Sexual dysfunction


Sexual dysfunction includes problems with erection and ejaculation, and can be a cause of significant distress for many men. Mr Malde offers a comprehensive assessment for men with sexual problems in a caring and compassionate way.

Appointments can be booked at any of his private urology clinics near you covering: 

Erectile dysfunction (impotence)

What is erectile dysfunction (impotence)?

Erectile dysfunction (impotence) means you cannot get or maintain an erection strong enough for normal sexual intercourse. It is very common and half of all men between 40-70 years of age are affected by sexual dysfunction.


What causes erectile dysfunction?

It can be caused by a number of factors and may be a sign of underlying cardiovascular disease. In fact, erectile dysfunction can be an ‘early warning sign’ that heart disease may develop in the future.  Therefore, it is important to seek medical advice to undergo a full assessment and further tests.

The causes can be divided into those that are physical and those that are mainly psychological.


  • Reduced blood flow to the penis. This is the most common cause of erectile dysfunction in men over 40 years old. The small arteries supplying blood to the penis can become narrowed by a build-up of fatty deposits, and so the blood flow may not be enough to cause an erection. Risk factors for the build-up of fatty deposits include smoking, being overweight, high blood pressure, high cholesterol and diabetes
  • Disease that affect the nerves going to the penis (such as following surgery)
  • Low levels of testosterone
  • Diabetes
  • Alcohol and drug abuse


  • Stress
  • Anxiety
  • Depression

Mr Malde offers specialist appointments for further investigation and treatment at his private urology clinics across London.


How we can help you

Mr Malde offers high-quality urology care in his specialist private clinics in London.

He provides a thorough assessment for men with erectile dysfunction which consists of a detailed medical and drug history, physical examination and blood pressure assessment. Routine blood tests to check hormonal levels (such as testosterone), as well as to rule out underlying diabetes and high cholesterol, are also offered. A heart-tracing (ECG) may be performed. Further investigation with other urology tests are undertaken as necessary and a range of treatments can be offered, including lifestyle modification, psychosexual support, oral medications and injection treatments.

Premature ejaculation

What is premature ejaculation?

Premature ejaculation is ejaculation occurring earlier than you would like, or with minimal stimulation and over which you have little control. It can be an extremely distressing condition. It is often lifelong and affects approximately 20-30% of all men.


What causes premature ejaculation?

Although the cause is unknown, it is thought to be related to hypersensitivity of the penis or nerve receptor sensitivity. It is more likely to happen if you are in your first sexual relationship or in the early stages of a relationship and in this case often gets better with time.


How can premature ejaculation be treated?

There are various techniques to try to stop you ejaculating too quickly and we will discuss these with you. The use of condoms, local anaesthetic creams or sprays may help reduce sensitivity of the penis and various medications may be helpful if these other measures fail.


How we can help you

Mr Malde offers a detailed assessment for men with ejaculation disorders, including premature ejaculation, in his private urology clinics across London. He offers a variety of treatments including behavioural therapies, referral for psychosexual support and oral or topical medications.

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To make an enquiry or book an appointment, email or call us on 020 3488 2636