If you or someone you love suffers from erectile dysfunction (ED), the most important thing you need to know is this: you are not alone.

Erectile dysfunction can affect men of any age for a variety of reasons, including (but not limited to) diabetes, high blood pressure, depression, and side effects from prostate cancer therapies. Here’s the good news, though: effective ED treatments are available. Below, we discuss these options along with answers to FAQs.
Reminder: this information is educational only, not medical advice. If you suspect you have erectile dysfunction, talk to your doctor or make an appointment with one of our urologists.

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Frequently Asked Questions

You need at least three healthy things for an erection: a penis, blood vessels, and nerves. The most simplistic explanation of an erection is that nerves send signals to the blood vessels to deliver more blood to the penis. Then, spongy (erectile) tissue of the penis (corpus cavernosum) gets filled with blood and an erection occurs. If any of the above components are not functioning well, an erection might not happen.

Risk of ED is higher if you have high blood pressure, diabetes, vascular disease, low testosterone, history of prostate surgery, or take certain medications. Stress and other psychological aspects can sometimes play a role. But the main risk for having ED is age. Yes, unfortunately, the older you are, the more likely you are to have ED. The Cleveland Clinic cites a study that indicates "ED is increasingly prevalent with age: approximately 40% of men are affected at age 40 and nearly 70% of men are affected at age 70. Age was the variable most strongly associated with ED."

According to the National Institute of Diabetes and Digestive and Kidney Diseases, "Researchers estimate that ED affects as many as 30 million men in the United States." But the site is also quick to note, "Although erectile dysfunction (ED) is very common, it is not a normal part of aging; talk with your health care professional about treatment."

While lifestyle changes won't cure ED for all patients, positive lifestyle changes will improve a person's overall health, which can only help whatever treatment you settle on. And, for some men, these lifestyle modifications might be enough:

  • Watch what you eat and drink. (We're looking at you, alcohol.) A nutritious diet has many health benefits, and one of them could be better erections. Over time, excessive alcohol use has been known to contribute to ED. Moderation is key.
  • Watch your weight. Yes, the straightforward advice you get at your yearly physical holds true here.
  • Get regular exercise. Regular exercise will help you lose/maintain your weight while improving blood flow throughout your body (and healthy blood flow is essential to healthy erections).
  • Stop smoking. Smoking causes many health issues, as we all know. One of the problems with smoking is that it damages blood vessels. Damaged blood vessels have a harder time delivering blood. Yes, including to your penis.
  • Monitor your emotional state. Are you getting enough sleep? Are you feeling depressed? Are you dealing with self-esteem issues? The mind-body connection is real, and your emotional state can affect your ability to achieve and maintain an erection. And remember: if you can't manage these things on your own, ask for help.

Treatment Options

A variety of treatment options exist, including medications, injections, vacuum devices, shock wave therapy, and penile implants. What you choose will depend on your overall health and discussions with your doctor, ideally a urologist since urologists are trained in treating erectile dysfunction.

Oral medications like Viagra, Cialis, Levitra, etc. are what doctors usually prescribe first. All those medications function by bringing more blood flow to the penis. They are all similar in their action, and if one of them works for you, chances are the others will, too. Some men will experience side effects, most common being facial flushing.

There is also MUSE (generic name: alprostadil), which is a suppository. Essentially, it's a small medication pellet that gets inserted inside the urethra (the tube that transports urine) and releases medication directly into the penis. Some men prefer it, as it may be a bit more effective than oral medications, but some will complain of pain and burning with insertion.
  Oral medications

Injections work quite well for most men, but not everyone is willing to stick a needle into one's penis. Most patients actually do quite well after a teaching session that we do in the office. It also helps that the needle is tiny and the part of the penis where you have to inject does not generally hurt.
  Penile Injections

A vacuum device is exactly what it sounds like: a tube that brings blood into the penis. You keep the erection by using a penis ring at the base of the penis.

Shock wave treatment for ED is a newer therapy that uses shock waves to improve blood flow to the penis. Many patients find the following to be attractive benefits: no surgery, no medication, and a short office visit. You can learn more about this treatment and its availability at Greater Boston Urology here.
  Shockwave treatment

A penile implant (or Inflatable Penile Prosthesis – IPP, as most urologists call it) is a hydraulic device that gets implanted into the penis and replaces the erectile tissue with two cylinders. There is a little pump that gets placed into the scrotum, next to the testicles (not into the testicles) to inflate and deflate the device.

  Because it is a hydraulic device, it can give you the hardest erection possible. IPPs have high satisfaction rates among patients AND their partners. (Read this first-hand account from a happy patient.) And once you are done having sex, you push the button in the scrotum and it deflates.
Here, one of our urologists, Dr. Ryan E. Frankel, discusses the penile prosthesis.

Like anything else you're thinking about purchasing from a radio or TV commercial, remember this sage advice: buyer beware.

Erectile dysfunction is a medical condition. As such, it makes sense to discuss your options with a board-certified urologist since urologists are trained in diagnosing and treating ED Urologists also "get" that ED is an incredibly sensitive topic and difficult for many men to talk about. So not only do urologists understand the medical condition, but also the emotional distress that often accompanies it.

Regarding some of the ads that populate places like sports radio: if you decide to go that route, do your homework. Read reviews. Check out Better Business Bureau listings. But most importantly, consult with your doctor first, especially before paying big bucks out of pocket. Keep in mind that many insurance plans will offer at least some form of coverage for ED treatments (consult your plan provider for more details). And working with a doctor means you'll have the follow-up care that your health requires—and deserves.

About Greater Boston Urology

Our board-certified urologists are trained in diagnosing and treating conditions like erectile dysfunction, low testosterone, testicular pain, urinary incontinence, premature ejaculation, and many other urologic conditions that affect men of all ages.

With over eight convenient locations throughout eastern Massachusetts, including the Cape, we offer patients comfortable, convenient settings with plenty of free parking (why drive into Boston if you don't have to?). Plus, as an integrated urology practice, we strive to manage all of your urologic care under one roof from the moment you walk through our doors. Think imaging studies, diagnostic testing, pathologic testing, and surgical treatments. This makes GBU unique, and we're proud of this distinction.

We're also proud to have such a dynamic group of individual physicians who can take care of so many different needs. We have great relationships with all of the surrounding hospitals and referring primary care physicians as well.

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