Erectile dysfunction treatment in Marbella

What is erectile dysfunction?

We talk about erectile dysfunction when there is a persistent or repeated difficulty in achieving or maintaining an erection sufficient for satisfactory sexual intercourse. We are not referring to an isolated, occasional episode, which can occur due to tiredness, momentary stress or alcohol.

An erection is a complex vascular and neurological phenomenon, also influenced by hormonal, metabolic, pharmacological and psychological factors. That is why, when the problem repeats, it makes sense to study it with medical judgement.

When should you seek advice?

A medical assessment may be useful when:

• the problem repeats or persists over time
• it affects quality of life or the couple's relationship
• there is a significant change from your usual erectile function
• cardiovascular or metabolic risk factors are present
• there are symptoms that could suggest hormonal alterations
• previously used treatments do not work well enough
• adverse effects or contraindications have appeared with previous treatments

An isolated episode does not mean disease. What matters is persistence and the impact on well-being.

An erection can also inform about general health

In certain patients, erectile dysfunction may coexist with cardiovascular and metabolic risk factors. That is why, beyond the symptom, a broader medical evaluation can be useful.

Erectile function may relate to aspects such as:

• vascular health and high blood pressure
• diabetes and insulin resistance
• lipid profile alterations (dyslipidaemia)
• overweight and obesity
• smoking and a sedentary lifestyle
• hormonal health
• certain medications

Not all erectile dysfunction indicates cardiovascular disease, but assessing the general context is part of good medical practice.

Medical assessment of erectile dysfunction

The assessment is individualised and, depending on the case, may include:

• Clinical history: onset and evolution of the problem, presence of spontaneous or morning erections when relevant, medical history, cardiovascular or metabolic conditions, usual medication, tobacco and alcohol use, lifestyle habits and previously used treatments.
• Physical examination when indicated.
• Individualised blood tests, assessing metabolic and hormonal parameters when there is a clinical indication (not a universal mandatory panel).
• Complementary studies in certain patients, which may require specialised tests.

When specific urological studies are needed —for example, penile Doppler ultrasound, anatomical evaluation or surgical assessment— the patient can be referred to the corresponding specialist.

Personalised treatment of erectile dysfunction

There is no single treatment suitable for all patients. The strategy depends on the probable cause, severity, medical history, medication, risk factors, response to previous treatments and the patient's preferences.

For educational purposes, the main lines of action include:

• Habits and risk factors: where appropriate, exercise, weight control, metabolic health, blood glucose, blood pressure, lipid profile, smoking cessation, sleep and reducing excessive alcohol consumption.
• Oral pharmacological treatment: there are oral medications that facilitate the erectile response and that must be selected according to history, contraindications and concomitant treatments.
• Intracavernosal treatment: an option for certain patients when oral treatment is not sufficient or not suitable (explained below).

Lifestyle changes are important, but they do not always replace medical treatment. No treatment should be understood as a promise of results.

Intracavernosal treatment

Intracavernosal injections are a therapeutic option used in certain patients, especially when oral treatment does not provide a sufficient response, is not tolerated or is not suitable.

The medication is administered directly into the corpora cavernosa and produces a local response intended to facilitate an erection. Different medications and combinations are used by this route —including, for educational purposes, papaverine— but the specific selection always depends on the medical assessment and on the applicable availability and regulation.

It is a treatment that:

• must be individualised and requires a prior medical assessment
• needs an individual dose adjustment
• requires adequate patient training for its use
• requires medical follow-up

For reasons of medical responsibility and regulation, this page does not include formulas, concentrations, doses or preparation instructions: that content belongs to the individual consultation.

Safety and follow-up

Treatments for erectile dysfunction must always be used under medical supervision.

In the case of intracavernosal treatment, and without alarmism, effects may appear such as:

• local pain
• haematoma
• fibrosis with prolonged use
• prolonged erection
• priapism (an abnormally prolonged erection)

An abnormally prolonged erection requires urgent medical attention. Follow-up is part of the treatment.

When do we refer to Urology or Andrology?

Clínica Valorian is not a Urology service. Certain patients may require assessment by Urology or Andrology, especially when the following are needed:

• specialised vascular tests
• anatomical evaluation
• study of Peyronie's disease
• management of an associated urological condition
• surgical treatment or a penile prosthesis
• other techniques outside the clinic's range of services

Coordination with the appropriate specialist is part of responsible medical care.

A confidential medical consultation

Erection problems are common and should not be a source of shame. The consultation at Clínica Valorian is carried out with discretion, respect and confidentiality.

The aim is to understand your case, explain the options clearly and support you in the decision, without promises or pressure.