Erectile dysfunction is a man's inability to obtain or sustain an erection firm enough for satisfying sex. A single incident is rarely cause for concern. Repeated incidents have a real impact on physical and mental health, and, importantly, can be an early warning sign of a more serious condition such as diabetes or cardiovascular disease.
ED is often a circulation problem first
This is the part most men are never told. The arteries supplying the penis are considerably narrower than the coronary arteries. When vascular disease begins, it shows up there first: frequently years before it shows up as a cardiac event.
That means ED isn't only a quality-of-life issue. It's information. It's a reason to look at your blood pressure, your cholesterol, your blood sugar and your testosterone, which is exactly what we do.
What causes it
- The vascular system: limited blood flow from arteriosclerosis, high blood pressure, high cholesterol, diabetes, obesity
- The hormonal system: low testosterone, thyroid disorders
- The nervous system: central and peripheral nerve involvement, including from diabetes or spinal issues
- Medications: many blood pressure medications, antidepressants and others contribute
- Psychological and stress-related factors: anxiety, depression, performance pressure, relationship strain
- Local factors within the erectile bodies themselves, including Peyronie's disease
According to the Massachusetts Male Aging Study, erectile dysfunction affects roughly 52% of men at some point, and becomes more common with age.
How we evaluate you
A physical examination, a discussion of your medical and sexual history, and appropriate blood work. Where it's useful, a Doppler ultrasound lets us actually measure blood flow rather than guess at it.
Treatment options
- Shockwave / pulse wave therapy (RejuvaWAVE®): non-invasive acoustic waves that stimulate new blood vessel growth, treating the cause rather than the symptom
- Testosterone and hormone optimization, when labs show it's a contributor
- Prescription medication, including options beyond the standard pills many men have already found disappointing
- Penile Botox® for specific presentations
- Injectable therapies for men who don't respond to oral medication
- Cardiovascular and metabolic risk reduction: including weight loss, which independently improves erectile function
The conversation you've been putting off
Our providers do this every day. There is nothing you can say that will surprise us, and nothing you say leaves the room. Call us or schedule a free consultation and let's find out what's actually going on.