Erectile Dysfunction

Erectile dysfunction, sometimes called impotence, is a common and treatable problem. It refers to a man’s inability to achieve or sustain an erection, and it is estimated to affect nearly 30 million American men. Many men may experience erectile dysfunction from time to time, but for some men, it is an ongoing problem. Fortunately, many safe and effective treatments are available for erectile dysfunction.

Risk Factors and Causes for Impotence

Several factors can contribute to a man’s risk of erectile dysfunction, and it may have more than one cause. Some conditions that can contribute to or cause erectile dysfunction, include:

  • Age
  • Certain medications
  • High blood pressure
  • High cholesterol
  • Diabetes
  • Depression
  • Smoking
  • Heart disease
  • Alcohol or substance abuse
  • Hormonal imbalance
  • Trauma or injury (including spinal cord injury)
  • Stress or psychological factors
  • Other health conditions

Diagnosing Erectile Dysfunction

Erectile dysfunction can be a sign of other serious health conditions, so it’s important to be evaluated by a trained physician. A thorough physical exam and health history, including all medications, are important first steps in diagnosing the cause. Blood tests and sometimes, a blood flow test may also help with diagnosis.

The Men’s Reproductive and Sexual Health Program is one of only a few in the country to have two fellowship-trained, nationally recognized specialists in andrology, which includes male infertility and male sexual dysfunction. Our specialists treat erectile dysfunction and related conditions every day. They have the experience, expertise and compassion to handle each patient’s needs individually with dignity and respect.

Treatments for Erectile Dysfunction

Treatment options include lifestyle changes, as well as medications and devices to help sustain an erection. Every treatment for erectile dysfunction has its risks and benefits. You should understand your diagnosis and all of your options in order to make an informed decision.

  • Lifestyle changes – Quitting smoking and moderating alcohol intake can help reduce the risk of erectile dysfunction. Controlling diabetes and high blood pressure, being treated for depression, and maintaining a healthy weight can also help.
  • Counseling – Psychological counseling for depression, anxiety or other conditions can help resolve impotence.
  • Medical management – Adjusting other medications that can cause impotence is sometimes an effective treatment. Andrology specialists work collaboratively with your primary care or referring physician to provide consultation, diagnosis, treatment and follow-up communication.
  • Oral medications – Oral medications are one common treatment for erectile dysfunction, and several different drugs – known as phosphodiesterase type 5 (PDE-5) inhibitors – are available. However, these medications do not work for about 30 percent of men.
  • Self-injection therapy – Self-injections, done with a tiny needle, allow men to inject medication(s) directly into the penis. The medication relaxes the penile blood vessels and smooth muscle to produce an erection.
  • Testosterone replacement therapy – If erectile dysfunction is caused by a hormonal imbalance, testosterone replacement therapy may be one treatment option. Testosterone therapy can be administered several ways – injections, gel applied to the skin, or a patch worn on the skin.
  • Vacuum erection therapy – A vacuum erection device uses a plastic tube that fits over the penis. A pump then creates a gentle vacuum to increase blood flow to the penis and produce an erection.
  • Constriction therapy – Constriction therapy can be used to treat venous leak syndrome. A band or tension ring is placed around the base of the penis to keep blood from flowing out of the penis during an erection.
  • Surgery – In some cases, such as injury or congenital defect, the underlying cause of erectile dysfunction can be treated with vascular surgery.
  • Penile implants – A penile implant – a surgically implanted penile prosthesis – is another treatment option for some men. There are different types of penile implants. Malleable or inflatable are two common choices.