Understand the cause. Restore confident performance.

Yes - many cases of ED are fully reversible, especially when the underlying cause is identified and treated early. Reversibility is highest for vascular ED treated with lifestyle changes and Li-ESWT, hormonal ED corrected with TRT, and medication-induced ED resolved by changing the offending drug. Some longstanding or severe cases require ongoing management rather than complete reversal.

Yes - diabetes is one of the strongest risk factors for ED, making it 2-3 times more common in diabetic men. Both diabetic neuropathy (nerve damage) and diabetic vasculopathy (blood vessel damage) contribute. Good glycaemic control significantly improves ED outcomes, which is why diabetes screening is part of every Hisential ED workup.

ED can occur at any age, but prevalence rises sharply with age - from approximately 10% at age 30 to over 50% at age 70. Younger men with ED most often have psychological, lifestyle, or medication-related causes; older men more often have vascular and hormonal causes.

Yes - every aspect of your treatment at Hisential is confidential. Your records are encrypted, our consultation rooms are private, and your personal health concierge is the only contact who knows your file end-to-end. We do not share information with employers, family, or insurers (unless you initiate a claim) without your explicit consent.

PDE5 inhibitors take effect in 30-60 minutes per dose. Li-ESWT effects accumulate over a 6-12 session course delivered across 6 weeks, with continued improvement for several months afterward. Hormonal interventions show meaningful effect over 8-12 weeks. Lifestyle changes show partial benefit within 4-6 weeks and continue improving for several months.

Not necessarily. Many patients use PDE5 inhibitors only as needed, and a substantial proportion are eventually able to discontinue medication entirely once underlying causes are addressed. Whether long-term medication is needed depends on the underlying cause and how completely it can be reversed.

Yes - but they are generally mild and transient. The most common are headache, facial flushing, nasal congestion, and indigestion. Visual disturbances are rare. Serious side effects are uncommon, but PDE5 inhibitors are contraindicated in men taking nitrate medications for chest pain - full medical history is reviewed at consultation.

Yes - psychological stress is a significant cause of ED, particularly in men under 40 with otherwise healthy cardiovascular and metabolic profiles. Performance anxiety, work stress, depression, and relationship factors all contribute. Treatment frequently combines clinical evaluation with psychological support and addresses both physical and psychological components.

Often, yes. ED can precede diagnosed cardiovascular disease by 3-5 years and shares most major risk factors with heart disease. This is why every Hisential ED workup includes cardiovascular risk assessment - treating one frequently improves the other.

ED (erectile dysfunction) is difficulty achieving or maintaining an erection. PE (premature ejaculation) is reaching climax sooner than desired. They are distinct conditions, though they sometimes co-occur. Hisential treats both - see our premature ejaculation treatment page for PE-specific information.

Testosterone testing is recommended when ED is accompanied by reduced libido, fatigue, mood changes, muscle loss, or other symptoms suggestive of hypogonadism. It's not a routine first-line test for isolated ED, but it's a critical investigation when the clinical picture suggests hormonal involvement.

Li-ESWT uses low-intensity acoustic shock waves to stimulate new blood vessel formation in penile tissue. The mechanical stimulus triggers cellular responses that promote angiogenesis and tissue regeneration over a period of weeks to months. Unlike medications, which provide on-demand effect, Li-ESWT addresses the underlying vascular cause for sustained improvement.

No - most patients describe the sensation as mild tapping or pressure, not pain. The procedure is non-invasive, requires no anaesthesia, and has no downtime. Mild discomfort during the session and occasional bruising are the most commonly reported effects.

A typical course is 6-12 sessions delivered over 6 weeks. The exact number depends on severity and response. Most men begin to notice improvement after 3-4 sessions, with continued improvement for several months after the course ends.

Yes, in moderation. PDE5 inhibitors and small-to-moderate amounts of alcohol are generally safe together. However, heavy alcohol consumption itself impairs erectile function and reduces medication effectiveness. We recommend keeping intake to ≤2 standard drinks on the day of use.

Several next-step options exist if PDE5 inhibitors don't produce a satisfactory response. These include dose adjustment, switching to a different PDE5 inhibitor, daily-dose tadalafil, Li-ESWT for sustained vascular improvement, intracavernosal injection therapy, vacuum erection devices, or - in severe cases - penile prosthesis. Hisential will discuss the appropriate next step based on assessment.

No - Hisential's consultations are designed to be matter-of-fact and judgment-free. our medical team conducts thousands of these conversations each year and approaches every consultation with directness and discretion. Most patients describe the experience as more comfortable than expected.

Only if you authorise it. Hisential does not contact your GP or share information with any other healthcare provider without your explicit written consent. If you'd like a treatment summary sent to your GP for continuity of care, your personal health concierge will arrange that.