Erectile Dysfunction (ED): A Guide to Symptoms, Causes, Diagnosis, and Treatment

Nearly 70% of men experience erectile dysfunction by the time they turn 70. Erectile dysfunction may be common, but it can still have a severe impact on your quality of life. Comprehensive Urology wants you to know you are not alone. Our specialists have years of experience helping men overcome this condition. With proven erectile dysfunction treatment methods, you can take back control of your life.

Kiarash Michel, MD, and his expert urology team understand how frustrating and dis-empowering erectile dysfunction (ED) can feel. That’s why they offer several cutting-edge treatments at their office in the Beverly Grove area of Los Angeles. Book an appointment with the team and reclaim your sexual vitality by calling Comprehensive Urology or by scheduling a visit online today.

What is erectile dysfunction?

Erectile dysfunction (ED), also commonly called impotence, is a type of male sexual dysfunction that causes an inability to achieve or maintain an erection. The condition frequently causes frustration, depression, low self-confidence, and a drop in overall quality of life. ED can also have an impact on your intimate relationships, because a fear of low sexual performance can lead to avoidance of sex and this can make the partner feel like they are unwanted. Countless patients have reported greater intimacy in their relationship after successful erectile dysfunction treatment.

Many men experience ED during times of stress or after consuming too much alcohol. However, recurring ED can be a sign of an underlying problem. Without treatment, erectile dysfunction can start to negatively impact your life. Commonly it can diminish your self-esteem and make it challenging to sustain fulfilling sexual relationships. Our goal is to help you overcome this condition and restore the life affirming power of healthy sex.

What causes erectile dysfunction?

Sexual arousal is a sophisticated process with many important components. A variety of physical, mental, and emotional factors can contribute to erectile dysfunction. A significant factor in treatment is identifying what factors are at play. For many men, it can be more than one. These factors include:

• Low testosterone

• Alcoholism

• Heart disease

• Diabetes

• High cholesterol

• Anxiety

• Depression

• Prostate cancer treatment

• High blood pressure

• Parkinson’s disease

While age isn’t the only reason men develop ED, it is a major contributing factor. As you age, erections can be difficult to achieve and maintain. However, it is far from impossible.

How do urologists diagnose erectile dysfunction?

Comprehensive Urology uses only the most advanced diagnostic capabilities available for diagnosing ED. Two key techniques for diagnosis include hormonal testing and medical imaging. At Comprehensive Urology, we provide both! Utilizing these methods, we can provide personalized solutions that match your unique situation.

We offer a full range of on-site hormonal testing to determine if you have low levels of testosterone. In addition, we have state-of-the-art imaging services to detect poor blood flow in your penis.

How do urologists treat erectile dysfunction?

Dr. Michel and the team at Comprehensive Urology use a multi-modality treatment system. The approach aims to minimize the symptoms of erectile dysfunction and can often treat the underlying conditions creating erectile dysfunction. Each treatment will vary, focusing on your unique needs and health.

You may benefit from a single treatment. Or, you may find a combination works best. In every case, we help you find the treatment that will provide optimal results. A comprehensive course of treatment is always customized to the patient. This often can include testosterone balancing combined with low-intensity shockwave therapy and medication. Vascular surgery options and implants are also available depending on the indivudalized needs of the patient. Whenever possible, restoring the patients natural ability to heal itself without dependency on external chemicals or devices is the preferred form of comprehensive treatment.

Medication

Medications can help you achieve and maintain a firm erection. When used correctly, they often can help you continue to have fulfilling sexual experiences.

Common prescription include:

• Viagra

• Cialis

• Levitra

• Stendra

• Staxynso

Shockwave therapy

Shockwave therapy, a.k.a. PulseWave therapy, is a non-invasive treatment that uses high-frequency acoustic (sound) waves to improve blood flow and stimulate the growth of new blood vessels in the penis, which can lead to improved erectile function. This is a preferred mode of treatment because it encouraged the body to heal itself without dependency on external chemicals and has little to no side effects. Patients are free to have same-day sex after each treatment.

PulseWave therapy typically involves a series of treatment sessions of about 15-20 minutes. Multiple sessions are usually required for best results, though the number of sessions needed varies depending on the severity of ED and the patient's response to treatment.

Intracorporeal injections

Intracorporeal injections, also known as penile injections or penile self-injection therapy, are an effective ED treatment option that involves injecting medication directly into the penis. The medication used in these injections is typically a vasodilator, which means it helps to relax and widen the blood vessels in the penis, allowing for improved blood flow and erection. These injections can be combined with Shockwave therapy to maximize blood flood to the penis, which is a vascular organ.

The injection is typically given using a very small needle. It typically takes effect within 5-20 minutes, and can last for up to an hour or more depending on dosage. Dr. Michel and the team use customized formulations for every patient.

Intracorporeal injections are typically used in patients who have not responded to other treatments, such as oral medications or vacuum erection devices. The injection therapy can be used as needed, before sexual activity.

