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PRIMARY CARE SERVICES

Diagnosis & Treatment

Erectile Dysfunction (ED)

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How is Erectile Dysfunction (ED) Diagnosed?

Diagnosis

If you have symptoms of erectile dysfunction (ED), your doctor will do an exam and perform several tests to determine their cause. These may include:

  • Assessment of your medical and sexual history
  • Physical examination
  • Evaluation of your mental health
  • Questionnaires
  • Blood tests to look for problems such as diabetes, kidney disease, and hormonal issues linked to ED
  • Doppler ultrasound to assess blood flow in the penis
  • A test to see if you are having erections at night while you sleep
  • Injection test (intracavernosal injection) to cause an erection and examine how full the penis becomes

How can a primary care doctor help?

A primary care physician may be able to do the medical and sexual history, physical exam, mental health assessment, and blood and urine tests. Your primary care doctor can refer you to a urologist for additional testing and treatment as needed.

How is Erectile Dysfunction Treated?

Treatment

There are many options available today to treat erectile dysfunction (ED), ranging from lifestyle changes to medications, injections, suppositories, devices, and surgery.

Lifestyle changes

Sometimes ED resolves with healthy lifestyle changes, such as quitting smoking, limiting or quitting alcohol, losing weight, being physically active, stopping illegal drug use, and seeking counseling for better emotional health.

Medical treatment of ED

If you are taking medications that cause ED, your doctor may be able to switch you to others that don’t cause this side effect. There are also several ED prescription medications available that work by increasing blood flow to the penis, such as:

  • Sildenafil (Viagra®)
  • Vardenafil (Levitra®, Staxyn®)
  • Tadalafil (Cialis®)
  • Avanafil (Stendra®)

If your ED is due to low testosterone, your doctor may prescribe testosterone replacement therapy.

Injections, suppositories, and pumps

The injection of a drug called alprostadil into the penis can result in a stronger erection. Alprostadil may also be inserted into the urethra using a special applicator, resulting in an erection that can last 30 to 60 minutes. Some men benefit from using a vacuum pump that pulls blood into the penis.

Surgery for ED

A urologist may perform surgery to place a penile prosthesis, which is an erectile dysfunction treatment option for men for whom medications, injections, suppositories, and vacuum devices are not satisfactory therapies. A urologist will counsel you about penile implant surgery.

Most of the penile implants used at NewYork-Presbyterian are inflatable—you activate and deactivate the implant by pressing on a small pump placed into the scrotum. Other penile implants are available for men who have limited dexterity. Another surgical option that is less utilized is the reconstruction of the arteries supplying the penis with blood.

Supplements

A number of supplements have been touted as alternative treatments for erectile dysfunction, such as “herbal Viagra,” but not all of them are safe. They may also interact with your other medications to cause health problems. If you have any questions about vitamins, minerals, or other supplements you have heard are natural treatments for ED, speak with your doctor before taking them.

FAQs

FAQs

The main cause of ED is impaired blood flow to the penis, often due to other health problems, cancer treatment, or medications.

There have been several new treatments for ED, including medications, injections, and suppositories. Penile implant surgery is a newer technique that has helped many men for whom other therapies were insufficient. Your doctor will help you choose the best option for you.

A drug’s safety can vary from person to person, depending on your other health issues and medications. Your doctor will match you with the most appropriate medication.

You may have erectile dysfunction if you have trouble achieving or sustaining an erection that is satisfactory for sexual intercourse.

The length of time that ED lasts depends on what is causing it.

Research has shown that circulation can improve within 2 to 12 weeks of quitting smoking, which could help ED. However, the benefit depends on how long you smoked and how much, since heavy smoking is likely to cause more damage to the blood vessels than light smoking.

There are many natural remedies advertised for ED, but more research into their efficacy is needed and they may interfere with your other medications. If you are interested in natural supplements to treat ED, speak with your doctor.

Get Care

Trust NewYork-Presbyterian for Erectile Dysfunction (ED) Treatment

NewYork-Presbyterian physicians are well-versed in the many treatment options for erectile dysfunction (ED), and our urologists have special expertise in penile implant surgery.

If you have ED symptoms, start your care by scheduling an appointment with a primary care physician, either in person or via telehealth. You can see a doctor at one of our NewYork-Presbyterian campuses or medical groups. Scheduling is easy and convenient hours are available. Most insurance plans are accepted. Give us a call today.