Erectile Dysfunction

Erectile dysfunction (ED)

Erectile dysfunction is the persistent inability to achieve or maintain an erection firm enough for intercourse. In the U.S. more than half of men over 40 have some degree of ED, and it is often the first sign of a circulation or hormone problem — so it deserves a proper evaluation rather than just a prescription.

Risk factors

There is no single cause; physical and psychological factors both play a role. Common risk factors include age, smoking, diabetes, high blood pressure, high cholesterol, depression, obesity, a sedentary lifestyle, low testosterone, and prior prostate cancer treatment. The short animations below explain the links between ED and heart disease, diabetes, and prostate cancer.

A stepwise plan

1. Evaluation — history, examination, and lab work including testosterone and cardiovascular risk factors
2. Oral medication (PDE5 inhibitors) — effective for most men
3. Second-line therapy — vacuum erection devices, penile injections, or intraurethral medication
4. Penile prosthesis — an inflatable implant that reliably restores erections when other options fail or are not tolerated; patient and partner satisfaction rates are among the highest of any urologic surgery

Dr. Sosenko has advanced training in prosthetic urology and men's health, and treats these conversations with the directness and discretion they deserve.

Patient resources

• EDCure.com — treatment options and patient stories, including the HARD docuseries
• Find your ED cure — patient brochure (PDF)

Statistics, videos and downloadable materials provided by Boston Scientific.