Erectile Dysfunction (ED): Causes, Diagnosis & Treatment

That said, many men seek medical advice to identify the underlying cause of their erectile dysfunction, which allows them to start the most effective treatment. When diagnosing erectile dysfunction, finding the cause is important so your doctor can determine the best treatment. The causes of ED may include: Do you think I need to see a specialist? Careful genital examination, noting testicular size (to screen for hypogonadism) and palpating the penis for Peyronie’s plaques. We specialize in treating men with erectile dysfunction (ED) or male impotence and the symptoms that occur with this condition. Dangerous drug combinations, postdischarge management of MI and cardiomyopathy in cocaine-using patients should follow published guidelines, except β-blockers should be prescribed only in select patients. Satisfaction rates for patients who underwent penile prosthesis surgery have been reported to be near 90%.

Men who are on medicines that contain nitrates such as nitroglycerine should not take oral ED medications.

Nurse practitioner. While ED can become more common with age, there are many medical, physical and emotional factors that can contribute to the issue. 13 The Sexual Health Inventory for Men is a short-form, 5-item questionnaire developed to monitor treatment progress. A rectal exam, in which your doctor uses a finger to feel your prostate gland, may be necessary to check the health of your prostate. Positron emission tomography scanning studies have suggested that sexual arousal is activated in higher cortical centers that then stimulate the medial preoptic and paraventricular nuclei of the hypothalamus. Nerves that send impulses to the penis can become damaged from stroke, diabetes, or other causes. Priapism is a prolonged erection, lasting longer than four hours.

Erectile dysfunction is not an uncommon condition or a condition that you should feel embarrassed about. Possible side effects include flushing, nasal congestion, headache, visual changes, backache and stomach upset. How long has ED been a problem, and did it start gradually or suddenly? » Your urologist may perform a physical exam by taking your blood pressure and examining your penis and testicles. Erectile dysfunction is a very common condition that over 3 million Americans experience each year. The cut is either above the penis where it joins the belly, or under the penis where it joins the scrotum. Because blood flow plays a major role in your ability to get and keep an erection, issues with blood flow can have adverse effects on erectile functions.

  • It involves using a wandlike device (transducer) held over the blood vessels that supply the penis.
  • Several studies have shown a positive effect of sleep apnea treatment on ED.
  • Given our special programs, we can help you succeed and achieve satisfaction.
  • This is normal.
  • With this method, you use a fine needle to inject alprostadil (Caverject Impulse, Edex) into the base or side of your penis.
  • Some people have trouble speaking with their doctors about sex.

Getting Ready for Your Visit

Providers nationwide use a specific patented methodology designed to optimize patient safety and results, and must comply with medical guidelines to ensure efficacy. The most commonly known drugs on the market today are Viagra®, Cialis® and Levitra®. Men with Peyronie’s disease have seen great results with GAINSWave and enjoy that it is one of the only surgery- and injection-free options available. Genital warts, 8 in the placebo group (P=0. The amounts of Viagra, Cialis, Levitra or Stendra that may be in these supplements is not under quality control and may differ from pill to pill. These devices offer a treatment option without the need for medication.

What are the side effects? By using advanced testing methods like this, our physicians can find the underlying causes of your ED and create more individual and effective erectile dysfunction treatments. It’s common for doctors to listen to your heart and test your blood pressure, as well as examine your penis, testicles, and prostrate for abnormalities. Other treatments include: A health care professional may ask you some personal questions and use a questionnaire to help diagnose any psychological or emotional issues that may be leading to ED. There are several prescription medications that claim to help patients. Your urologist may also ask about any diuretics you’re taking or about your caffeine and alcohol consumption. Medications including antidepressants, blood pressure medicines, and drugs used to treat hypertension, cardiac disease, and psychiatric disorders.

A mental health professional, such as a counselor, psychologist, or psychiatrist, can help determine if a psychological condition is causing your ED. Oral medications are a successful erectile dysfunction treatment for many men. Create a plan to relieve your back pain. Traction devices apply upward tension on the penis to stretch it. Vision changes are the least common. Effect of antihypertensive drugs, furthermore, we found that the proportion of 4°C pepsin-soluble collagen decreased significantly with age in erectile tissue from SHR and was significantly lower in SHR compared with WKY starting as early as 6 wk of age. Being overweight can cause — or worsen — erectile dysfunction.

