Discussing your sex life with a physician may seem intimidating or embarrassing. But it is one of the best things you can do for both your physical and mental health.

If you suffer from a sexual disorder like premature ejaculation or erectile dysfunction (ED) you are not alone. More than half of men over the age of 40 have difficulty achieving or maintaining an erection. Seldom fewer, however, ever talk to their doctor about it or seek out help.

Summit Health urologists want you to know there are many treatment options available. Your sexual health — and how you feel about it — has a profound impact on your physical, mental, and social well-being.

Having a conversation with your primary care physician or a specialist about any symptoms of ED you are experiencing is the first step towards feeling more confident and improving your relationships. It may even have added health benefits too.

“For far too long, men have suffered in silence about this very personal medical problem. They are often embarrassed to bring it up at appointments, but sexual health is a topic that should be discussed more,” says Alan Krieger, MD, a urologic surgeon at Summit Health who specializes in treating ED. “Many men often do not realize there is help beyond the little blue pill they see in advertisements on TV.”

ED is classified as the inability to achieve an erection for sexual intercourse, explains Dr. Krieger. Like many medical conditions, there is a spectrum of ED and sexual dysfunction. Some men may be able to get an erection, but it does not last as long as they would like. Others suffer from issues like premature ejaculation or being unable to climax.

“ED impacts men both physically and psychologically. For many, the symptoms have a domino effect because a man may feel he is inadequate or a failure,” describes Dr. Krieger. “This can make the ED worse by leading to sexual performance anxiety.”

Men aren't the only ones who suffer. ED also has a significant impact on the person's partner and relationships with their entire family if there is stress or tension in the household. Women also experience sexual dysfunction, most commonly a persistent lack of desire or vaginal pain and dryness that is impacted by hormonal changes or menopause.

What causes erectile dysfunction?

There are several known causes of ED. Underlying medical conditions, taking certain medications, stress, or simply getting older can impact a man’s sexual function. In fact, ED is often the first sign that there is another medical issue which has yet to be diagnosed like heart disease, diabetes, high blood pressure, elevated cholesterol, or a thyroid condition.

“Getting help for ED may actually benefit your health if it ends up being a sign of a more serious condition.” explains Dr. Krieger. “The most common cause of ED is heart disease because the blood flow to the body decreases. Since the blood vessels that go into the penis are smaller than the heart, difficulty maintaining an erection is often the first sign of a cardiac condition.”

Treatment options for erectile dysfunction

ED is often caused by a lack of blood flow. So, finding ways to increase the blood supply to the penis is typically the key to finding a therapy that will work for you. Here are some treatments options to discuss with your physician:

• Medications. Erectile dysfunction medications are usually a good place to start, explains Dr. Krieger. These medications can help to achieve and maintain an erection through a process that increases the blood supply to the penis. The problem is that not all men will respond to these medications.  
• Vacuum constriction device. When this specialized pump is placed over the penis it creates a vacuum that helps draw more blood into the penis. A constriction ring is then applied to try and prevent the blood from leaving. Dr. Krieger notes that men often stop using the device because of discomfort.
• Penile injection therapy. This injection is self-administered directly into the side of the penis each time a person wants to have intercourse. Specific testing must be done to see if you are a candidate for penile injection therapy.
• Penile implants. Devices can be surgically implanted inside the penis that, when activated, give you a naturally appearing erection. There have been many improvements to penile implant technology over the past few decades. Dr. Krieger encourages men to consult an implant surgeon if they want to learn more about this treatment option. He adds that 92 percent of men who have penile implants report their sexual activity is excellent or satisfactory. The procedure takes about two hours and can be done in the outpatient setting.

Dr. Krieger encourages patients to talk about ED with their primary care physician or make an appointment with a urologist to discuss their treatment options.

“There are a lot of medical topics people feel embarrassed to talk about and ED is one that needs more open discussion. A lot of men come in and when we are done talking, they breathe this sigh of relief because they felt like they had no one to talk to,” says Dr. Krieger. “There is help out there and Summit Health offers several pathways for patients to find what works best for them.”