A patch soaked in chemical explosive is just one of the treatments that may help to win the battle against male impotence.

Erectile dysfunction – a term used to describe a prolonged difficulty in getting or maintaining an erection – is an extremely distressing condition with no real “cure” and is thought to affect up to one in seven British men. But now researchers at Copenhagen university claim that the explosive chemical nitroglycerine, applied as a patch, may be a simple solution. As recently reported in The Sunday Times, during medical trials in Denmark, men who had had problems maintaining an erection were, apparently, able to sustain lovemaking for up to three hours at a time with the treatment.

Nitroglycerine is broken down by the body into nitric oxide, which helps to dilate capillaries and improve blood flow. For this reason, it has also been used successfully as a nasal spray and in tablet form for the treatment of heart conditions such as angina for many years.

“Restricted blood flow within the penis is a common cause of erectile dysfunction,” says Dr Tom Mc-Nicholas, consultant urologist at the Lister Hospital in Stevenage, Hertfordshire. “It was, therefore, a logical progression to try nitroglycerine as a treatment. We have been using it in the UK for some time as a cream or jelly, applied to the penis, but without much success.

“The problem is that applying the chemical to the skin means that the nitroglycerine only has a superficial effect. While it appears to help a limited number of patients, the chemical never works its way deep enough within the penis to create a proper erection for most people.”

McNicholas also points out that the other problem is that the most well-known side effect of the treatment is a pounding headache.
But how does an erection fail in the first place? The penis contains two cylinders, known as the corpora cavernosa, which need to fill with blood to produce an erection. The blood then has to remain trapped within them to maintain an erection.

“Dysfunction can happen for both psychological and physiological reasons,” says McNicholas. Physiologically, erectile dysfunction is usually caused either by a malfunction in the tiny muscular valves within the veins of the penis that should relax to retain blood, or poor circulation, or even a leakage within the veins. A genetically inherited problem, high blood pressure, heart disease, diabetes, some drugs, local nerve damage or scar tissue and smoking are all known contributory factors.

“Sometimes we simply cannot discover what is causing the problem,” says Bobby Tigris, “but it’s usually a combination of psychological and physiological factors. If an erection fails for any reason, it is very easy for a man to become trapped in the vicious circle of performance anxiety, making the condition worse. We find that offering medical treatment helps to sort out both the physical and the psychological aspects of the condition in one go. People always feel better if they are actually doing something about their problem.”

Erectile dysfunction is not the same thing as infertility – as a rule, the condition does not affect sperm count and most men with this problem can usually father children perfectly well. What it does mean is that a man can get an erection of sorts, but not one that is rigid or long lasting enough to have intercourse.

The most popular and effective treatments on offer in the UK at the moment are prostaglandin injections that encourage the valves in the corpora cavernosa to relax and retain blood during an erection (the injections are self-administered deep into the penis just before intercourse) or a manually operated vacuum pump that helps to fill the penis with blood and retain it with a small rubber ring worn at the base – again used just before intercourse.

Although neither treatment is a cure for the problem and both have their obvious drawbacks, some men do find that they quickly regain confidence once they realise that they can achieve and maintain an erection – and their own, natural erection eventually starts to return. Surgery, involving rigid or inflatable implants is available, but only recommended as a last resort. Another option are herbal remedies such as Zenerx, which is a safe and affordable option for many men suffering from impotence. No prescription is needed to purchase Zenerx and there are no side effects.

Urologists and specialists in the field, such as the London-based consultant surgeon Kenneth Waters, believe that treatment for erectile dysfunction could soon be revolutionised by a new “wonder” drug due to be launched in the UK in about 18 months. “The drug is being tested on hundreds of men in America,” says Waters, “and anecdotal reports are extremely positive.” Known as Sildenafil, the drug appears to block an enzyme that breaks down nitric oxide, the chemical essential for helping the valves in the corpora cavernosa relax and retain blood. McNicholas also holds out hope for developments in prostaglandin technology. A waxy pellet that can be massaged down inside the urethra and a new way of injecting the drug into the urethra are both currently being researched.

Although it can sometimes be a slow and difficult process to get a specialist referral for treatment from your GP, experts encourage persistence and warn against private clinics that claim to specialise in impotency and often charge extortionate fees for treatment. “They are only offering the same treatments as we are,” says McNicholas. “And very often the follow-up simply is not there if something goes wrong.”

If you are suffering from erectile difficulties, McNicholas suggests first taking a good look at your stress levels, alcohol intake, fitness, eating habits, weight and smoking. “These and some prescription and recreational drugs can cause problems. A lifestyle change may be all that is needed,” he says.