Erectile Dysfunction — Assessment & Treatment
Erectile dysfunction is one of the most common conditions in men — and one of the most successfully treated. Rather than simply prescribing medication, Mr. Jesuraj investigates the root cause and builds a treatment plan around your specific situation.
Completely Discreet
A private, professional setting. Your consultation is handled with complete confidentiality.
Root Cause Investigation
Not just a prescription — a thorough assessment to find what’s actually causing the problem.
ED as a Health Signal
ED in younger men is often an early warning sign of cardiovascular disease — important to investigate.
UNDERSTANDING ED
You Are Not Alone — and This Is Treatable
Erectile dysfunction affects an estimated 1 in 5 men in the UK — rising significantly with age, but increasingly common in younger men too. Despite being so prevalent, most men delay seeking help for years due to embarrassment or the mistaken belief that nothing can be done.
ED is defined as the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual activity. It can be caused by physical factors, psychological factors, or — most commonly — a combination of both. Understanding which is driving your symptoms is the key to effective treatment.
Importantly, ED in men under 50 is associated with an increased risk of cardiovascular disease. The blood vessels that supply the penis are small and can show signs of disease earlier than larger vessels. A proper assessment is therefore not just about sexual function — it can be an important health check.
1 in 5
men in the UK affected by ED
70%
of ED cases have a physical cause
40%
of men over 40 experience some degree of ED
Most
cases are highly treatable with the right approach
What Causes Erectile Dysfunction?
ED is rarely simple — it usually involves an interplay of physical and psychological factors. Identifying which are at play is the foundation of effective treatment.
Physical Causes
- Cardiovascular disease & poor blood flow
- Diabetes mellitus (Types 1 & 2)
- High blood pressure (hypertension)
- High cholesterol
- Hormonal imbalance — low testosterone
- Obesity & metabolic syndrome
- Neurological conditions (MS, Parkinson’s)
- Peyronie’s disease — penile scarring
- Side effects of medication
- Previous pelvic surgery or radiotherapy
- Smoking, excessive alcohol
Psychological Causes
- Performance anxiety
- Depression & low mood
- Relationship difficulties
- Stress — work, financial, life events
- Past sexual trauma
- Low self-confidence or body image
- Fear of intimacy
Psychological ED often presents with normal morning erections and erections during masturbation — an important diagnostic clue that helps distinguish psychological from physical causes.
Mixed Causes — Most Common
Most men with ED have a combination of physical and psychological factors. A physical cause reduces erectile function, which then triggers performance anxiety — which further worsens the physical problem. This cycle is very treatable once both elements are addressed.
Even when the root cause is physical, psychological support and lifestyle changes are an important part of effective treatment.
A Thorough Approach — Not Just a Prescription
Mr. Jesuraj takes a comprehensive approach to ED — going well beyond simply prescribing a PDE5 inhibitor to find what is really driving your symptoms.
1
Detailed History
A thorough exploration of your symptoms — onset, severity, presence of morning erections, relationship factors, psychological wellbeing, medications, smoking and alcohol. This alone often points strongly to the likely cause.
2
Physical Examination
Assessment of blood pressure, cardiovascular risk factors, signs of hormonal imbalance, genital examination for Peyronie’s plaques, testicular size and any neurological signs.
3
Targeted Blood Tests
Testosterone, LH, FSH, prolactin, blood glucose (HbA1c), lipid profile, thyroid function and full blood count — tailored to your specific presentation and risk factors.
4
Penile Doppler Ultrasound
Where vascular ED is suspected, a penile Doppler study can assess blood flow in the penile arteries directly — identifying arterial insufficiency or venous leak as specific causes.
5
Tailored Treatment Plan
Based on all findings, a personalised treatment plan is prepared — addressing the specific physical and psychological factors identified, not a one-size-fits-all approach.
TREATMENT OPTIONS
How We Treat Erectile Dysfunction
Treatment is always personalised. The right option depends on the cause, severity, your preferences and your overall health.
Oral Medication (PDE5 Inhibitors)
Sildenafil (Viagra), tadalafil (Cialis) and vardenafil are effective for many men. However, they work best when the underlying cause is addressed simultaneously — and don’t work for everyone. Mr. Jesuraj advises on the right agent, dose and timing for your situation.
Hormone Therapy
Where low testosterone (hypogonadism) is identified, testosterone replacement therapy can dramatically improve erectile function, libido and energy levels. This requires careful assessment and monitoring.
Intracavernosal Injection Therapy
Alprostadil injections directly into the penis produce reliable erections regardless of the cause of ED. Effective when oral medication has failed. Mr. Jesuraj provides full instruction and follow-up for self-injection therapy.
Vacuum Erection Device
A non-invasive mechanical device that draws blood into the penis to produce an erection. Particularly useful following pelvic surgery or where medication is contraindicated. No side effects, no medication.
Psychological Support & Referral
Where anxiety, depression or relationship factors are contributing, referral to a psychosexual therapist or clinical psychologist is an important part of treatment. Mr. Jesuraj works collaboratively with psychological services.
Lifestyle Modification
Addressing the modifiable risk factors that drive vascular ED — weight, exercise, smoking cessation, alcohol reduction, blood pressure and cholesterol control. These changes can produce significant improvements in erectile function independently of medication.
DON’T WAIT
When Should You Seek Help?
There is no threshold of severity you need to reach before seeking assessment. If ED is affecting your quality of life, your relationship, or your confidence — that is reason enough. Early assessment also means earlier identification of any underlying cardiovascular or hormonal conditions.
Frequently Asked Questions
Interested?
Book a consultation with Mr. Jesuraj to find out if you are a suitable candidate. Appointments available within days.