Erectile dysfunction (ED) refers to men having trouble achieving and/or keeping a firm erection. It’s a common problem that isn’t always easy to talk about. At UW Health, urologists assess and treat men experiencing ED. Erectile problems can have many causes. Finding what’s behind yours is the first step in finding treatment that will help you.
A problem that increases with age
Approximately 50% of men in their 50s experience mild or moderate erectile dysfunction. As you age, the number grows. It is expected that 60% of men in their 60s, and 70% of men in their 70s experience some form of ED.
Physical and organic causes
Your overall health and certain medications can contribute to ED. Specific medical conditions that can play a part include:
Atherosclerosis (blocked arteries)
Benign prostatic hyperplasia (noncancerous enlargement of the prostate gland)
Certain medications
Heart disease
High blood pressure
High cholesterol and lipid levels
Hormonal disorders
Injury to the penis
Kidney disease
Low testosterone
Neurological diseases
Obesity
Peyronie’s disease
Prostate cancer treatment
Spinal cord injury
Psychological and environmental causes
Causes of ED that can be related to your mental health and environment include:
Alcoholism
Depression
Drug abuse
Fatigue
Poor communication with your partner
Smoking
Stress
Evaluating your condition
Our urologists will talk with you to learn about your health and what might be causing your ED. They’ll do a physical exam, and they might order tests, too. These can include blood tests to look for hidden medical conditions or an ultrasound to check blood flow in your penis.
There are several steps you can take to reduce your risk for developing ED:
Avoid or limit alcohol
Eat a healthy diet
Exercise regularly
Get regular checkups to monitor your blood pressure, blood sugar and cholesterol levels
If you smoke, quit
Maintain a healthy weight
Reduce stress
Seek help for anxiety or depression
Talk with your doctor about stopping drugs with harmful side effects
With treatment, ED may improve. Sometimes ED is possible following treatment for other conditions, such as cancer. We work closely with those providing your care to preserve your sexual function and fertility. In all cases, we help you weigh your treatment options.
Lifestyle changes
Making healthy lifestyle changes improves ED in some men. This could include eating a better diet, stopping smoking or getting help for drug or alcohol abuse. Often getting more exercise and losing weight help, too.
Oral medications
Several medicines that you take by mouth may help you have a stronger or longer-lasting erection by improving blood flow to your penis.
Injectable medications
We also have medicines that you inject directly into your penis when you want to have an erection. Another option is a dissolvable pellet that you insert in the opening at the tip of your penis to stimulate the development of an erection.
Hormone replacement therapy
Testosterone is a hormone that plays a key role in your sex drive and sexual function. As you age, levels of this hormone decline. Certain medications and medical conditions can affect testosterone levels as well.
If you have symptoms of low testosterone, we might recommend checking your testosterone levels. If your levels are low, other tests can help us find the cause.
Several treatments can bring your testosterone levels to a normal range. These include:
Injectable pellets that we place under your skin
Injections
Patches applied on your gum or cheek
Skin patches
Topical gels
Your doctor will work with you to determine which option is best.
Vacuum erection device
A vacuum erection device is a device that you place over your penis when you want to have sex. It draws blood into the penis and leads to an erection. To keep the blood there, you place a special ring around the base of your penis. This allows most men to maintain an erection long enough for intercourse.
Penile implants
If other ED treatments don’t help you enough, you might consider a penile implant. This involves surgery to place a device inside your penis that helps you have an erection. In most cases, you go home the day of your surgery or after an overnight hospital stay.
Counseling
Issues such as stress, depression or relationship difficulties often contribute to ED. Speaking with a counselor can give you insight into these challenges and help you to deal with them.
Achieving success one patient at a time
UW Health Urology is recognized as a top national program for providing new and effective approaches to treatment. Although we do thousands of complex procedures every year, the care we provide you is the most important.
Our urologists have advanced training in men’s sexual health. They help put you at ease so you can speak freely, without embarrassment. They work with other experts to make sure you get the help that will benefit you most. Psychologists, cardiologists and nutritionists are some of the specialists who might take part in your care at UW Health.
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UW Health offers a number of services and information to help you better understand and address ED.
Behavioral health
Through our behavioral health department, we look after your mental health and psychological well-being. We offer counseling for individuals and couples. We also offer help for people with drug or alcohol use issues.
Generations Fertility Clinic
For some men, concerns about ED are centered on problems conceiving a baby. Our Generations Fertility Clinic offers expert care for couples having trouble getting pregnant. We can help you and your partner as you work to have a successful pregnancy.
Nutrition services
Good nutrition is essential. This is especially true for people with diabetes, heart disease and other conditions that can play a part in ED. Our nutritionists can help you create a healthy eating plan. They can also work with you to help you achieve a healthy weight.