Also, it is important to remember that there are psychogenic issues such as performance-related issues, traumatic past experiences, relationship problems, anxiety, depression and stress that can certainly cause or be considered a comorbid condition contributing to ED.
Secondary premature ejaculation can be caused by both psychological and physical factors and has been linked to drinking too much alcohol. .
You shouldn’t use these medicines if you take nitroglycerin or any other nitrates for chest pain. If you have heart problems, tell your doctor before taking any ED medicines. These medicines can have serious side effects in people who have heart problems.
If your doctor thinks there’s a psychological cause, he might refer you to a mental health professional.
Contact our Referral Center to initiate a referral on behalf of your patient or to request a physician-to-physician phone consultation. Related Links UC Davis Medical Center UC Davis Comprehensive Cancer Center UC Davis Children's Hospital UC Davis Department of Surgery Quick Links Social Media Faculty Directory Academic Administrative Team UC Davis Health Newsroom UC Davis UC Davis Health Encompasses School of Medicine Betty Irene Moore School of Nursing Medical Group Medical Center
Men with diabetes, radical prostatectomy, and other complicating factors may still benefit from treatment with a phosphodiesterase type-5 inhibitor such as Viagra. Patients who fail a trial of PDE5 inhibitor should be informed of the benefits and risks of other therapies. This of a different PDE5 inhibitor is unlikely to have a profound effect on sexual function and someone who fails a first drug trial, but should be considered in selected cases. Second-line therapies include intra-urethral suppositories, intra-cavernous drug injection, vacuum-constriction devices, and penile prosthesis. Medicated Urethral System for Erection (MUSE). MUSE is an intra-urethral suppository of alprostadil, of vaso-active drug that relaxes smooth muscle in the penis and induces penile erection. Although not as effective as intra-cavernosal penile injection, MUSE is a less invasive treatment option. An initial trial dose of intra-urethral alprostadil should be administered under healthcare provider supervision due to the risk of fainting. The cost of intra-urethral suppositories is high with respect to the overall success and therefore should be used judiciously.
Footnotes*Note: Coverage of injectable medications is subject to the terms of the member’s benefit plan. Please check benefit plan descriptions for details.
To summarize, there are many different factors that can cause or contribute to ED. Some of the strongest contributors, such as comorbid conditions, can be modified and controlled with lifestyle changes. Most common however, ED causes are multifactorial and complex. Our urology team is here to work with you to resolve your ED and improve your sexual function.
Harvard Health. 2021. Benefits of exercise for the prostate and erectile dysfunction help – Harvard Health. [online] Available at:
An erection occurs because of increased blood flow to your penis. ED can occur as a problem in any stage of the erection process. It may be related to problems with blood flow to your penis, nerve damage, or stressors and emotions.
What patients and caregivers need to know about cancer, coronavirus, and COVID-19. Close Critical Alert Banner 800.227.2345 Contact Us Español More Languages Give In Honor & Memorial Donate Search
Erection problems usually produce a significant psychological and emotional reaction in most men. This is often described as a pattern of anxiety, low self-esteem, and stress that can further interfere with normal sexual performance. This "performance anxiety" needs to be recognized and addressed by your health care provider.
This information was updated by the EAU Patient Information Working Group, July 2021.
Oakwood Health Network specialists commonly send patients a requisition form for: A blood test to check the patient’s testosterone levelsAn ultrasound to diagnose a relatively common condition called Peyronie’s disease
The authors stated that this was the first study evaluating serum melatonin level as a causative factor in this patient group. A low serum melatonin level may result in an inadequate erection by preventing sufficient antioxidant capacity. There is a need for additional studies to determine the exact role of melatonin deficiency in ED patients. The drawbacks of this study were the absence of Doppler ultrasound findings, the lack of a treatment group and follow-up data on melatonin levels and the small sample size (n = 62). They stated that future studies may evaluate the association or a possible correlation between serum melatonin levels and Doppler ultrasound parameters of erectile function. Pelvic Floor Muscle Training for Erectile Dysfunction Following Radical Prostatectomy Use of Serum Homocysteine Levels as Biomarkers for the Development and/or Progression of Erectile Dysfunction
Psychosexual counselling, or sex therapy, is an appropriate recommendation especially for men who are experiencing discord with their partner especially if the conflict is related to the man’s ED. Counselling usually consists of 5–20 sessions with counsellor. It is our recommendation that referral doctors treating men with ED make a referral to a psychotherapist or sex therapist who is certified by AASECT (American Association of Sexuality Educators, Counselors and Therapists) of certified sexuality educator.43