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Erectile Dysfunction

More than 50 percent of men ages 40 to 70 have some degree of erectile dysfunction, which is the inability to achieve or maintain an erection sufficient for satisfactory sexual performance.

Factors Leading to Erectile Dysfunction

There are multiple reasons why erectile dysfunction can occur. These include the following:

  • Aging
  • Other comorbidities (ex: hypertension, diabetes, hyperlipidemia, etc.)
  • Medicines
  • Treatment for prostate cancer
  • Low testosterone
  • Peyronie’s disease (plaque build-up on the penis causing curvature)
  • Trauma (ex: penile fracture)


Treatment Options for Erectile Dysfunction

In general, treating erectile dysfunction begins with a conversation between you and your physician. To determine the best treatment option, your physician will perform a history and physical exam. He/she may also conduct a blood test and, in rare cases, may perform a penile ultrasound.

Other ways that are used to treat erectile dysfunction are outlined below.

#1 – Examine your lifestyle.

Are you a smoker? overweight? Your doctor will work with you to come up with a plan that hinges on healthier lifestyle habits, such as avoiding smoking and exercising regularly.

#2 – Consider the medications you are taking.

Sometimes, stopping or starting new medications may contribute to erectile dysfunction. If this is the case, you may be required to change certain medicines.

In other cases, taking certain medications can help alleviate or resolve erectile dysfunction issues by increasing blood flow to the penis and preventing blood from escaping. These medications include: Viagra, Levitra, Cialis, Staxyn, and Muse and can cost around $30/pill or more.

With the above mentioned medications, the success rate ranges between 65 to 85 percent. Side effects may include:

  • headache
  • change in hearing/vision
  • muscle aches
  • dizziness
  • priapism (erection that lasts 4+ hours)
  • life threatening drop in blood pressure if combined with nitrates (Nitroglycerin)

#3 – Vacuum Erection Devices

A vacuum erection device is a ring that is placed at the base of the penis with a cylinder that goes over the penis to pull blood in. Recent studies have shown a 50 to 80 percent satisfaction rate. Most insurance companies will cover part of the one-time cost, which ranges anywhere from $300 to $500. Drawbacks include: discomfort, lack of spontaneity and complaints of the device being cumbersome to use.

#4 – Penile Injection Therapy

Penile injection therapy involves a medicine that is injected into the penis with a very small needle. The success rate for this type of therapy is greater than 75% with side effects that may include: bruising, pain, bleeding, trauma to penis, or priapism.

#5 – Penile Prosthesis

A last option for erectile dysfunction is the use of a penile prosthesis. The benefit of the prosthesis is that it is malleable and always firm. Penile prostheses are inflatable and come with a pump system.

Ask Your Physician

Erectile dysfunction can and is often a sensitive subject for men (and can be for couples as well). Don’t suffer in silence. Instead, speak with your physician to find out the best treatment plan for you.


About Brandon Rubens, MD

Dr. Brandon Rubens is a board certified urologist with WakeMed Physician Practices – Urology. His clinical expertise lies in robotic and laparoscopic surgery, urologic cancer and general urology, including prostate enlargement, urinary incontinence, erectile dysfunction, blood in the urine and kidney stones.

Request an appointment with Dr. Rubens today.