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How to Treat Impotence?

Things to note:
  • Thorough medical and psychosexual history.
  • Examination should exclude gynaecomastia, testicular atrophy or penile abnormalities.
  • Consider the removal of drugs that may be associated with the problem.
  • A change in lifestyle or drugs may resolve the problem.

Medical Treatment:
Treat the underlying condition.
In patients with proven testosterone deficiency:
  • Testosterone. Specialist initiated.
Screen hypogonadal men for prostate cancer before starting the replacement of testosterone.
Individualise dosage and review doses based on clinical response.
  • Testosterone cyprionate, deep IM, 200-300 mg every 2-4 weeks.
Monitor prostate cancer patients as normal during the treatment.

When to refer:
  • Where an organic disease or medical condition is suspected as a cause.
  • To a urologist or appropriate specialist if surgical intervention is needed, e.g. penile prostheses, vascular surgery and pelvic fractures.