Vacuum devices

A vacuum constriction device (VCD) uses a pump to help you get and maintain an erection. While it does not treat underlying causes, it delivers functional results. Vacuum devices are typically recommended for patients with mild to moderate ED, although they may also be used in combination with other treatments for more severe cases.

To use a vacuum device, a man typically places a plastic cylinder over the penis and uses a hand pump or battery-powered pump to create a vacuum inside the cylinder. The vacuum draws blood into the penis, causing it to become erect. Once an erection is achieved, a constriction band is placed around the base of the penis to help maintain the erection during sexual activity.

Inflatable penis prosthesis

An inflatable penis prosthesis is a surgically implanted device that is used to treat severe cases of ED that do not respond to other treatments. The prosthesis consists of two inflatable cylinders that are surgically implanted into the penis, along with a pump that is placed in the scrotum, and a reservoir that is placed in the abdomen.

To use the prosthesis, a man pumps fluid from the reservoir into the cylinders using the pump, which inflates the cylinders and causes the penis to become erect. The erection can be maintained for as long as desired, and the device can be deflated when sexual activity is completed.

What are the risk factors for erectile dysfunction?

There are several potential risk factors which may contribute to ED. Some of these include:

• Age: As men age, the risk of developing ED increases. It is estimated that 40% of men aged 40 experience ED, and this percentage increases with age.

• Medical conditions: Certain medical conditions can increase the risk of ED, including diabetes, heart disease, high blood pressure, obesity, and prostate cancer.

• Lifestyle factors: Lifestyle factors—such as smoking, excessive alcohol consumption, drug abuse, and lack of exercise—can contribute to ED.

• Medications: Certain medications, such as antidepressants, blood pressure medications, and antihistamines, can cause ED.

• Psychological factors: Psychological factors, such as stress, anxiety, depression, and relationship problems can contribute to ED.

• Hormonal imbalances: Low levels of testosterone or high levels of prolactin can contribute to ED.

• Neurological disorders: Neurological disorders, such as multiple sclerosis, Parkinson's disease, and spinal cord injuries, can increase the risk of ED.

Of course, not all men who have these risk factors will develop ED. And that ED can also occur in men without any known risk factors. However, by identifying and addressing these risk factors, men may be able to reduce their risk of developing ED.

Treating underlying conditions

Treating underlying medical conditions that contribute to ED is an important step in management and resolution of symptoms. If you have an underlying medical condition that is contributing to your ED, your Comprehensive Urology provider may recommend the following treatments:

• Medications: Depending on the underlying medical condition, medications such as oral medications or injections may be recommended to manage the condition and improve ED.

• Lifestyle changes: Making lifestyle changes, such as maintaining a healthy diet, exercising regularly, quitting smoking, and reducing alcohol consumption, can help manage underlying medical conditions and improve ED.

• Surgery: In some cases, surgery may be recommended to treat the underlying medical condition, such as prostate cancer.

• Counseling: If psychological factors such as stress, anxiety, or depression are contributing to ED, counseling or therapy may be recommended to address these factors.

It is important to work with your healthcare provider to develop a treatment plan that addresses both your underlying medical condition and ED. With appropriate treatment, it may be possible to manage or resolve ED and improve your overall quality of life.

How do I know whether my erectile dysfunction is physical or mental?

Determining whether erectile dysfunction is caused by underlying physical or psychological issues can be challenging. There can be a range of factors that contribute to ED, and often, a combination of physical and psychological factors are involved. However, there are some signs that can help you determine whether your ED is physical or psychological:

• Physical causes: If your ED is caused by physical factors, you may have difficulty achieving or maintaining an erection, even during sexual activity that would normally be stimulating. You may also experience other physical symptoms such as reduced libido, a lack of morning erections, or decreased sensitivity in the penis.

• Psychological causes: If your ED is caused by psychological factors, you may have no problem achieving an erection when masturbating or during sleep. You may also experience anxiety, stress, or depression, and you may find that your ED is triggered by specific situations or events, such as relationship problems or performance anxiety.

Can I combine erectile dysfunction treatments?

Dr. Michel's team at Comprehensive Urology have found that combining multiple therapies often helps men achieve more reliable erections that last longer during sexual intercourse. For lasting results, nearly all of our patients use Shockwave Therapy to enhance capillary growth, nerve rejuvenation, and blood flow to optimize erections.

This non-invasive treatment can be combined with prescription drugs, proper diet and exercise, and various surgical options to help you restore your confidence during sexual intercourse. Additionally, many patients report that they have more satisfying intimate relationships after completing medical treatments.

Which Option Is Best for Me?

We look at every aspect of your situation to build your treatment plan. Our experienced experts have helped countless men overcome ED already, and they look forward to helping you, too. At every step, we carefully consider every unique factor that causes your ED.

What works for one patient might not help another patient with ED. So, we take everything into account when finding the right option for you.

Schedule Your Appointment Today

You can start to take back control today when you schedule your appointment. During your initial consultation, we will begin working on a plan for diagnosis and treatment. Every step of the way, we provide you with complete information. Call us today to learn more about erectile dysfunction treatment.