Erectile dysfunction in young men is an increasingly common chief complaint seen in urology clinics across the world (1). The international urologic community has taken an increased interest in this topic, with experts in the field of andrology and sexual dysfunction publishing multiple review articles (2,3) and an AUA Update Series Lesson (4) dedicated to this concerning issue. These articles skillfully address the epidemiology and diagnostic evaluation of ED and categorize ED (Table 1) into psychogenic or organic causes, addressing treatment options with specific interventions for each of the most common diagnoses.
Side effects of sildenafil are similar to those from taking niacin or any vasodilator, namely, headaches, lightheadedness, dizziness, and flushing. Some individuals experience a bluish tinge of their cornea, which makes them feel as if they are wearing light blue–tinted sunglasses. This effect can last for several hours. Syncope and myocardial infarction, the most serious side effects, are seen in men who are also taking nitrates for coronary heart disease. Sildenafil also has adverse effects in people with hypertrophic cardiomyopathy because a decrease in preload and after load in the cardiac output can increase the outflow obstruction, culminating in an unstable hemodynamic state.
Neurologic illnesses leading to ED have been recently reviewed (64). The most common of them (i.e., consequences of prostatic surgery, stroke and Parkinson’s disease) are not typical of younger age and, similarly to conditions less common but more typical of younger men, such as spinal cord injury, multiple sclerosis and spina bifida, the clinical features of the underlying disease are clearly apparent, being ED one of the multiple manifestations, rather than a harbinger of a subtle condition. Diagnosis of neurologic origin of ED is often quite simple, based on medical history and physical exam. The clinical management is a multidimensional and coordinated work of rehabilitation and medical therapy, which includes ICI injection of vaso-relaxant drugs, vacuum device and surgery (64).
Cognitive behavioral therapy (CBT) is a common and highly effective treatment for psychological issues in general, but also for ED. Facilitated by a therapist, this type of treatment helps you to identify and change unhealthy patterns of thought and action which may be contributing to your erectile issues. This kind of treatment is based on the idea that the situation itself (your inability to achieve or maintain an erection) is not the core problem, but rather your reaction to it. If you can learn to better understand yourself and your thought patterns, you can change them in a positive way to resolve your issues.
Tadalafil (Cialis) is the third oral medicine approved by the U.S. FDA for the treatment of erectile dysfunction. Like sildenafil (Viagra) and vardenafil (Levitra), tadalafil inhibits PDE5 (as described earlier). Unlike the other PDE 5 inhibitors, patients should take tadalafil once daily and is approved for the treatment of BPH (benign enlargement of the prostate).
Wing, R. R., Rosen, R. C., Fava, J. L., Bahnson, J., Brancati, F., Gendrano, I. N. C., … Wadden, T. A. (2010, January). Effects of weight loss intervention on erectile function in older men with type 2 diabetes in the Look AHEAD trial. The Journal of Sexual Medicine, 7(1), 156-165. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4461030/
Unconventional CV risk factors, such as impaired erections during masturbation and reduced flaccid acceleration, are interesting parameters to implement in Sexual Medicine context, because they can help fill the gap of information on CV risk, left by the conventional risk factors (the so-called residual risk) (38). However, it should be recognized that not all the healthcare professionals who deal with the complaint of ED (i.e., general practitioners, diabetologists, cardiologists, sport physicians, nurses, etc.) have the facilities or competence for the specific assessment of these parameters. In contexts different than Sexual Medicine and Andrology, the assessment of conventional risk factors is certainly more convenient. Metabolic syndrome (MetS) represents a cluster of metabolic derangements easily and commonly evaluated in several different medical contexts. In a population of more than 600 subjects attending the Sexual Medicine and Andrology Unit of the University of Florence for ED, the presence of MetS was associated with an increased incidence of MACE during 4.3 years of follow-up in younger (first tertile of age: 18–52 years) (Figure 3, Panel A and B) but not in middle aged and older men (second and third tertiles of age: 53–60 and 61–88 years, respectively) (Figure 3, Panel B). Similar to MetS, the algorithms for estimating the risk of developing MACE are easily computed and they take into account factors largely available in a clinical setting. In Europe, the most commonly used algorithm is the SCORE, which takes into account age, smoking habits, systolic blood pressure and total cholesterol (26). These parameters are introduced in a calculation tool that returns the 10-year risk of developing the first MACE. The same estimated risk rate can obviously be derived from different combinations and extent of the single risk factors and, as aforementioned, age has a heavy weight in the amount of risk, even when the other parameters are normal. For overcoming this overestimation, the concept of vascular age, based on the predicted CV risk, has been introduced. Vascular age of a subjects with a specific CV risk profile corresponds to the chronological age of a subjects who has the same estimated risk but only due to chronological age, because of the absence of the other modifiable risk factors (i.e., a non-smoker, normotensive and normocholesterolemic subject) (39,40). Vascular age carries the advantage of easily and directly communicating the concept of high relative risk to patients, in particular to younger ones, who are by definition at low absolute risk (“Your CV risk is the same of a man that is 15 years older than you”). Based on this interesting and useful concept of vascular age, we recently studied the clinical consequences of having a high discrepancy between the estimated vascular and the actual chronological age in our population of men consulting for ED. In our sample, a greater difference between vascular and chronological age was associated with higher glucose and triglyceride levels as well as with impaired penile colour Doppler ultrasound parameters, suggesting a CV impairment (41). When evaluating the subset of men for whom information on incident MACE during a mean follow-up of 4.3 years was available, a greater difference between vascular and chronological age was associated with the incidence of MACE in younger, but not in older men (42).
This man’s situational ED, possibly due to performance anxiety or perhaps fear of a repeat injury and pain. Structural, neurogenic, arteriogenic, and venous occlusive erectile dysfunction can be ruled out as he has normal self-stimulated erections. He responds well to low dose oral PDE5 inhibitors. Additional assessment with cold and hot perception testing and biothesiometer were performed due to his complaint of decreased sensation; both test results were normal. He was started on low dose terazosin once daily at bedtime along with Cialis 5 mg as needed. He is responding well to treatment.
The most common diagnostic test for erectile dysfunction is called penile ultrasound. This test uses sound waves to look for abnormal penile blood supply. Another test that may be done is nocturnal penile tumescence testing, in which a type of computer is attached to the penis to see if nighttime erections are occurring. If a young man is having nighttime erections but can’t get an erection during sex, a psychological cause becomes more likely.

