Erectile Dysfunction: What Treatment Options Exist?

Discussing your sex life with a physician may seem intimidating or embarrassing. However, it is often one of the best things you can do for both your physical and mental health.

If you suffer from a sexual disorder like premature ejaculation or erectile dysfunction (ED) you are not alone. More than half of men over the age of 40 have difficulty achieving or maintaining an erection. Far fewer, however, talk to their doctor about the problem or seek help.

Summit Health urologists want you to know there are many treatment options available. Your sexual health can have a profound impact on your physical, mental, and social well-being.

Having a conversation with your primary care physician or a specialist about symptoms of ED is the first addressing sexual dysfunction which is often very treatable.

“Due to the nature of sexual dysfunction, men are often hesitant to bring it up during an appointment, even with specialists like us who commonly treat ED.” says Matt Ashley, MD, a Urology provider at Summit Health. “There is an overall underappreciation of how common ED is, and also how many treatments are available and easily accessible.”

ED is classified as the inability to achieve or maintain an erection for sexual activity. Like many medical conditions, there is a spectrum of ED and sexual dysfunction. There is also a wide range of other sexual problems that men can experience including premature or delayed ejaculation, decreased libido (interest in sex) and Peyronie’s disease, which is curvature of the penis.

“ED impacts men both physically and mentally, in addition to often being a strain on relationships,” describes Dr. Ashley. “Anxiety about sexual performance tends to make ED worse, which can sometimes cause men to avoid intimacy altogether.”

What causes erectile dysfunction?

There are several known causes of ED. Underlying medical conditions such as diabetes and high blood pressure, use of certain medications, stress, and the natural aging of arteries can all affect a man’s sexual function. Due to its multifactorial causes, ED is sometimes the first indication that there may be another underlying medical issue developing.

“Discussing ED with your physician can not only benefit your sexual health, can but often be an important clue to uncovering other important health issues,” explains Dr. Ashley.

Treatment options for erectile dysfunction

Most ED treatments are directed toward improving blood flow by various means. Here are a few of the current options:

• Lifestyle and current medications. Treatment of ED typically begins with identifying anything in the patient’s current lifestyle can be changed to improve erectile function. This often includes weight loss and stress reduction. It is also critical to optimize any health conditions that may exacerbating ED such as diabetes and high blood pressure. A thorough medication review is also important since many common medications negative affect sexual function
• Behavioral health. There is a close link between the physical, mental and emotional aspects of sexual dysfunction. Work with a counselor or behavioral health specialist is often extremely beneficial and can be tailored for the individual or couple.
• Hormone therapy. Some ED can be caused by changes in your body’s production of hormones such as testosterone. Low testosterone is rarely the only cause of ED, but it can be an important element of treatment in some men.
• Oral Medications to treat ED. There are numerous oral options to treat ED and they are typically much more affordable than in years past. Some of these pills can interact with your current medications so checking for interactions is important.
• Vacuum constriction device. This is a specialized pump that is placed over the penis to create a vacuum to draw more blood into the area. A constriction ring is then applied at the base of the penis to prevent the blood from leaving.
• Penile injection therapy. This injection is self-administered directly into the penis and typically works in a matter of minutes. These injections are often used by men who do not respond to oral medications or have contraindications to their use.
• Penile implants. This is an inflatable device that can be surgically implanted inside the penis and activated by the patient for sexual activity. There have been many improvements to penile implant technology over the past few decades.

Dr. Ashley encourages patients to talk about ED with their primary care physician or make an appointment with a urologist to discuss their particular situation and potential treatment options.“ Although progress is being made, ED remains one of the more underdiscussed and undertreated issues in men’s health,” says Dr. Ashley. “I hope that more men will take this as an invitation to talk with their healthcare team about sexual dysfunction.”

Summit Health Urology has many providers, both in primary care and urology, with expertise in treating all aspects of sexual health.