  • While it is true that some older men may need more stimulation, they should still be able to achieve an erection and enjoy intercourse.
  • The technician passes a handheld device lightly over your penis to measure blood flow.
  • More information may be found here.
  • This trained professional with seven years of specialized education in pharmacy studies prepares the medications that your doctor has prescribed.
  • Lengthens the shorter side of the penis by removing the scar tissue and adding healthy tissue (graft).
  • Although placement of a penile implant is a surgery which carries risks, they have the highest rates of success and satisfaction among ED treatment options.
  • 2020, Vol 17, No.


Can everyone use ED medications? Millions of men in the United States suffer from erectile dysfunction. Higher rates of reporting, diagnosis, and treatment of ED have been driven by effective treatments, direct to consumer advertising, and screening by health care providers. It may be recommended if medication is not effective. Estimates suggest that one of every 10 men will suffer from ED at some point during his lifetime.

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Patients suffering from erectile dysfunction often experience negative psychological side effects. You can also request an appointment with Dr. Your PCP will likely ask some questions about your symptoms and medical history. This treatment has been widely used and accepted since the early 1980s. If there is persisting swelling or pain, the use of the implant may be delayed.

Please contact us to schedule an appointment at 1-866-844-2273. Niemczyk online or by phone today. Examples include papaverine, alprostadil and phentolamine.

An inconsistent ability to do so – You can only occasionally get an erection. Hormone therapy works by balancing your hormones, allowing sexual function to resume. Simoncini online today! Self-injection therapy can be used by the patient at his own discretion and at any time with a minimum of preparation.

What to Expect?

Nonetheless, it is important to try to discontinue possible offending medications before proceeding to more invasive ED treatment options. Pay your bill online, mONEY BACK GUARANTEE:. 19 These surgeries are only indicated when a patient demonstrates recent-onset ED and an occlusive lesion seen on angiogram or magnetic resonance angiography and should be performed only in centers of excellence for ED. GAINSWave is an effective option because it addresses the root cause of many penile issues - poor blood flow. How can I best manage other health conditions with my erectile dysfunction? Sex therapy also helps a man's partner accept and cope with the problems. The injections are relatively painless and are easily taught to the patient in one or two visits with the doctor. In many cases, simple lifestyle changes can result in the restoration of sexual functions.

Antiarrhythmics (drug for irregular heart action). Even less strenuous, regular exercise might reduce the risk of erectile dysfunction. This depth of experience means every patient sees a physician who is an expert at diagnosing ED and choosing the most effective method of treatment. Erectile dysfunction (ED) is a common type of male sexual dysfunction.

Your physician can help you decide which treatment is best for you. The physicians and surgeons who staff the UAB Department of Urology are subspecialists in their areas of expertise. While medicines may “mask” the symptoms of ED, UWave can improve and eliminate erectile difficulties. The health care professional may also ask your sexual partner questions about your relationship and how it may affect your ED.

Vitality MDs

This creates a vacuum that pulls blood into your penis. The medicine relaxes the blood vessels, allowing blood to flow into the penis. Common eye problems and infections, you really have to open your mind and accept that there are other ways to do things. Different types of prostheses have been developed, and hundreds of thousands of men throughout the world have been successfully treated with penile implants. ED has many potential causes, so you may need a comprehensive physical examination to diagnose it. This multidisciplinary team of urologists, radiation and medical oncologists, nurse practitioners, and urology nurses and technicians work together to provide the most accurate diagnoses and effective treatment options available for male and female adult and pediatric patients. Erectile dysfunction refers to an inability to get or maintain an erection strong or long enough to have intercourse. To learn more about erectile dysfunction treatments, call Bluewater Urology Associates or schedule an appointment online.

The members of your erectile dysfunction team will reflect the fact that many health and personal conditions can contribute to your impotence: Psychological exam. Treatment options include: Our urologists have led or participated in many clinical research studies to evaluate the most effective treatments for ED. GAINSWave is the premium brand of shockwave therapy used to treat erectile dysfunction, Peyronie’s disease and optimize sexual performance. Overall, penile prosthesis surgery offers the highest satisfaction rates of any treatment for ED for both the patient and his partner. Causes of ED include a combination of physical and emotional problems. But starting the conversation is well worth it.

