Erectile Dysfunction

Erectile dysfunction is typically associated with aging, but it may also be a consequence of illness or medical treatments. It can occur in men even in their 20s. Causes include low blood flow into the erectile tissue, impaired nerve impulses from the brain to the penis and health conditions including diabetes, kidney disease, vascular disease, neurological diseases and prostate cancer.

An occasional inability to achieve an erection is normal and shouldn’t be cause for worry. But failure to reach or sustain an erection more than half of the time, at any age, may indicate a condition that needs treatment.

A physician will perform a physical exam and a psychosocial evaluation to determine stress levels. It is essential to provide a detailed history of medication and drug use since nearly 25% of ED cases can be attributed to medications for other conditions. A series of tests are available, including:

• Blood test: Detects abnormal hormone levels, thyroid levels or cholesterol levels.
• Urinalysis: Provides a reading of protein and sugar in the urine. Abnormal measurements of these substances can indicate diabetes or kidney disease, which can cause ED.
• Ultrasound: Take images of the body’s tissues and evaluate blood flow.

Depending on the cause and severity of your condition, there are several treatment options available, including:

• Medication: Several drugs can increase the flow of blood into the penis so when a man is sexually stimulated, he can get an erection.
• Low-intensity Shockwave Therapy: Ultrasound wave therapy improves penile blood flow to address the cause of many forms of ED, not just manage symptoms.
• Intra-urethral therapy: Medicated pellets, each about the size of a grain of rice, are inserted into the urethra through the tip of the penis, enabling an erection.
• Intracavernosal injection therapy: Medications are injected into the shaft of the penis to increase blood flow.
• Vacuum/constrictive devices: A large cylinder is placed over the penis and a vacuum is created, drawing blood into the penis for an erection. A small rubber ring is then placed around the base of the penis to maintain the erection.
• Penile prosthesis: The physician implants a bendable or inflatable device that can create an erection.
• Psychotherapy and behavioral therapy: If ED is the result of performance anxiety, depression or other psychosocial issues, the physician can refer to a specialist.

Dr. Brooke Edwards discusses low-intensity shockwave therapy for ED.