Sexual Health & Wellness

Erectile Dysfunction

Symptoms, Causes & Various Treatment

Millions of men worldwide suffer from Erectile dysfunction, classified as a man’s inability to achieve and maintain an erection that is hard and long enough to perform sexual intercourse. Over 80% of Erectile Dysfunction (ED) issues are caused by poor blood flow. *This inability becomes a true medical condition once difficulty persist for an extended period.

Unfortunately, most men are reluctant to report erectile dysfunction (ED) to their partner, or even to their physician, due to self-esteem and embarrassment with their performance in the bedroom. Erectile Dysfunction is far more common than the public realize.  A huge contributing factor is the overall health of the man who suffers from the condition.  A Johns Hopkins Study revealed that over 18 million men in the U.S. over the age of 20 experience difficulties having and maintaining an erection.

Signs & Symptoms:

Erectile Dysfunction (ED)is the inability to achieve or maintain an erection to sexual intercourse completion.  ED is sometimes referred to as impotence, and while most men will have occasional difficulty achieving a healthy erection during sexual intercourse, ED is a chronic condition.   ED is only considered a possible medical diagnosis for these symptoms if erection difficulties have been an ongoing issue affecting the man for an extended period of time. The penis has two chambers on each side (medial) that fill with blood during arousal resulting in the penis becoming engorged (hard).  When blood flow to the corpora cavernosa is blocked, diminished or restricted, this can result in ED.

Causes of Erectile Dysfunction:

Due to physical, psychological or emotional reasons men all over the world suffer from erectile dysfunction. Most of these men seek or would welcome a natural, drug-free solution to their ED with long-lasting results. There are many causative medical and psychological factors related to impotence. Age is, often, the main consideration and predominant factor in erectile dysfunction. Your l age, however, is not solely responsible for ED’s development. Typically, men over the 40 experience ED as the result of inadequate blood flow to the penis and often due to the narrowing of blood vessels. Inadequate blood flow can arise due to many causes including:

Poor blood circulation

The most common cause of ED is a lack of flowing blood through veins and to erectile tissue in and connecting to the penis. Damaged blood vessels and plaque buildup and can restrict circulation resulting in disrupted function. Symptoms will begin in the man having difficulty maintaining an erection.  If not treated, this may soon advance to a complete inability to achieve an erection.

Hormonal imbalances

Testosterone (and other hormones) production decreases with age and this can have a critical impact on the man’s ability to achieve erections. Also, in rare instances, kidney failure and liver disease may throw off the balance of hormones necessary for proper erection and intercourse. Testosterone replacement therapy can bring levels of the hormone back into normal which should aid most men for whom some of the other causes is not a factor.

Obesity or Inactive Lifestyle

Everyone knows that exercise should be good for your health, but most do not know that it is also a critical factor in your Sexual Wellness. Along with Proper Nutrition, engaging in an active lifestyle is essential for weight management, stress, anxiety, and depression. All of these beneficial results of an Active Lifestyle decrease the risk of developing ED while positively impacting other medical conditions. Adiposity (the irregular accumulation of excess fat in the body) may actually cause your ED as it causes a drop in active testosterone levels. Additionally, obesity can cause cardiovascular and metabolic disorders that are known to contribute to ED.

Alcohol consumption

Although alcohol can act as a social lubricant and reduces inhibition, consumption of greater than two drinks a day is considered a risk factor for ED. Alcohol can lower testosterone levels, decreases blood flow to the penis, and causes hormonal and nerve imbalances. Alcohol or drug abuse can also affect your libido and performance, reducing your testosterone levels and potentially leading to further psychological ED complications.


Smoking has a myriad of negative medical implications.  What most people do not consider is the hardening of the arteries associated with smoking tobacco can inhibit blood flow to the penis. Oxidative stress is another important implication for smokers because it is another risk factor for erectile dysfunction. Fortunately, quitting smoking habits has shown to relieve much of the related ED risks.

