Dr Derran M Govender treats erectile dysfunction at his practice in Durban North. He prefers a low-dose treatment taken three times a week. It costs less than on-demand tablets, has very few side effects and means you don’t have to time your medication around sex.
What causes weak erections?
Erections depend on healthy blood flow, healthy nerves and healthy hormones. Common causes of weak erections include:
- poor blood flow from high blood pressure, high cholesterol or smoking
- diabetes and insulin resistance
- low testosterone
- excess weight
- some medications, including certain blood pressure tablets and antidepressants
- stress, anxiety and poor sleep
Weak erections can be an early warning sign of heart disease or diabetes, so it’s worth getting checked.
Diabetes and insulin resistance. Erection tablets help at first, but on their own they only mask the problem. Over time, insulin resistance damages the erectile tissue itself. The smooth muscle that lets the penis fill with blood is gradually lost and replaced by scar tissue, so less blood can flow in.
Low-dose Cialis three times a week
Dr Govender prefers Cialis (tadalafil) 2.5 mg, taken on Monday, Wednesday and Friday.
- No timing needed. Cialis stays active in the body for days, so with regular doses you’re ready whenever the moment comes.
- Fewer side effects. At this low dose, side effects such as a blocked nose or headache are rare.
- Lower cost. Three small doses a week cost less than high on-demand doses.
- Other health benefits. Regular low-dose tadalafil can improve blood vessel health and eases prostate and urinary symptoms (BPH).
How Cialis makes sex better
Cialis works by improving blood flow to the penis when you’re aroused. In practice, that means:
- Firmer erections. More blood flow gives a harder, more reliable erection.
- Erections that last. It’s easier to keep an erection for the whole of sex, not just at the start.
- Confidence. Knowing your erection will hold takes away performance anxiety, which is itself a common cause of erection problems.
- Spontaneity. With regular low doses, Cialis is always active, so sex doesn’t need to be planned around a tablet.
Many patients also say they last longer, recover faster between rounds and that sex simply feels better.
Erections and libido are different. Cialis doesn’t increase your sex drive. Low libido is usually hormonal. In men, it’s often caused by low testosterone, which Dr Govender treats with TRT. In women, low libido is usually linked to menopause and is treated with hormone replacement therapy.
Heart and blood pressure check
Because weak erections can point to heart disease or diabetes, Dr Govender checks your heart and blood pressure before starting treatment. This matters most for men who have high blood pressure or take blood pressure medication. Cialis must never be taken with nitrates, such as chest-pain sprays or tablets.
An ECG test is one part of the heart assessment that may be discussed during your consultation.
What to bring
Please bring:
- your ID
- your medical aid card, if applicable
- a list of your current medicines
- any previous test results
Fees and medical aid
The practice accepts all major medical aids. For fees, contact the practice.
Appointments
The practice is open Monday to Friday, 09:00 to 17:00, and walk-ins are welcome. Book an online or in-person appointment.
Frequently asked questions
What is the difference between Cialis and Viagra?
Both improve erections by increasing blood flow to the penis. Viagra (sildenafil) wears off within a few hours, so it has to be timed around sex, and it more often causes side effects such as headache, flushing and a blocked nose. Cialis (tadalafil) lasts much longer. Taken in small regular doses, it keeps you ready at any time with fewer side effects. That’s why Dr Govender prefers Cialis.
Is there a permanent cure for erectile dysfunction?
Sometimes, yes. Treating the cause is what makes the difference. Fixing insulin resistance, low testosterone or excess weight, and getting blood pressure and cholesterol under control, can restore erections, especially when they’re addressed early. Cialis helps in the meantime, but long-term results come from treating the underlying problem.
What is the latest treatment for erectile dysfunction?
The biggest change in ED treatment is the move to low, regular doses of tadalafil instead of large on-demand doses. It’s combined with treating the root causes, such as insulin resistance and low testosterone.
References
- Porst H, Giuliano F, Glina S, et al. Evaluation of the efficacy and safety of once-a-day dosing of tadalafil 5mg and 10mg in the treatment of erectile dysfunction: results of a multicenter, randomized, double-blind, placebo-controlled trial. Eur Urol. 2006;50:351–359. Read source
- Roehrborn CG, McVary KT, Elion-Mboussa A, Viktrup L. Tadalafil administered once daily for lower urinary tract symptoms secondary to benign prostatic hyperplasia: a dose finding study. J Urol. 2008;180:1228–1234. Read source
- Thompson IM, Tangen CM, Goodman PJ, Probstfield JL, Moinpour CM, Coltman CA Jr. Erectile dysfunction and subsequent cardiovascular disease. JAMA. 2005;294(23):2996–3002. Read source
- Castela Â, Costa C. Molecular mechanisms associated with diabetic endothelial-erectile dysfunction. Nat Rev Urol. 2016;13:266–274. Read source