The Ashe Street Clinic, Tralee

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Erectile Dysfunction (ED) Treatment

Erectile dysfunction (also known as impotence or ED) is a very common condition, which affects the majority of men at some point in their lives. Up to 50% of men aged 40 - 70 and up to 70% of men over the age of 70 suffer from erectile dysfunction to some extent. There are several treatment options, which are currently licensed for the treatment of erectile dysfunction in the Ireland. Modern treatments are safe, affordable and effective and can help up to 80% of men with erectile dysfunction.


What Causes Erectile Dysfunction?

There are many causes of erectile dysfunction and the process of achieving an erection is complicated. These causes can be either physical or mental.


Physical factors may include:
High blood pressure
High cholesterol
Cycling for long periods
Kidney, liver or thyroid disease
Some medications
Low testosterone (male sex hormone)
High prolactin

Mental factors may include:

Although one or two small drinks can relax a man before sex, too much alcohol over a long period of time can damage the nerves leading in the penis which can cause ED; getting drunk can cause “Brewer’s droop”.

Although there are many causes for erectile dysfunction the primary cause for over 70% of men is usually a narrowing of the arteries in the penis (which may be caused by high blood pressure, high cholesterol, smoking as well as other risk factors). Once a man has had a problem with trying to get or maintain an erection during sex he will be very nervous the next time he tries to have sex. This can lead to anxiety and a “fear of failure”. Drugs for ED, as discussed below, can help a man regain his confidence and after a few successful sexual encounters some men may be able to manage to have sex without these ED drugs.


What are the available treatment options for Erectile Dysfunction?
There are many effective treatments for erectile dysfunction including Viagra (sildenafil), Cialis (tadafil), Levitra (Vardenafil) and Spedra (avanafil).


Spedra for ED


What is Spedra (Avanafil)?
Spedra is the latest mediciation approved for the tratment of erectile dysfunction. Spedra contains the active ingredient avanafil. Spedra is a treatment for adult men suffering from erectile dysfunction (also known as impotence). This is when you cannot get, or keep a hard, erect penis suitable for sexual activity. For Spedra to be effective, sexual stimulation is required.


How does Spedra work?
Spedra works by helping the blood vessels in your penis to relax. This increases the blood flow into your penis, helping it stay hard and erect when you get sexually excited. Spedra does not cure your condition.

It is important to note that Spedra only works if you are sexually stimulated. You and your partner will still need to use foreplay to get ready for sex – just as you would if you were not taking a medicine to help you. It is best to discuss taking these tablets with your partner. Be open and honest. Otherwise your partner may worry you do not find her attractive any more or, worse still, might wonder if you are having an affair. Spedra will not help you if you do not have erectile dysfunction. Spedra is not for women. Spedra will not directly help with loss of libido (sex drive) but it may restore a man’s confidence and his enjoyment and desire to have sex.

Spedra starts to work in around 30 minutes and in some men it may work as quickly as 15 minutes. It is best taken on an empty stomach at least 30 minutes before you plan to have sex. Mens natural testosterone (male sex hormone) is usually highest in the mornings and this is why men sometimes wake up in the morning with an erection. Therefore the morning, after good nights sleep, is probably the best time to have sex. Spedra will stay active in the system for up to six hours after taking one tablet. The normal starting dose is 100mg but the effective dose can vary from 50mg to 200mg per dose. Only one dose should be taken per day.


Are they any possible side effects?
Side effects are rare but can include nausea, dizziness, headache, stuffed nose, flushing, visual and hearing abnormalities. Priapism is a very rare side effect that causes an erection that will not go away after sex. If you have any suspected side effects, please discuss it with one of the doctors or nurses in The Ashe Street Clinic.

Spedra should not be taken if you have severe kidney or liver disease, unstable angina or very high or low blood pressure. It should not be taken if you are taking nitrates which can be found in some angina and heart tablets, sprays or patches. Spedra should not be taken if you are on potent CYP3A4 inhibitors; e.g. tablets containing ketocanazole (e.g. Nizoral), clarithromycin (e.g. Klacid), or itraconazole (e.g. Sporanox ).