Cycling and horseback riding

Nerve and vascular damage can result due to the pressure applied to the pelvic floor through long-term exposure to these activities that may inhibit erections.

Sleep apnea

Study found that 69% of men involved in a sleep apnea study also suffered from ED. Apnea-related disruptions to breathing during sleep affect oxygen levels in the blood, thereby, causing problems generating an erection. Lack of sleep also negatively impacts hormone production.

Psychological difficulties

Stress finds a way to ruin everything – even sex.  Stress has a harmful effect on your body in almost every capacity.  However, in the bedroom, it can make it difficult for a man to achieve an erection and certainly maintain one.  Sadly, this can lead to more stress and you enter a vicious cycle out of an activity that has stress-relieving properties. Depression, anxiety, and medications to treat them may also contribute to impotence.

Poor dental health

the Journal of Sexual Medicine published a recent study that reported that men with severe periodontal disease were three times more likely to have consistent difficulties having an erection, symptoms of ED. Although the link may be a result of correlation rather than causation, poor dental health has long been associated with vascular disease, which is known to contribute to ED.


35-90% of diabetic men also experience ED because Hyperglycemia can have a negative impact on several factors leading to erectile function. Complications and changes associated with diabetes can compromise macrovascular and microvascular structures, the nervous system, and blood vessel linings.


30-50% of hypertensive men also suffer from Erectile Dysfunction because it can disrupt erectile tissue function. In addition, some prescriptions to treat hypertension can cause ED. Evidence suggests that once adequate blood pressure control is regained – even for those on medication – ED becomes less likely.

Metabolic syndrome (MetS)

MetS are defined by the five maladies that include: hypertension, elevated fasting glucose levels, elevated triglycerides, central obesity, and reduced high-density lipoprotein levels of cholesterol. MetS results in a pro-inflammatory state and hormonal imbalance that can lead to ED. Treatment for MetS can include lifestyle changes, testosterone replacement, pharmaceuticals, and (as an absolute last resort) bariatric surgery.

High cholesterol

Cholesterol has been linked as a causative factor in damage to blood vessel linings throughout the body – this includes the penis. Elevated cholesterol level blockages or plaques that restrict flowing blood can prevent erectile tissue from engorging with blood. A healthy Lifestyle, Proper Nutrition and regular exercise, can help control these levels and the risk of developing ED. In addition, doctors may prescribe pharmaceuticals to lower cholesterol in the blood.  However, some of these medications may have side-effects linked to ED.

Peyronie’s disease

This condition is characterized by curvature or bending of the penis which can result in the narrowing of the penile shaft. Scarring related to Peyronie’s disease can cause circulation problems in the penis.  Peyronie’s Disease is rare and proper precaution must be taken in monitoring treatments.

This analysis enables our team to develop a medically supervised Hormone Replacement Therapy that matches each of your body’s key internal levels to optimize your body’s peak performance based on a more comprehensive picture of your own personal health. Developing a comprehensive and customized HRT Protocol is the first step in restoring your body’s natural hormonal balance giving you back the optimal years of your hormonal life.

Treatment Options For Erectile Dysfunction

Good Nutrition and Exercise

One Clinical Research study indicated that intensive glycemic control (possibly a Ketogenic diet)  might decrease the chances of ED in diabetic men.

PDE-5 Inhibitors are not typically recommended for men taking nitrate drugs or alpha-blockers.  However, no matter what medications, including over-the-counter herbs and supplements, the information needs to be shared with your doctor to prevent negative interactions. The commonly reported potential side effects of phosphodiesterase-5 (PDE-5) inhibitors include headache, flushing, runny nose, stomach pain, back pain, indigestion, vision changes, and dizziness.  What the pharma companies do not tell you is that if you are responding to PDE-5s but do not address the factors described above that impact your overall health, they will begin working less and less over time.  The prescriptions can only work if there is good vascular health throughout the body, especially the penis.  Without it, this is like pouring the best gasoline in the world into a rusty engine that hasn’t been cleaned and tuned up.  You may get it to turn over a few times, but it will sputter and then, eventually, nothing will work.