It's tempting to think of erectile dysfunction (ED) as a condition that only affects aging men. But a small number of younger men will develop erectile dysfunction too. One survey found that about 2 percent of men in their 20s are unable to have erections. Overall, 6.5 percent of these younger males said they had at least occasional difficulty getting or sustaining an erection.

Unfortunately, studies specifically considering the relationship between couple liaison and ED in younger men are not available. Although the aforementioned studies include also young men, thus making their results theoretically applicable even in this specific group, it should be recognized that mean age of men enrolled is usually shifted toward the middle-age, rather than younger age. It is conceivable that couple relationship can act differently in younger men because it could show peculiar characteristics likely affecting ED onset, maintenance, resolution or responsiveness to therapies, including the short duration, lack of experience in both the partners, limited privacy, fears for emotional involvement or worry for undesired pregnancies.
ED is common and has a significant impact on men and their partners. The first step is acknowledging that ED is affecting you and that it bothers you. If so, then it is time to get help. Often your primary care health provider can start the evaluation of your ED to determine if there are any potential reversible causes. It is important to be evaluated if you have ED as ED is often caused by medical conditions, which if not recognized and treated, could cause you harm. Did you know that the ED is a strong predictor of underlying cardiovascular disease? If you have underlying cardiovascular disease, your primary health care provider or a specialist (if needed) needs to make sure it is safe for you to participate in sexual activity.
When these drugs don't work, there are other options. Medications that dilate blood vessels, such as alprostadil, can be injected or deposited in the penis; they work in more than 80 percent of men with diabetes. Beyond that, penile implants can be an effective surgical solution. Implants are either malleable rods, which can be manually adjusted to the desired position, or inflatable cylinders that fill with fluid when a pump under the skin of the scrotum is pressed.
Cigarette smoking is a risk factor for ED, according to the 2014 Report of the U.S. Surgeon General. Excess weight can also contribute to erectile dysfunction. A 2004 Italian study found that one-third of their 110 obese study subjects were able to eliminate their erectile dysfunction problems by losing fifteen percent of their weight through diet and exercise.
While pills for ED are convenient, some men sustain stronger erections by injecting medication directly into the penis. Drugs approved for this purpose work by widening the blood vessels, causing the penis to become engorged with blood. Another option is inserting a medicated pellet into the urethra. The pellet can trigger an erection within 10 minutes.

