paper.

‘But erectile dysfunctio­n can wreck relationsh­ips and cause t errible depression, which i s why i t’s so important for men know what other options are out there. ‘Injections into the penis to relax the muscles, allowing blood to flow through before sex, are one option. This sounds like every man’s worst nightmare but they really are effective. Vacuum pumps and constricti­on rings (to keep blood in the area) are another good alternativ­e. ‘For those who find pills work for them, but not at the right time, or who suffer from performanc­e anxiety, one option is to take a small, 5mg daily dose of Cialis, available on private

IT WAS VERY NEARLY SHELVED ...SOME THOUGHT IT WAS MORALLY WRONG

prescripti­on. At full dose, the effects of Cialis last twice as long as Viagra.’

THE FUTURE: GELS, STEM CELLS AND SHOCKWAVES

DAVID RALPH is a consultant urologist at University College Hospital London and in Harley Street. He is president of the Sexual Advice Associatio­n. HE SAYS: ‘ Viagra is the best option we have for erectile dysfunctio­n. But t here are promising treatments in the pipeline for men who can’t take or tolerate the tablets, or get no effect from them. I have been involved in developing a new gel that provides an alternativ­e, more localised treatment.

‘The key ingredient is glyceryl trinitrate (GTN), a drug that has been used to treat angina sufferers in the past.

‘It is applied to the penis and releases nitric oxide gas, which widens blood vessels and increases blood flow. Our research found that 44 per cent of men tested managed to achieve an erection after five minutes – 12 times faster than Viagra. It also avoided side effects such as headaches, and we hope it will be available to buy in the next couple of years.

‘ Another t reatment growing in popularity is shockwave therapy.

‘ Each 15- to 20- minute outpatient session involves shockwaves applied to the penile shaft. This encourages new blood- vessel formation in the penis. Studies show it to be quite successful, and it can help people who don’t respond to tablets.

‘Patients have anywhere between four and 12 sessions. A course of treatment costs about £3,000 privately.

‘From a research point of view, there is a lot going on with stem-cell therapy, where cells are injected into the genital area to encourage the growth of new blood vessels. This is still at a very experiment­al stage.’

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