ED Medications:

Pharmaceuticals such as Viagra (Sildenafil), Levitra (Vardenafil), and Cialis (Tadalafil) are among the most popular treatment options for erectile dysfunction. Although popular and boast an 80% success rate, these drugs are classified as phosphodiesterase-5 inhibitors (PDE-5) – which, temporarily, enable an erection but are not the best for maintaining an erection over time. Because the prescription is typically the first and easiest solution, it is relied upon heavily.  Therefore, the man needs to space out sex eradicating any chance of a spontaneous sexual experience and creating anxiety when he does not have a “little blue pill” in his jacket or close by.  The body does not react immediately to some of the pills and can take up to 1.5 days to respond.  This type of activity also builds up a drug dependence – even if it is psychological.

In response, a number of erectile dysfunction nutritional treatments have been developed, with varying efficacy and side effects.

Testosterone Replacement treatments to enhance your Libido

Most men over the age of 30 will experience a reduction in the production of testosterone at a rate of 1% per year.  A decrease in testosterone level is a natural result of aging. While this reduction affects every man individually, 20% of men over the age of 60 years have clinically low testosterone and this number increases to 30% for men in their 70s.

Testosterone is an important hormone which affects many important bodily functions including:
  • Sex drive
  • Sperm production
  • Red blood cell production
  • Muscle mass/strength
  • Bone density
  • Fat distribution

A decrease in testosterone levels can result in significant physical and emotional symptoms including fatigue, loss of libido, weight gain.    The effects of this are attributed to aging but through a medically supervised approach, we can help you replace your dwindling testosterone and monitor your progress.  Through Testosterone therapy, we have helped 100s of men increase energy level; achieve better and more satisfying sexual relationships and improve confidence regardless your age.  Testosterone Replacement as a treatment for Erectile Dysfunction can only work if there is good vascular health throughout the body, especially the penis.  Without it, this is like pouring the best gasoline in the world into a rusty engine that hasn’t been cleaned and tuned up.  You may get it to turn over a few times, but it will sputter and then, eventually, nothing will work.

Shockwave Therapy® Shockwave Treatment Protocol

Introducing Acoustic Shockwave Therapy:  Shockwave Therapy is a clinically proven, non-invasive soundwave therapy, specifically developed for men seeking a long-term solution to improve their sexual performance or erectile dysfunction. treats the Cause not the Symptom of Erectile Dysfunction.  Shockwave Therapy is the name of a protocol given to a procedure for ED utilizing Extracorporeal Shockwave Therapy (ESWT).  ESWT is high-frequency, low-intensity soundwaves (acoustic) to improve blood flow to the penis, remove micro-plaque, and stimulate the growth of new blood vessels (angiogenesis). We use a specific protocol designed to optimize efficacy, safety, and results based upon your level of ED severity. The Protocol we use is based on a series of over 30 clinical studies showing a greater than 75% success rate in treating Erectile Dysfunction (ED).

The procedure calls for 1000s of shockwaves on and around the penis, improving blood flow to the penis by dissolving plaque build-up and stimulating the growth of new blood vessels.  This is accomplished as a result of the microtraumas created by the focused waves and the healthy inflammation your body generated that follows. This regenerative treatment results in stronger, harder, and more sustainable erections with long-term effects resulting from the pulsating waves that trigger a healing response that “wakes-up” dormant stem cells and growth factors in the penis for an overall rejuvenation of male erectile tissue.

Don't wait, reach out today!

If you are suffering from Erectile Dysfunction, Peyronie’s Disease, or simply want to restore your youthful sexual performance, contact us now!  Your first step toward Sexual Health could be as simple as a phone call.

Request your free consultation today!

Our comprehensive practice is prepared to address all of your medical needs, whether you’re looking for world-class primary care, or the latest advances in health & wellness.

Request an appointment