Erectile dysfunction is your body’s “check engine light” because ED can be an early sign of serious health problems like high blood pressure, diabetes, high cholesterol or low testosterone. The blood vessels in the penis are smaller than other parts of the body. So ED symptoms often occur long before more serious problems like a heart attack or stroke. When an otherwise healthy man in his 20’s experiences ED, it’s cause for concern.
There are four main prescription-only medicines which are used to treat erectile dysfunction in young men: Viagra (sildenafil), Cialis, Levitra and Spedra. You can purchase all of these erectile dysfunction medicines through our discreet online service. They all work in roughly the same way, by opening up the arteries which supply blood to the penis. This allows blood to fill the erectile tissue in the penis, and for an erection to be achieved and maintained.
The various PDE5 inhibitors for the treatment of ED share several common side effects, including headache, flushing, nasal congestion, nausea, dyspepsia (stomach discomfort), and diarrhea. Differences exist in side effects of the different PDE5 inhibitors, and thus it is important to be familiar with the prescribing information of the PDE5 inhibitor you are prescribed.
Pelvic exercises, commonly known as Kegel exercises, were first described in 1948 by American gynaecologist Arnold Kegel. They are usually advocated by doctors to women after they have delivered a baby, and are not something most men are aware of. But Kegels help promote urinary continence and sexual health because they strengthen the bulbocavernosus muscle, which does three things: allows the penis to engorge with blood during erection, pumps during ejaculation, and helps empty the urethra after urination.
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The condition is often an early warning sign of heart disease and other circulatory problems. To achieve and maintain an erection, extra blood must be able to flow unimpeded. Anything that interferes with healthy flow – for example atherosclerosis, the artery-clogging process at the root of most heart attacks, strokes, and other cardiovascular conditions – has the potential to cause erectile dysfunction, too.
Erections also require neural input to redirect blood flow into the corpora cavernosae. Psychogenic erections secondary to sexual images or auditory stimuli relay sensual input to the spinal cord at T-11 to L-2. Neural impulses flow to the pelvic vascular bed, redirecting blood flow into the corpora cavernosae. Reflex erections secondary to tactile stimulus to the penis or genital area activate a reflex arc with sacral roots at S2 to S4. Nocturnal erections occur during rapid-eye-movement (REM) sleep and occur 3–4 times nightly. Depressed men rarely experience REM sleep and therefore do not have nocturnal or early-morning erections.
Taking one of these tablets will not automatically produce an erection. Sexual stimulation is needed first to cause the release of nitric oxide from your penile nerves. These medications amplify that signal, allowing some men to function normally. Oral erectile dysfunction medications are not aphrodisiacs, will not cause excitement and are not needed in men who get normal erections.

The time the dose should be taken and how long the effects last depend on the medication used. The most common side effect of these medications is a headache. However, there is a potential for certain dangerous drug interactions. Anyone prescribed this medication must let his doctor know about any medications he's on, and especially if he's taking nitrates (e.g., nitroglycerin spray, nitroglycerin pills, or nitroglycerin patch) for heart problems.
Intraurethral alprostadil (Muse) provides a less invasive alternative to intrapenile injection. It is a pellet that is inserted 5–10 min before intercourse, and its effects last for 1 h. The response rate is ∼50–60%. It can be used twice daily but is not recommended for use with pregnant partners. Complications of priapism and penile fibrosis are less common than after alprostadil given by penile injection. The cost is ∼$18–24 per treatment.
"Stress and anxiety can adversely affect sexual performance and are common causes of erectile dysfunction,” warns Feloney. “Feelings of stress and anxiety can also lead to depression and a loss of interest in sex." It's important to get these feelings out in the open where you can deal with them. Issues that can lead to erectile dysfunction include fear from previous bad experiences with sex, family or work related stress, poor communication with your partner, and unrealistic goals and expectations.
Think of erectile dysfunction as your body’s “check engine light.” The blood vessels in the penis are smaller than other parts of the body, so underlying conditions like blocked arteries, heart disease, or high blood pressure usually show up as ED before something more serious like a heart attack or stroke. ED is your body’s way of saying, “Something is wrong.” And the list of things that cause erectile dysfunction can include:
"Stress and anxiety can adversely affect sexual performance and are common causes of erectile dysfunction,” warns Feloney. “Feelings of stress and anxiety can also lead to depression and a loss of interest in sex." It's important to get these feelings out in the open where you can deal with them. Issues that can lead to erectile dysfunction include fear from previous bad experiences with sex, family or work related stress, poor communication with your partner, and unrealistic goals and expectations.
The pills currently available by prescription all work the same way—by boosting the effects of NO in the penis. They typically have mild side effects. Some work faster but others last longer. There is no “best” drug, as some will work better for some men than others, but they all are about equally effective at increasing the hardness of an erection. Pills don’t work for everyone. The main risk is using them with nitroglycerine which can be fatal and must absolutely be avoided.
Alprostadil self-injection. With this method, you use a fine needle to inject alprostadil (Caverject Impulse, Edex) into the base or side of your penis. In some cases, medications generally used for other conditions are used for penile injections on their own or in combination. Examples include papaverine, alprostadil and phentolamine. Often these combination medications are known as bimix (if two medications are included) or trimix (if three are included).
Sildenafil (Viagra) was the first oral phosphodiesterase type 5 (PDE5) inhibitor approved by the FDA in the United States for the treatment of erectile dysfunction (it is not approved for women). Sildenafil inhibits PDE5, which is an enzyme that destroys cGMP. By inhibiting the destruction of cGMP by PDE5, sildenafil allows cGMP to accumulate. The cGMP in turn prolongs relaxation of the smooth muscle of the corpora cavernosa. Relaxation of the corpora cavernosa smooth muscle allows blood to flow into the penis resulting in increased engorgement of the penis. In short, sildenafil increases blood flow into the penis and decreases blood flow out of the penis.

