Erectile Dysfunction

Erectile dysfunction (ED)—the inability to consistently achieve or maintain an erection adequate for sexual activity—is extremely common and becomes more prevalent with age.

About 50% of men in their 50s experience some degree of ED, with prevalence increasing with age. Many younger men also experience ED. ED may result from vascular disease, diabetes, neurologic conditions, medications, hormonal abnormalities, pelvic surgery, psychological factors, or a combination of these.

Because ED can be an early marker of cardiovascular and metabolic disease, evaluation extends beyond simply treating the erection itself, especially in younger men.

Evaluation includes a detailed medical and sexual history, physical examination, and targeted laboratory testing, including morning testosterone when appropriate. For selected patients, I offer penile Doppler ultrasound (penile duplex ultrasound) with medication injection to assess penile blood flow and help guide treatment.

Treatment is individualized and depends on each patient's goals, severity of ED, underlying cause, and response to previous therapies.

Treatment options include lifestyle modification, oral medications such as PDE5 inhibitors, vacuum erection devices, intracavernosal injection therapy, and inflatable penile prosthesis surgery, with penile prosthesis surgery being the most definitive and highly effective treatment for men with medication-resistant ED.

My goal is to enhance your sexual functioning and restore confidence, working closely with you to get you back where you want to be.