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.