The selective serotonin reuptake inhibitors (eg, fluoxetine, sertraline, paroxetine, citalopram) can also cause difficulties with ED, but they might also have other significant sexual side effects, including decreased libido and anorgasmia.

Sex Counselor

Your health care provider may also suggest treating emotional problems. They also may suggest lifestyle changes, like meditation, exercise, and a clean diet. These oral medications reversibly inhibit penile-specific PDE5 and enhance the nitric oxide–cGMP pathways of cavernous smooth muscle relaxation; that is, all prevent the breakdown of cGMP by PDE5. Sex education, healthcare professionals both inside and outside of Sexual Medicine are likely to deal with young men complaining for ED and it is important that basic knowledge on this topic is available. UWave is a safe, comfortable, and non-invasive shock wave therapy performed by our experts at the Men’s Health Center. As experts in the field of ED, we offer a full range of treatment options.

Your reassurance that this isn't the case can help.

Other surgical procedures–including venous ligation to limit penile venous outflow and penile revascularization procedures–are rarely successful and are not recommended. Make personal performance a priority and reclaim the intimacy that you have come to cherish with your partner when you visit our Aventura office for an evaluation. Men in the oldest cohort (50 to 59) were more than 3 times as likely to experience erection problems and to report low sexual desire compared with men 18 to 29. They make a stiff penis that lets you have normal sex. There is generally no change to a man's feeling or orgasm. The doctor will ask if you smoke, how much alcohol you drink, and whether or not you use recreational drugs. We use a minimally invasive technique through a small incision which allows quicker return to normal activity.

Physician and Employee Portals

It is also best to avoid the use of vardenafil with class III antiarrhythmic drugs, such as amiodarone or sotalol. ED shouldn’t be seen as a normal part of aging; it can indicate a serious health problem. Is this condition temporary? Clinical experience in switching medications to improve ED has been disappointing in that improvement does not often occur. Medications work by increasing blood flow to your penis in response to sexual stimulation. How can we help? With some trial and error, you’re likely to find an ED treatment that works for you. Hormone replacement in the form of topical gels, creams, patches, injections and pellets are only used after physician evaluation. In addition to a thorough medical history and physical examination, physicians will also conduct baseline blood testing to determine if the testosterone levels are adequate. Semi-rigid prostheses involve the surgical implantation of a silicon-covered flexible metal rod that provides rigidity for intercourse.


However, some primary care practitioners may recommend vacuum constriction devices. We also offer placement of inflatable penile prostheses for men who have failed other forms of treatment for erectile dysfunction. .patients .type-full-content {column-count:1 !important; -webkit-column-count:1 !important; -moz-column-count:1 !important;}, the triple combination regimen of papaverine, phentolamine and alprostadil has the highest efficacy rates, reaching 92%; this combination has similar side-effects as alprostadil monotherapy, but a lower incidence of penile pain due to lower doses of alprostadil. Like blood tests, urine tests are used to look for signs of diabetes and other underlying health conditions.

Alternative medicine practitioner. Erectile dysfunction (ED) occurs when a man cannot maintain an erection. It can often be self-diagnosed, with symptoms including: Your doctor will help you decide which treatment is best for you. If you are concerned about your erectile dysfunction or other sexual health problems, a specialist at Ogden Clinic in Utah can review and treat your symptoms. 36 However, in the majority of patients who receive this treatment, less invasive alternatives have failed and therefore satisfaction with this treatment would be expected to be higher in this subset of patients.

Pressing on a deflation valve attached to the pump returns the fluid to the reservoir, which returns the penis to a flaccid state. Single-question assessment of erectile dysfunction, the active ingredient in marijuana is THC. Side effects can include pain, minor bleeding in the urethra and formation of fibrous tissue inside your penis. Oral medications are an effective way of treating erectile dysfunction. ED can be caused by a number of factors, including: Penile implants were first used in the 1950s, and since then further advances have occurred. Alprostadil is injected into the side of penis with a very fine needle.


Maintaining a healthy weight and eliminating other lifestyle issues like smoking and excessive alcohol use, and learning how to manage stress may also help. Self-injection lessons should be given in your doctor's office by an experienced professional. An operation (i. )The more blood trapped in the penis, the firmer the erection.

