ERECTILE DYSFUNCTION | Jeannie Su, M.D.

WHAT IS ED?

Erectile dysfunction (ED) is a common condition that can impact men of all ages, causing difficulty achieving or maintaining an erection during sexual activity.

Erectile dysfunction symptoms and complications can include:

Difficulty becoming erect
Difficulty staying erect
Decreased rigidity
Stress and anxiety around sexual activity
Reduced libido or sexual desire
Low self-esteem
Inability to perform intercourse

Causes of erections can include:

Medical conditions such as high blood pressure, diabetes, heart disease, and prostate cancer
Psychological factors such as anxiety, depression, and stress
Lifestyle habits such as smoking, alcohol or drug use, and lack of exercise
Medications such as antidepressants, blood pressure medications, and antihistamines
Hormonal imbalances such as low testosterone levels
Neurological disorders that affect nerve function in the penis
Physical injury or trauma to the genital area

Erectile dysfunction (ED) is a chronic condition characterized by regular difficulty achieving or maintaining an erection during sexual activity. While occasional difficulty with erections is not uncommon, ED can have a significant negative impact on a person's quality of life and may require medical intervention.

Treatment Options

PDE-5 inhibitors

PDE5 inhibitors (PDE5i) are oral medications that work by increasing blood flow to the penis, helping to achieve and maintain an erection.

Examples of PDE5i:

Sildenafil (Viagra)
Tadalafil (Cialis)
Vardenafil (Levitra)
Stendra

Intraurethral suppositories

Intraurethral suppositories are small pellets or capsules that are inserted into the urethra.

They can be a good option for men who cannot or do not want to use oral medications or injections. Side effects include discomfort or irritation in the urethra.

Penile injections

Intracavernosal injection therapy (ICI) involves injecting a medication directly into the base of the penis, which causes vasodilation and increase in blood flow to the penis, resulting in an erection.

Examples:

Aprostadil
Bimix
Trimix

Low intensity shockwave therapy

Pulsewave therapy involves using a device that delivers low-intensity sound waves to the penis, which stimulates the growth of new blood vessels and improves blood flow to the penis, resulting in better erections.

Pulsewave therapy is a safe and painless procedure, and there are few reported side effects. The treatment is performed in the office, and typically involves multiple sessions over several weeks.

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Inflatable Penile Prosthesis

A penile implant, also called a penile prosthesis, is a medical device surgically implanted in the penis to treat severe erectile dysfunction that does not respond to other treatments. It consists of inflatable or non-inflatable cylinders placed in the penis, a pump in the scrotum, and a fluid reservoir. When activated, the pump sends fluid into the cylinders, creating an erection. Penile implants can be a safe and effective treatment option for men with severe ED who have not responded to other treatments.