I suffer from erectile dysfunction and the pills I’ve been given won’t work. What can I do? DR PHILIPPA KAYE reveals sinister hidden health condition behind the problem – and the simple tablet that could fix it

I have erectile dysfunction and tadalafil does not work. What should I do?

Dr Philippa Kaye answers: It is not uncommon for Tadalafil to be ineffective. The good news is that there are other ways to deal with erectile dysfunction.

This stigma issue, where men struggle to maintain an erection during sex, will affect nearly half of men between the ages of 40 and 70 at some point.

It is also more than a sexual performance problem. Doctors tend to view erectile dysfunction as the canary in the coal mine for many potentially life-threatening conditions.

This is because erectile dysfunction can often be caused by blood flow problems caused by high blood pressure, high cholesterol, or diabetes.

All of these conditions, typically triggered by poor nutrition and lack of exercise, significantly increase the risk of fatal heart attack or stroke.

It can usually be diagnosed through a blood test or blood pressure check, which a GP may order.

General practitioners often advise erectile dysfunction patients to exercise regularly, lose weight if necessary, quit smoking and limit alcohol consumption.

There are also drug treatments, such as statins, for high cholesterol that can help manage the effects of these underlying conditions.

All these measures should improve blood flow and increase erections.

There are also psychological factors that make erectile dysfunction worse. Stress, anxiety, grief, and relationship problems are all known triggers. Research shows that talk therapy and counseling can help in these cases.

However, many men will need medication to maintain an erection.

Tadalafil, also known as Cialis, is one of the most widely used in the UK. This is a type of medication called PDE5 that increases blood flow to the penis.

It is a slow-release medication, meaning its effects last up to 36 hours. However, it is not effective for everyone.

Instead, some men find they get a better response when taking sildenafil or Viagra. This tablet only works for about four to six hours, which means it should be taken in the hours before sex.

But this shorter, quick-release dose usually has a more pronounced effect on the strength of the erection.

For those who cannot respond to any medication, there are vacuum erection devices, also known as penis pumps. These work by drawing blood into the penis and then keeping it there using a constriction ring placed around the base of the organ.

I have irritable bowel syndrome. It has been said that the FODMAP diet may help. But this seems too restrictive and I’m worried I won’t be able to stick with it. really? Is it worth it?

GP, author and broadcaster Dr. Philippa Kaye

Dr Philippa Kaye answers: The FODMAP diet can be a game changer for patients with irritable bowel syndrome (IBS) and patients only need to stick to it for a few months.

Irritable bowel syndrome is a very common, long-term condition of the digestive system that often causes symptoms such as stomach cramps, bloating, diarrhea and constipation.

Unfortunately, there is no approved treatment that can cure this. Many patients rely on medications to help calm the worst of the symptoms.

One of these is a medication called mebeverine, or Colofac, which relaxes the muscles in the intestine to relieve the cramping that comes with the condition.

There is evidence that probiotics (drinks called healthy bacteria) as well as regular exercise help symptoms.

However, one of the most effective ways to combat IBS is a diet called FODMAP, which is short for fermentable oligosaccharides, disaccharides, monosaccharides and polyols, which are certain types of carbohydrates that are poorly absorbed in the gut and can ferment and lead to IBS symptoms.

The diet includes eliminating those foods that contain carbohydrates, such as pasta, bread, pastries and cereals; onion and garlic; dairy products; legumes and legumes, including chickpeas and beans; and some fruits such as apples and pears.

It’s a pretty extensive list of foods, which means the diet can be both boring and challenging.

But most importantly, the FODMAP diet is designed to be temporary. Most patients follow a strict restriction diet for up to eight weeks. At this point, they begin reintroducing foods one at a time to determine which ones cause a flare-up of symptoms.

Anything that causes flare-ups should be avoided in the future. The key is to create a personalized diet plan that limits bothersome symptoms while also allowing patients to eat a balanced and varied diet.

• Write to Dr Philippa Kaye at Health, Daily Mail, 9 Derry Street, London, W8 5HY or email health@mailonsunday.co.uk – include contact details. Dr Kaye cannot engage in personal correspondence. Answers should be taken in general context. If you have any health concerns, consult your own physician.