Erectile Dysfunction

What is ED?

If you’re having problems getting and/or keeping an erection hard enough for sex, you might have symptoms of erectile dysfunction (ED). ED is defined as the persistent inability to achieve or maintain a penile erection sufficient for satisfactory sexual performance.¹ ED can limit your intimacy, affect your self-esteem, and impact your most important relationships. Beyond the physical manifestations, ED can cause emotional distress and may impact your quality of life.² The important thing to understand is that ED is more common than you may think, and you’re not alone. In fact, more than half of men over the age of 40 suffer from some degree of ED.³

What Causes ED?

ED occurs when the blood flow to the penis is interrupted or when the nerves become damaged. There are many different factors that may contribute to this and can include diabetes, heart disease, prostate cancer treatment, depression, anxiety, and the side effects of some medications.^2,4 Lifestyle habits like sleep, smoking, alcohol consumption, exercise, and diet can also affect the quality of your erection.

Other causes of erectile dysfunction can include:

• Heart disease

• High blood pressure

• High cholesterol

• Diabetes

• Obesity

• Conditions like multiple sclerosis, Parkinson’s disease, and low testosterone

How is ED Diagnosed?

If you cannot get an erection more than 50% of the time, it may be time to visit your doctor. A personal history and physical exam can help you and your doctor understand the underlying causes of your ED. Lab tests and other tests may identify a source such as diabetes, coronary artery disease or other conditions that affect the nerves and blood flow to the penis. Understanding what is causing your ED can help you and your doctor determine the treatment options that are right for you.

When Should I Talk to a Doctor About ED?

You should schedule a consultation if your ED symptoms or other signs of sexual dysfunction are frequent or disruptive to your life, sexuality, or self-confidence.

You should also make an appointment if you have any health conditions like heart disease, high blood pressure, or diabetes.

How is ED Treated?

Our physicians will begin with an exam to identify the condition causing your ED. This may require blood tests, urinalysis, and ultrasound to evaluate your condition.

Depending on the root cause of your ED, our physician will create a personalized treatment plan. Your program might include oral medication and treatment to address the underlying cause.

• Oral medications: There are a number of prescription medications available that may improve blood flow to the penis. Combined with sexual stimulation, this can produce an erection.
• Vacuum erection devices: A hollow plastic tube is placed over the penis and a pump (hand/battery-powered) is used to create a vacuum that pulls blood into the penis. Once an erection is achieved, an elastic tension ring is placed at the base of the penis to help maintain the erection.
• Penile implants: A device is implanted into the penis that is intended to allow a man with ED to have an erection. The device is entirely contained in the body so no one is able to see it and is controlled by the user to achieve an erection. This treatment is designed to allow for spontaneity and the erection is maintained for as long as the man desires.
• Injections: With injection therapy, a needle is used to inject medication directly into the penis. The medication allows blood to flow into the penis, creating an erection.
• Intraurethral suppositories: An applicator
  containing a small pellet (suppository) is inserted into the urethra and the pellet is released. The pellet dissolves and increases blood flow to the penis, creating an erection.

Often, getting your diabetes or high blood pressure under control can improve your ability to achieve erections. If low testosterone is the root cause of your ED, your doctor might recommend testosterone replacement therapy.

Lifestyle changes such as giving up tobacco, healthy eating, getting more exercise, or losing weight could also help with erectile dysfunction. You might also benefit from psychological counseling to learn to manage stress or resolve any mental or emotional health issues that are interfering with your sex life.

If you have further questions about erectile dysfunction, never hesitate to call us. To receive the highest quality of treatment for erectile dysfunction, schedule an appointment today.

<sub>1. Erectile dysfunction. NIH: National Institute of Diabetes and Digestive and Kidney Diseases. http://www.nlm.nih.gov/medlineplus/erectiledysfunction.html. Accessed May 2015.
2. DiMeo PJ. Psychosocial and relationship issues in men with erectile dysfunction. Urol Nurs. 2006 Dec;26(6):442-6.
3. Feldman HA, Goldstein I, Hatzichristou DG, et al. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol. 1994 Jan;151(1):54-61.
4. Shabsigh R, Lue TF. A Clinician’s Guide to ED Management. New York: Haymarket Media Inc.; 2006.</sub>