Erectile Dysfunction

Erectile dysfunction is the inability to achieve or maintain an erection firm enough for sexual intercourse.  It is a very common problem and can lead to significant psychological and health problems.


Erections require psychological or sexual stimulation which then through nerves, signals penile smooth muscles to relax and increase blood flow. The increased volume of blood then blocks blood draining from the veins. This should remain erect until after ejaculation. An interruption in any of these steps will lead to erectile dysfunction.


Causes of erectile dysfunction include diabetes, high blood pressure, prostate cancer treatments, medications, nerve disorders or spinal cord injuries, among others.


Treatment of erectile dysfunction is performed in a step-wise fashion. First line therapies include oral phosphodiesterase inhibitors (PDEi) such as sildenafil, tadalafil, and vardenafil. These medications help increase blood flow to the penis by increasing a certain neurotransmitter.


If oral medications do not work, or they are contraindicated, the next step includes options such as a vacuum erect device, intercavernosal injections, or intraurethral suppositories.


A penile prosthesis is also an option if medications have failed. This procedure is a permanent ED treatment and has the highest satisfaction rate among all treatment options.


Have questions about erectile dysfunction? Schedule an appointment at 360-733-7687



Author: Daniel Reznicek, MD

Last Updated: 2/22/2017