Erectile dysfunction can be caused by many factors, the most common being;

1. Physchological

2. Disease such as high cholesterol, diabetes, heart disease, vascular (this accounts for 73% of all cases), neurological, anti-depressant, tranquiliser therapy, blood pressure therapies, opioids, alcohol and smoking.

3. Hormonally low testosterone, high estrogen, high prolactin levels or thyroid disease.

4. Pyronies disease, which is the curvature of the penis and decreased circulation.

5. Aged related andropause which leads to a decrease in free circulating testosterone and or increase in estradiol levels.  

Before any treatment can be started, eliminating any of the above causes is essential, if however any of the above cannot be treated there are now many treatments available.

The blood levels of testosterone required to help male sexual problems vary. The normal serum range is between 300-1000ng/dL. Increasing the testosterone blood levels to between 400-600ng/dL may increase the likelihood of night time erections, increased sexual activity and increased libido. There are many therapies available. We have sublingual formulas which have an onset of action within 15 minutes and can be taken without regard to meals. We have topical formulas available which can increase nitric oxide concentration which is essential in maintaining an erection. These topical formulas have the same ingredients as the injectable formulas and can work quicker than orally taken therapies, but can cross contaminte with partners therefore need to be rubbed in well prior to activity. Other therapies available such as mixed injections act synergistically to increase circulation. Some natural supplements such as L-Arginine, ginseng, L-citrulline, N-acetyl carnitine and yohimbine are available in concentrated forms which may be appropriate after consultation with us at custom made medicine. Lifestyle changes which involve diet and exercise, pelvic floor exercises such as Kegel are highly recommended in conjuction with the therapies we provide.

Custom made medicine have also formulated therapies for pre-mature ejaculation to be used on demand. They are short acting with rapid absorption and elimination, taken 1-3 hours prior to sexual activity. Examples include clomipramine, paroxitine, dapoxetine or tramadol. These have a common effect in increasing serotonin levels.