To avoid the dreaded whiskey d---, you don’t necessarily have to stop drinking alcohol. Just drink in moderation. The National Institute on Alcohol Abuse and Alcoholism defines moderate drinking as no more than two drinks a day for men, and one drink a day for women. The liver can only process 1 ounce of liquor or one standard drink in one hour. Consuming more than this will lead the system to become saturated, where extra alcohol will increase in the blood and body tissues, until the liver is ready to metabolize it again. Until then, high blood alcohol concentration will last for several hours and affect you physiologically.
Nevertheless, this study highlights the ubiquitousness of sexual problems in the heavy-drinking population. It also stresses the need for addiction medicine specialists to note the possibility of sexual problems in their clients. In addition, it highlights the need for sexual medicine specialists to consider the effects of heavy alcohol use on sexual functioning. However, there is ample evidence that alcohol-induced sexual dysfunction, for the most part, is reversible with cessation of alcohol use.[18] Thus, this information can be used in motivational counselling of heavy drinkers to provide impetus for change. Clinicians are well advised to routinely assess sexual functioning in patients with alcohol dependence.
The physical exam should focus on femoral and peripheral pulses, femoral bruits (vascular abnormalities), visual field defects (prolactinoma or pituitary mass), breast exam (hyperprolactinemia), penile strictures (Peyronie’s disease), testicle atrophy (testosterone deficiency), and asymmetry or masses (hypogonadism). A rectal exam allows for assessment of both the prostate and sphincter tone, abnormalities that are associated with autonomic dysfunction. Sacral and perineal neurological exam will help in assessing autonomic function.
Nevertheless, this study highlights the ubiquitousness of sexual problems in the heavy-drinking population. It also stresses the need for addiction medicine specialists to note the possibility of sexual problems in their clients. In addition, it highlights the need for sexual medicine specialists to consider the effects of heavy alcohol use on sexual functioning. However, there is ample evidence that alcohol-induced sexual dysfunction, for the most part, is reversible with cessation of alcohol use.[18] Thus, this information can be used in motivational counselling of heavy drinkers to provide impetus for change. Clinicians are well advised to routinely assess sexual functioning in patients with alcohol dependence.

