559.277.3963 (559.27.SexMD)

7005 N Milburn Ave #202
Fresno, CA 93722


What causes ED?

Male Reproductive TractErectile dysfunction (ED) is the consistent inability to obtain an erection sufficient for sexual intercourse. Approximately 30 million American men suffer from erectile dysfunction. Most men in certain situations, at one one time or another during their sexual life, are unable to get an erection. This is normal and does not indicate a problem.

Most people believe that ED is merely a result of aging. In fact, it is not age that causes ED. Changes in body due to physical / mental health issues, medication or injury, can contribute to the development of ED. Although frequency of erections may decrease, and the stimulation required to develop an erection may increase with age, men with good vascular, neurologic and hormonal status should be able to develop an erection at any age.

What types of conditions cause ED ?

MaleED can be caused by diabetes, which can cause changes in the vascular and nervous system. Cardiovascular disease may cause blockage or leakage in the vascular bed, which prohibits the development of an erection or prevents the erection from being maintained. Injury to the nerves due to accidents, surgical procedures, or neurologic events (such as stroke) can cause the development of ED.

The presence of adequate hormones in the body, in particular testosterone, is also necessary for normal erectile activity. Any condition with significant impact on general health, the cardiovascular system can contribute to the development of ED. Substances not usually considered by patients as contributors also include smoking, alcohol, and elicit drugs.

Mental health or psychological health can be the primary cause of this condition in some patients. In recent years the majority of patients affected with ED show a physical component to the primary cause with a secondary psychological effect developing.

Whether the psychological contribution to the development of ED is primary or secondary, appropriate treatment for this component may also be recommended option.

How is ED Treated?

  1. Hormone Therapy for appropriate patients with inadequate hormones is a simple treatment involving injections given approximately 1-2 times a month. In addition, topical creams can also be used on a daily basis.
  2. External Devices are available, which can be utilized to develop and sustain an erection for penetration. These devices are easy to use, have minimal risk, and allow the patient to develop and sustain an erection for sexual activity.
  3. Oral Medications may be used to increase blood flow to the penis by enhancing the engorgement of blood in the penis and the maintenance of the erection.
  4. Injection Therapy is utilized by some patients. This involves the injection of a medication directly into the penis prior to sexual activity. These medications act on the vascular bed of the penis to allow the development of an adequate erection.
  5. A Penile Implant is a semi-rigid or inflatable device that is implanted into the penis to treat impotence. Using a small incision, your urologist will position inflatable cylinders in the corpora cavernosa (the two parallel chambers of the penis that produce an erection when filled with blood). A small pump is positioned in the scrotum and a reservoir is placed deep in the abdomen. The reservoir is filled with saline solution. To achieve an erection, gently squeeze the concealed pump in your scrotum several times.
  6. Counseling with a sex therapist may be recommended for some patients in conjunction with medical treatment. This can be a very beneficial component in the overall treatment process.

Click here to fill out the male sexual dysfunction questionnaire.