Some things in life are easy to discuss, and others aren’t. Issues around intimacy can be challenging to talk about with anyone, let alone a stranger. But it’s your urologist’s job to support your health and wellness.
Sometimes, that means talking about very personal matters, like erectile dysfunction, or ED.
For many men, making the appointment is the hardest part. Once they realize their doctor has helped hundreds of men with the same condition, their anxiety usually passes. With 30-50 million men experiencing some form of ED in the US alone, it’s one of the most common conditions urologists treat.
What Is Erectile Dysfunction (ED)?
Erectile dysfunction is the ongoing inability to get or keep an erection firm enough for sexual activity. Nearly every man experiences erection difficulties on occasion. And that’s especially true during periods of stress or illness. But when the problem becomes frequent or persistent, and when it starts to interfere with your health and happiness, it’s time to speak with a urologist.
ED isn’t something you have to accept because you’re stressed, anxious, or getting older. While it’s true that the condition becomes more common in these circumstances, many cases involve underlying health conditions, medications, hormonal changes, or lifestyle factors that can be treated. Talking to your urologist can help you get to the root of your ED, so you can develop a treatment plan together.
Why Is It So Hard to Talk About ED?
It’s completely understandable (and common) for men to feel embarrassed or ashamed about dealing with ED. But these feelings can negatively impact how you see yourself, creating a cycle of self-consciousness, further embarrassment, and even isolation.
The truth is, erectile dysfunction affects millions of men, and urologists talk about it every day. The details of your condition are not unique to them, nor are they surprising. From a medical perspective, ED offers valuable insight into your overall health. For example, erections depend on healthy blood flow and hormones, so ED can be an early warning sign for high blood pressure, heart disease, and even diabetes. That’s why talking about ED sooner rather than later has huge benefits for not only your sexual health, but your overall health as well.
What Causes ED?
While there’s no single cause of erectile dysfunction, doctors know the drill. In many cases, several factors contribute simultaneously, and your urologist will know what to look for.
Common physical causes include:
- Diabetes
- High blood pressure
- Heart and vascular disease
- High cholesterol
- Low testosterone
- Certain medications
- Nerve damage
- Obesity
- Smoking
- Excessive alcohol use
Emotional and psychological factors can also play a role, including:
- Stress
- Anxiety
- Depression
- Relationship difficulties
- Performance anxiety
Is ED Physical or Psychological?
When it comes to physical versus psychological, ED isn’t either/or. Sometimes, an original occurrence is due to a physical reason, but subsequent occurrences stem from the man becoming self-conscious and even fearful.
One thing to consider is this: If you consistently have symptoms across sex with a partner, masturbation, and morning erections, the signs point to a physical root cause. But if your ED is selective, meaning it only shows up in specific situations or with certain people, it’s more likely to have a psychological root cause.
Speaking with your urologist is important because he can help determine what’s driving your symptoms and which treatments might help.
What ED Treatments Are Available?
The right treatment depends on the underlying cause of your erectile dysfunction, your overall health, and your personal goals.
Treatment options may include:
- Lifestyle changes: Improving exercise, nutrition, sleep, weight management, and quitting smoking can significantly improve erectile function for many men.
- Medication: Prescription medications that increase blood flow to the penis are often an effective first-line treatment.
- Injection therapy: For men who don’t respond to oral medications, injectable medications can produce reliable erections.
- Penile implants: For severe or long-standing erectile dysfunction, penile implants provide a highly effective, long-term solution with excellent patient satisfaction.
- Shockwave therapy: Some men with vascular-related erectile dysfunction (ED) may benefit from low-intensity shockwave therapy, which promotes the growth of new blood vessels and improves circulation. Plasma-rich platelet (PRP) injections and stem cell injections have also been explored as potential treatments. However, all of these therapies are considered investigational at this time.
Your urologist will explain the benefits, risks, and expected outcomes of each option before recommending a treatment plan.
A Note on Counseling
Erectile dysfunction isn’t always purely physical or purely psychological. If stress, anxiety, trauma, grief, or relationship difficulties are contributing to your ED symptoms, counseling can be an important part of your treatment plan. A therapist can help you work through emotional triggers while your urologist identifies and treats any underlying medical issues. Sometimes, the best results come about after addressing both the psychological and the physical.
How Should I Talk to My Urologist About ED?
Remember, there’s no right way to talk to your urologist about ED. But anticipating which questions he might ask can help you feel more prepared.
To help identify the cause, your urologist may ask questions like:
- When did the problem begin?
- Does it happen every time or only occasionally?
- Do you still wake up with morning erections?
- Can you get an erection during masturbation?
- Are you experiencing changes in sexual desire?
- What medications are you taking?
- Do you have diabetes, heart disease, or high blood pressure?
- Have you recently experienced significant stress or anxiety?
Answering honestly helps your doctor recommend the most effective treatment.
Can ED Be Cured?
Many cases of ED are successfully treated. In some instances, ED can be reversed when the underlying issue is addressed. For example, many men see improvements or their symptoms disappear entirely when they address their blood sugar, adjust their medication, reduce stress levels, or address low testosterone levels.
Other men may require ongoing treatment to achieve reliable erections, but today’s therapies allow most patients to enjoy a healthy, satisfying sex life. The sooner you seek evaluation, the more treatment options you’ll usually have available to you.
Don’t Let Embarrassment Keep You from Getting Help
Dr. Farhad Nowzari provides compassionate, confidential evaluation and personalized treatment for erectile dysfunction. Whether your symptoms are new or you’ve been struggling for years, identifying the cause is the first step toward finding a solution.
Call us at (310) 921-1100 to schedule a consultation today. We’ll discuss your symptoms privately and explore the treatment options that are right for you.