Medications: Many common medicines produce erectile dysfunction as a side effect. Medicines that can cause erectile dysfunction include many used to treat high blood pressure, antihistamines, antidepressants, tranquilizers, and appetite suppressants. Examples of common medicines that can cause erectile dysfunction include propranolol (Inderal) or other beta-blockers, hydrochlorothiazide, digoxin (Lanoxin), amitriptyline (Elavil), famotidine (Pepcid), cimetidine (Tagamet), metoclopramide (Reglan), naproxen, indomethacin (Indocin), lithium (Eskalith, Lithobid), verapamil (Calan, Verelan, Isoptin), phenytoin (Dilantin), gemfibrozil (Lopid), amphetamine/dextroamphetamine (Adderall), and phentermine. Prostate cancer medications that lower testosterone levels such as leuprolide (Lupron) may affect erectile function. Some chemotherapies such as cyclophosphamide (Cytoxan) may affect erectile function.
When sexually stimulated there is a release of a chemical, nitric oxide (NO) in the blood vessels of the corpus cavernosum. The NO stimulates the production of a compound called cGMP, which causes relaxation of the smooth muscle in the blood vessels supplying the corpus cavernosum. PDE 5 is an enzyme that breaks down cGMP. By inhibiting the breakdown of cGMP by PDE5, these medications allow cGMP to build up in the penis. cGMP causes muscles in the corpora cavernosa of the penis to relax. When the muscle is relaxed, more blood can flow into the penis and fill the spaces in the penis. As the penis fills with blood, the veins in the penis are compressed, and this results a hard erection. When the effect on PDE5 decreases, the cGMP levels go down and the muscle in the penis contracts, causing less blood to flow into the penis and allowing the veins to open up and drain blood out of the penis.
“Although having sex at 70 is not the same as having sex at 20, erectile dysfunction is not a normal part of aging,” according to Michael Feloney, MD, urologic surgeon and expert on sexual dysfunction issues at the Nebraska Medical Center in Omaha. “You should still be able to have a satisfying sex life as you age." If you are experiencing erectile dysfunction, these 10 dos and don'ts may help.
Some men should not take PDE5 inhibitors. They can cause hypotension (abnormally low blood pressure that can lead to fainting and even shock) when given to patients who are taking nitrates (medications taken for heart disease). Therefore, patients taking nitrates daily should not take any of the PDE5 inhibitors. Nitrates relieve angina (chest pain due to insufficient blood supply to the heart muscle because of narrowing of the coronary arteries); these include nitroglycerine tablets, patches, ointments, sprays, and pastes, as well as isosorbide dinitrate and isosorbide mononitrate. Other nitrates such as amyl nitrate and butyl nitrate also are in some recreational drugs called "poppers."
"We used to think that ED in young men was 90 percent psychological, but we now know that most cases are caused by a combination of risk factors. Erectile function depends on hormones, blood supply, nerve function, and psychological health,” said Run Wang, MD, professor of urology at The University of Texas Health Science Center in Houston and director of sexual medicine at MD Anderson Cancer Center.
Prostaglandins (alprostadil): Alprostadil can be injected into the penis or inserted as a pellet through the urethra. It causes an erection without sexual stimulation that usually lasts about 60 minutes. The danger with this method is that too high a dose can cause priapism, an erection that won't go away. This condition requires immediate medical attention as it can cause serious bruising, bleeding, pain and permanent penile damage. Once the doctor is sure of the right dose, the man can self-inject at home.
Patients should continue testosterone therapy only if there is improvement in the symptoms of hypogonadism and should be monitored regularly. You will need periodic blood tests for testosterone levels and blood tests to monitor your blood count and PSA. Testosterone therapy has health risks, and thus doctors should closely monitor its use. Testosterone therapy can worsen sleep apnea and congestive heart failure.
What has been excluded entirely from all recent discussions of ED in young men is a concept presented many years ago—the concept of increased sympathetic tone as an organic etiology of “psychogenic” erectile dysfunction in young men (5). Previous studies have shown that elevated central sympathetic tone may be one cause of impotence (6,7). This article focuses on the presentation, work-up, and treatment of young men (age: 16–35 years old) with complaints of ED, and we will attempt to present a new method of approaching these patients. It is important to identify the precise etiology of ED in these men before proceeding with potentially unnecessary evaluation and treatment as the process can be anxiety-provoking, invasive, and costly and may provide an unreliable diagnosis which produces further psychological distress in these psychologically fragile young men.
ED usually has something physical behind it, particularly in older men. But psychological factors can be a factor in many cases of ED. Experts say stress, depression, poor self-esteem, and performance anxiety can short-circuit the process that leads to an erection. These factors can also make the problem worse in men whose ED stems from something physical.
Obesity.  Obesity and erectile dysfunction in men has unfortunately become an epidemic in this country, affecting children, teenagers, young adults and up.  This disease tends to follow men and women through adulthood, if not addressed.  Obesity leads to heart disease, diabetes and high blood pressure.  This trifecta results in the three main medical causes of erectile dysfunction.
While erectile dysfunction can occur at any age, the risk of developing erectile dysfunction increases with age. According to the Massachusetts Male Aging Study, the prevalence of erectile dysfunction was 52% in men 40-70 years of age. The prevalence of complete erectile dysfunction increases from 5% at 40 years of age to 15% among men 70 years of age and older.