How do I get more information?

Please make an appointment to talk to one of the doctors in The Ashe Street Clinic. Please try to overcome any embarrassments and talk to one of our doctors. We discuss this and other sexual problems with patients on a daily basis. There is nothing we have not heard before. Phone 066 7125611 for an appointment.

Confidentiality is assured at all times.


Bogus Allergy Tests Can Cause Real Harm

It seems to be fashionable to be allergic to some foods these days. All kinds of vague symptoms are commonly attributed to food allergies such as fatigue, bloating, cramps, migraine, rashes and coughs. However, most people with these symptoms probably don’t have true food allergies. Some may have food intolerance while others may be getting their symptoms from stress or a poor diet with too much sugar, caffeine, yeast, processed foods, fast foods or alcohol. True food allergies are quite rare. Food intolerance is much more common. It is usually as a result of the gut not being able to process certain foods such as lactose in milk (common in children), caffeine, cheese or red wine. It can only be picked up by excluding suspected food for a few weeks and then reintroducing it to see whether the symptoms are relieved and relapse if the food is reintroduced.

There are many bogus allergy tests on the market at present as the whole area of allergy testing is unregulated in Ireland and anyone can set up an allergy testing service without having to prove that their tests are accurate or scientific. Many of these bogus tests are sold online or via pharmacies and health food shops. Websites and promotional literature can look impressive and convincing but lack any scientific validation. All of these bogus tests are expensive and can fail to pick up serious allergies (false negatives) and often diagnose allergies to multiple foods when in fact there is no such allergy is present (false positives). This can lead to food faddism, inconvenient, expensive and restrictive diets that can lead to nutritional deficiencies.

The following is a list of “Allergy tests” which have not been proven to be accurate or scientific:

York test

Fitzwilliam test


Hair analysis

Vega test

For sound information about scientifically accurate food allergy testing talk to your GP or see Irish Food Allergy Networks (

DrDavidBuckley 2

Dr David Buckley





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1. Almost everybody knows smoking is a major cause of heart attacks, strokes and lung cancer. However, smoking can also cause the following:-
- Wrinkles on your face as you get older
- Sexual problems such as impotence (i.e. difficulty in getting or maintain an -erection during sex)
- Cervical cancer in women
- Mouth cancer
- Low birth rate babies in women who smoke during pregnancy
- Low IQ in children whose mother smoked during pregnancy

2. Apart from these physical ill effects, smoking can also cause bad breath, smelly hair and smelly clothes.

Passive smoking is harmful for children. Children who see their parents smoke are more likely to smoke themselves. Is this what you would want for your children?

3. One third of hospital beds are filled with people with smoking related problems.

While smoking can cause premature death, it is more likely to cause chronic illness such as chronic lung disease, a stroke or angina which can affect your quality of life. Do you want to end up in a nursing home with a stroke or so breathless that you cannot walk to the shop?

Remember, if you get sick from a smoking related illness, you would have brought it on yourself and your family. You will have nobody but yourself to blame. Is this really what you want?

4. People mistakenly believe that smoking helps them relax or deal with stress. This is untrue. The withdrawal effects of nicotine make you feel agitated and you can get temporary relief from these symptoms when you smoke. Withdrawal effects from nicotine usually only lasts a few days or a few weeks at most. Nicotine replacement therapy such as Nicotine Gums or E-Cigarettes may help ease the withdrawal effects from nicotine. However, if you use these nicotine replacement methods you should plan to wean yourself gradually off them over the course of three to six months. “Champex” a tablet that helps reduce cravings, can be helpful for some people. Ask one of the doctors in The Ashe Street Clinic about this prescription medicine if you are interested.

