Erectile dysfunction (ED) is the inability to get or keep an erection firm enough to engage in sexual intercourse.
This condition is easily among the subjects most men would rather not discuss with anyone, including a doctor. But in order to address it safely and effectively, it’s important to find a doctor who treats ED.
You may need to find a specialist rather than rely on your primary care physician (PCP), or you may need the assistance of more than one doctor.
Discussing your concerns with your PCP is a good place to start. But if you don’t feel comfortable in that setting, or if you need more help, you may want to see a specialist. In some cases, your PCP may also refer you to a specialist.
If you’re insured, you should be able to get a list of doctors covered by your plan from your insurance company. But you should still do a little homework to find the right match for you. You can ask for recommendations from:
- your PCP
- other healthcare providers
- trusted friends or family members
You should also check a doctor’s credentials on your state medical board’s website.
Keep in mind that if you’re not comfortable after the first visit, you don’t have to keep seeing that doctor. Consult others until you find one you like. You’ll get much better care if you’re comfortable enough to share your experience and if the communication between you is clear and thorough.
A urologist is a doctor who specializes in the health of the urinary system and the male reproductive system. Most urologists treat ED, though some urologists specialize in treating women.
Urologists can use medications, therapy, and surgical procedures to correct ED, depending on the underlying cause.
Endocrinologists are specialists in treating the body’s endocrine system, which controls hormones that affect most systems of the body.
An endocrinologist can treat abnormal hormone levels, such as low levels of the hormone testosterone. Low testosterone can lead to ED.
If your annual blood work shows low testosterone, seeing an endocrinologist may be very helpful. If you haven’t had your testosterone checked, ask your PCP about including it in your next blood work.
Mental health provider
If you have a mental health condition, or if your PCP recommends it, you may want to consider talking to a mental health provider about ED.
Online health experts
A growing number of other healthcare providers, such as nurse practitioners, nurses, and physician’s assistants, are available for online chats or virtual appointments. Communicating this way can be informative, but an online exam won’t be as thorough as an in-person one.
If you’re unable to see a doctor in person, virtual care is better than getting no assistance at all. But if possible, try to find a healthcare provider in your community with whom you can build a relationship.
The best way to approach a conversation about ED is to treat it openly as you would any other health concern, like chest pain or vision problems. Remember that:
- ED is simply one of many conditions your doctor treats.
- You’re not alone. Your doctor likely has many other patients with health concerns similar to yours.
You don’t need to do much to prepare for the first appointment, but you should have some questions ready. You may want to consider asking:
- What might be causing my ED?
- What tests will I need?
- Will medications help?
- What other treatment options are available?
- What lifestyle changes can I make to help improve my sexual function?
- Where can I get more information about ED?
Your doctor will also have plenty of questions for you, including some that are very personal. They may ask you about:
- your sexual history
- sexually transmitted infections
- your recent sexual activity
- how long you’ve been having ED symptoms
- whether you’re able to get an erection when you masturbate
- how often you get erections
- whether you get erections while sleeping
You may also be asked about how important sexual activity is in your life and what treatments you are or are not willing to consider.
You should also be prepared to discuss your whole medical history and any current medications and supplements you take. Because there’s a psychological element to ED, you may be asked about symptoms of depression, anxiety, or other mental health conditions.
The appointment will include a physical examination. You may be asked for a urine sample to help determine whether diabetes or kidney problems play a role in your ED. Your doctor might order a complete blood count (CBC) to gauge your overall health and rule out any factors that may be causing a change in your sexual function.
A blood test is often ordered before your first appointment so that the results can be reviewed with you during the visit.
The severity and cause of your ED
For some men, medications may be enough to effectively treat ED, while lifestyle changes or mental health counseling may be needed for others. In some cases, ED may be a sign of an underlying health condition that needs to be treated.
Your doctor may first recommend proven ED medications, such as tadalafil (Cialis) and sildenafil (Viagra). Tadalafil can be effective up to 36 hours after taking it. Sildenafil is faster acting, but the effects don’t last as long, usually around 4 hours.
Common side effects of ED medications can include headaches, flushing, and congestion. If your doctor prescribes medication, it may take a couple tries to figure out which one you tolerate the best and which best fits your lifestyle.
In some cases, your doctor may advise you to make lifestyle changes. These may be in addition to, or instead of, medications or procedures. Your doctor may suggest the following:
- Drink less alcohol.
- Stop smoking.
- Exercise at least 30 minutes per day.
- Get at least 7 to 8 hours of sleep each night.
- Practice stress-reduction strategies, such as meditation or yoga.
Be sure to talk with your doctor first before using these treatments, though. Herbal supplements aren’t tested and regulated as thoroughly as prescription and OTC medications, so you need to exercise caution.
Many men also benefit from mental health counseling to address symptoms of anxiety, depression, or other conditions that may be affecting their sexual health. Couples therapy or sex therapy can help both partners work through their sexual relationship and any changes in intimacy.
Other possible ED treatments include:
- penis injections of alprostadil (Caverject, Edex, MUSE) or phentolamine (OraVerse, Regitine) to improve blood flow to the penis
- testosterone replacement therapy
- penis pumps to trigger erections
- penis implants that include partially rigid or inflatable rods to control the timing of your erection
Erectile dysfunction is a common condition that’s often treatable. When speaking with a doctor about ED, remember that you’re being proactive about an important aspect of your health. Your conversations can be matter-of-fact and productive.
Consider lifestyle changes, medications or procedures, and mental health counseling to address this condition from all sides and to restore sexual function and confidence.