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Given the different questions and response options used here, I’d be cautious about concluding that the NSSHB is necessarily registering a rise in ED among young men compared to the aforementioned US study from the 90s. Given that the NSSHB response options allowed for different degrees of severity, it’s likely that this study is detecting more guys who occasionally have mild erectile issues (issues that may not even be significant enough to prompt distress or clinical attention). Also, the NSSHB was bound to produce different figures given that participants only had to think about the most recent time they had sex, as opposed to recalling all sexual experiences over the last year (indeed, thinking only about a single, recent event could make it easier to remember a mild problem that would otherwise be forgotten). For these reasons, the NSSHB data just aren’t directly comparable to the 90s data.
Talk with your doctor before trying supplements for ED. They can contain 10 or more ingredients and may complicate other health conditions. Asian ginseng and ginkgo biloba (seen here) are popular, but there isn't a lot of good research on their effectiveness. Some men find that taking a DHEA supplement improves their ability to have an erection. Unfortunately, the long-term safety of DHEA supplements is unknown. Most doctors do not recommend using it.
Patient can inject medications directly into the corpora cavernosa to help attain and maintain erections. Medications such as papaverine hydrochloride, phentolamine, and prostaglandin E1 (alprostadil) can be used alone or in combinations to attain erections. All of these medications are vasodilators and work by increasing blood flow into the penis. Prostaglandin E1 (Caverject, Edex) is easier to obtain; however, it is associated with penile pain in some individuals. The use of combinations of two or three of these medications can decrease the risk of having penile pain.
And yes, this may all seem easier said than done, when it comes to a condition that is more often than not the subject of jokes—or the cause of embarrassment. Talking to your doctor is the first step in dealing with this complication, which can wreak havoc on your quality of life. Keeping diabetes in check and enjoying a healthy lifestyle can make a huge difference in reducing ED risk, but if that isn't enough, there are successful treatments. Sex brings a range of physical and psychological benefits, whether you have diabetes or not. Preventing or reversing ED isn't just about sex—it's a step toward better health and a more satisfying life.
The first is a vacuum erection device (VED).  The device, which can be purchased on line and used at home, is placed over the penis, then pumped up to create a vacuum around the penis. This draws blood into the penis, creating an erection. One study found that the dropout rate with the VED was quite high, with only 50% of couples finding the treatment satisfactory. 2

In patients with low testosterone, testosterone treatment can improve libido and erectile dysfunction, but many men still may need additional oral medications such as sildenafil, vardenafil, or tadalafil. Some studies suggest that men with ED and low testosterone may respond better to PDE5 inhibitors when given testosterone therapy; however, this is controversial.

Our team includes a sex advisor/counselor who can help you understand what is making you anxious around sex, and give you techniques to decrease your anxiety about sex. He has also helped many of our younger patients get better at sex. We also have an exercise physiologist, who will work with you on both diet and exercise, which can have a profound effect on the quality of your erections.


As you can imagine, these symptoms can make it difficult to take pleasure in much of anything, let alone sex. A study published in a 1998 edition of Psychosomatic Medicine shows a clear link between depression and erectile dysfunction in men. Using data obtained from the Massachusetts Male Aging Study, researchers were able to conclude that a relationship between depressive symptoms and erectile dysfunction existed and was independent of aging and demographics.
Research has shown that the same eating patterns that can cause heart attacks due to restricted blood flow in the coronary arteries can also impede blood flow to and within the penis. The blood flow is needed for the penis to become erect. Diets that include very few fruits and vegetables along with lots of fatty, fried, and processed foods can contribute to decreased blood circulation throughout the body.
The lab testing obtained for the evaluation of erectile dysfunction may vary with the information obtained on the health history, physical examination, and recent lab testing. A testosterone level is not necessary in all men; however, a physician will order labs to determine a patient's testosterone level if other signs and symptoms of hypogonadism (low testosterone) such as decreased libido, loss of body hair, muscle loss, breast enlargement, osteoporosis, infertility, and decreased penile/testicular size are present.

ED is easily and successfully treated! If your sex drive is unaffected, but you experience problems achieving or sustaining erection for a period of four to five weeks, you may have ED. Talk to your doctor immediately. Don’t delay—erectile dysfunction doesn’t “just go away!” Additionally, ED could be a sign of a serious, even life-threatening complication, such as congestive heart failure or kidney disease. Ignoring your ED because it’s embarrassing could jeopardize your health.
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