 5. There are many benefits to stopping smoking. Not only will you be better and healthier, your food and drinks will taste better and your clothes and hair will not smell like an ashtray. You can also make substantial financial savings by giving up smoking. If you smoke twenty cigarettes a day, you can save enough for a family holiday after one year or a decent family car after ten years. The money you save from not smoking twenty cigarettes a day, over forty years, would buy you a family home.

 6. Addiction to nicotine is treatable. After all, people have given up far more addictive habits such as alcohol, heroin and gambling.

Plan the date you intend to quit. Tell all your friends, relatives and work mates your plan and get their help and support. Avoid situations that might make you think about smoking such as drinking alcohol outdoors or drinking coffee after a meal.

7. When you give up one bad habit such as smoking, you should take up a good habit such as more physical exercise. Try walking, jogging, tennis or golf. Physical exercise release endorphins which are natural feel good hormones that will help to counteract the withdrawal effects of nicotine. When you give up smoking cigarettes, you should adopt a healthy lifestyle and try to concentrate on having a good healthy diet, getting plenty of fresh air and exercise. Keep alcohol to a minimum and don’t binge drink. Try to deal with any stress in your life in a positive way.

8. For most people, giving up smoking is an all or nothing process. Complete abstinence will give you your best chance of success. If you do happen to fall off the wagon and have a cigarette, examine the reasons why you smoked and try to avoid that situation in the future, at least until you have gotten over the craving stages. Take your smoking cessation programme one day at a time. Be determined. Recognise your achievements and give yourself a small reward once in a while (i.e. the money you saved might buy you a nice shirt or the pair of shoes you saw in the shop last week).

9. The peace of mind that comes with not smoking should not be underestimated. You will have no more worries about your health and the guilt associated with smoking will disappear. Cravings will pass and you will no longer have to plan your life around your next cigarette.

10. If you do get a craving to smoke, try some or all of the following:
- Take a few deep breaths and remind yourself why you need to stop
- Brush your teeth
- Drink fresh juice
- Go for a brisk walk or a jog
- Chew on some sugar-free gum

Most cravings pass within a few minutes.

Your breathing, circulation and skin will significantly improve within two years of stopping smoking.

For more help and advice about trying to stop smoking please visit the following website: or phone the HSE’s National Smoker’s Quit line: 1850 201 203 (8am – 10pm, Mon to Sat).

You might also like to contact the local HSE’s Smoking Cessation Service for Kerry at: 066 719 5617.

‘’YOU CAN QUIT’’ Facebook page: is another useful service for quitters.

All the doctors and nurses in The Ashe Street Clinic are trained in nicotine addiction and how to help people to stop smoking. Please do not hesitate to ask us for our advice and support.

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This leaflet contains information about Benzodiazepine and Z Drug addiction.

This leaflet contains information about the allergy testing services here at The Ashe Street Clinic.

This leaflet contains important tips for mental health in teenagers and young adults.

This leaflet contains useful advice about keeping healthy and motivated for the active retired.

This leaflet contains useful advice about the common cold.

This leaflet contains advice for diabetes management regarding guidelines for food.

This leaflet contains advice for the treatment of head lice.

This leaflet contains useful information about home blood pressure monitoring.

This leaflet contains information about influenza (flu).

This leaflet contains information about the oral contraceptive pill.

This leaflet contains information for parents about oral rehydration of children.

This leaflet offers tips on how to get a better night's sleep.

This leaflet offers ten top tips for beating stress.

This leaflet offers advice for parents regarding temperature in children.

This leaflet contains useful information regarding how to determine whether or not you are overweight and looks as BMI (Body Mass Index).

This leaflet contains useful information regarding weight loss with 10 top tips from our experts here at The Ashe Street Clinic.

This leaflet looks at the benefits of exercise and gives usefull tips about how to get fit.  There is also a linkt to a very informative Youtube video with more information on the subject.

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 36 Ashe Street, Tralee, Co. Kerry

 066 712 5611

 066 712 2626

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The Ashe Street Clinic