It is important to understand that in most cases, ED is a symptom of another, underlying problem. In those rare cases where a low sex drive and low blood levels of Testosterone are at fault for ED, Testosterone Therapy may fix normal erections or help when combined with ED drugs (PDE type 5 inhibitors). Some men may be able to gain an erection by self-injecting drugs into their penis, causing it to become engorged with blood. Peyronie's disease is a condition that causes fibrous scar tissue to develop inside your penis.

If you are uncertain or embarrassed about seeking treatment, please rest assured that we treat every patient with the utmost respect and complete confidentiality. Continued, this may be accompanied by anxiety and despair, particularly about his health and his sexual ability. This will include your penis and prostate. Laudersdale, Florida area, contact Dr. The doctor will start by asking about your medical history. But if you have ED, you should tell your doctor. If you have erectile dysfunction, you’re not alone:

For many men, the answer is as simple as taking a pill.

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But it's not a natural part of aging. Because penile vascular surgery is not recommended for aging males who have failed oral PDE5 inhibitors, ICI or IU therapies, implants are the next step for these patients. Erectile dysfunction can have a number of different causes and possible treatments, so your treatment team will evolve as you get a better diagnosis your impotence.

At this time, there is no evidence that nutritional supplements or vitamins have any significant bearing on sexual performance.

Depending on the cause and severity of your erectile dysfunction and any underlying health conditions, you might have various treatment options. This drug comes in two forms, based on how it is to be used: The term ED describes difficulty attaining or sustaining an erection.

There are relatively few contraindications to the use of vacuum devices.

About the Program

Depending on the diagnosis, mental health professionals may recommend prescription medication to treat mental illness, which will also help alleviate the symptoms of your ED. You should not take more than 1 dose in 24 hours. Physical exam. Not all patients respond to this type of treatment, but those who do should develop an erection that lasts anywhere from 30 to 120 minutes.

This holds the blood in the penis (and keeps it hard) for up to 30 minutes. Weather, non-oral drugs Alternatives to oral medications include:. Before using any supplement, check with your doctor to make sure it's safe for you — especially if you have chronic health conditions. 2 The study demonstrated that ED is increasingly prevalent with age:

Psychological states : While the devices are well-tolerated they may not offer the same benefits of other therapies in terms of spontaneity and being discreet. Use these drugs as directed. Different types of penile prostheses are available and we can help you decide which device is right for you. You shouldn’t use these medicines if you take nitroglycerin or any other nitrates for chest pain.

Non-Drug Treatment Options

Discuss your options with your doctor to determine the best treatment for you. While most are pill form, some are injected directly into the penis or administrated through a suppository placed in your urethra. Your significant other. 4 tips for coping with an enlarged prostate, premature ejaculation is divided into primary and secondary forms:. What are the alternatives to the primary approach that you're suggesting? Our specialists work with you to create a treatment plan that best suits your needs and lifestyle, taking into consideration any health conditions that may be contributing to your symptoms.

Effective Medications and Procedures

In rare cases, the drug Cialis® can cause or increase back pain or aching muscles in the back. Good manual dexterity is also needed to use the device; if manual dexterity is impaired, a willing sexual partner can learn to apply the device. However, 2 previously approved devices–the OmniPhase and the DuraPhase penile prostheses–are not considered safe in this environment. In some cases, nocturnal penile tumescence monitoring is conducted to evaluate the quality of the patient’s nocturnal erections. Tranquilizers. That’s why our team at the Male Infertility & Sexual Health Program at UH uses a specialized, team-based approach to deliver expert and highly individual ED care.

It’s common, and it’s treatable. All of the team members are recognized leaders in their field of expertise, and all potential therapeutic options are considered and discussed with each patient, including observation (no active treatment), medical management and surgery. Patients who are interested should discuss the risks and benefits (informed consent) of each, as well as costs before starting any clinical trials. There are oral medications available, including Viagra and Cialis. Your doctor may also take a sample of blood to test for underlying health problems that could be causing the erectile dysfunction, such as diabetes or low testosterone. The blood that flows into the penis must then be trapped to maintain an erection.

Blood and urine tests are often used to check your cholesterol, blood sugar, triglycerides, testosterone, etc. The health care professional will evaluate how full your penis becomes and how long your erection lasts. What kinds of tests do I need? Sexual dysfunction is a common problem affecting men of all ages, and it becomes more likely as we age. Vascular reconstructive surgery can be performed to improve blood flow to the penis. Don’t avoid seeking help because you think you’re not old enough to have ED.