How We Diagnose ED

Every patient is different, so understanding your specific situation is important. After discussing your symptoms and medical history, I typically recommend a penile duplex ultrasound. This is a  specialized test that uses sound waves to check blood flow in your penis.

The ultrasound helps us see:

• How well blood flows into the penis
• Whether blood is leaking out too quickly
• If there are any structural problems

This information lets us create a treatment plan tailored to your specific type of ED.

 

Treatment Options
Treatment depends on what’s causing your ED and your overall health. Many men benefit from a combination of approaches.

 

Lifestyle Changes

Sometimes simple changes make a big difference:

• Exercise regularly – Even 30 minutes of walking daily can improve ED
• Eat a healthy diet – Focus on vegetables, fruits, whole grains, and lean protein
• Lose weight if needed – Losing just 10% of body weight can improve symptoms
• Quit smoking – Smoking damages blood vessels and makes ED worse
• Limit alcohol – More than two drinks per day can contribute to ED
• Manage stress – Consider counseling if stress or anxiety is a factor
• Get enough sleep – Poor sleep affects testosterone and sexual function

 

Medications

Oral medications are often the first treatment. These include sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra). They work by improving blood flow to the penis. Some men do well with these alone.

 For more resistant cases, injectable medications can be very effective. These are injected directly into the penis before sex and work by relaxing blood vessels. While the idea of an injection may sound uncomfortable, most men find it’s quick, relatively painless, and produces reliable erections.

If low testosterone is part of the problem, testosterone replacement may help.

Shockwave Therapy

Shockwave therapy is a newer treatment that uses sound waves to improve blood flow and potentially help the penis grow new blood vessels. It’s especially helpful for men with blood flow problems.

The treatment is non-invasive and done in the office. Most men need 6-12 sessions over several weeks.

To get the best results, I typically use a protocol that includes:

• Daily low-dose Cialis – This keeps blood flowing to the penis between treatments
• Trimix injection at the time of therapy – Research suggests that having an erection during shockwave treatment helps the sound waves work better.

Not everyone is a candidate for shockwave therapy, which is why the ultrasound assessment is so
important.

Other Treatments

Vacuum devices use suction to draw blood into the penis. A ring placed at the base keeps the blood there during sex.

Penile implants are surgically placed devices that let you control when you have an erection. These are typically reserved for men who haven’t responded to other treatments.

What to Expect

ED treatment is rarely one-size-fits-all. It may take time to find the right approach or combination of treatments for you. Most men see improvement with treatment, and many regain the ability to have satisfying sex.

It’s also important to address any underlying health problems. ED can be an early warning sign of heart disease or diabetes, so treating it isn’t just about sex—it’s about your overall health.

Taking the Next Step

If you’re experiencing ED, you don’t have to live with it. The first step is an honest conversation about your symptoms and concerns. From there, we can do the testing needed to understand what’s happening and create a treatment plan that works for you.

Many men feel embarrassed to talk about ED, but it’s a medical condition like any other. You’re not alone, and help is available.

Ready to discuss your symptoms? Contact our office to schedule a consultation. We’ll take the time to understand your situation and work with you to find a solution.