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Erectile Dysfunction (or Impotence) is a man’s inability to attain and/or maintain an erection sufficient enough for sexual activity. Its persistence tends to cause personal issues such as stress, relationship problems, and affect self-confidence, which in turn makes it even more difficult to attain.


Progressive Urology is here to help! Make an appointment if the following signs and symptoms are present:

  • Trouble attaining an erection
  • Trouble maintaining an erection
  • Reduced sexual desire


There are many factors that go into obtaining an erection – emotions, hormones, muscles, blood vessels, nerves and the brain.  Thus, the diagnosis is an equally complex process.  Doctors need to distinguish between two categories that can contribute to impotence:  Physical and/or Psychological causes.

Physical Causes:

  • Diabetes
  • Kidney Disease
  • Neurological Disorder (stroke, multiple sclerosis, Alzheimer’s disease, Parkinson’s disease)
  • Vascular Diseases (atherosclerosis, high blood pressure, high cholesterol)
  • Enlarged Prostate or BPH
  • Prostate Cancer treatment

Other potential physical causes that are not necessarily disease-related include:

  • Injury to the brain, spinal cord, pelvic, bladder, and penis
  • Surgery for prostate cancer and bladder cancer
  • Tobacco, alcohol or recreational drug use
  • Prescription drugs
  • Hormone problems (Low Testosterone)
  • Venous leak (usually caused by injury or surgery)

Psychological Causes: 

  • Mental health conditions such as depression or anxiety
  • Stress
  • Exhaustion
  • Relationship troubles

Although these causes can be primary contributing factors, many times they are responsible for worsening temporary impotent issues.

Diagnosis/ Workup

The possible causes of ED are disparate; therefore, finding the underlying source of your symptoms requires a variety of tests to rule out every case.

Psychological Evaluation

  • Doctor will ask series of questions to screen for depression, anxiety and other psychological causes

Physical exam

  • Breast enlargement to rule out hormonal issues
  • Pulse to rule out any vascular issues (blood flow problems)

Blood Test

  • Cholesterol
  • Testosterone
  • Glucose

Urine Tests

  • Urinalysis to rule out diabetes and other health conditions


  • Penile Doppler Ultrasound (or Penile Duplex)
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