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Erectile Dysfunction (ED, also known as impotence) is a man’s inability to obtain and/or maintain an erection sufficient enough for sexual activity. Chronic ED can cause stress, relationship problems, and it affects self-confidence. 

When it comes to generating an erection, there are many factors at play: emotions, hormones, muscles, blood vessels, nerves, and the brain. Therefore, the cause of ED can be ruled either physical or psychological. Developing a complete diagnosis takes time and a full medical history is required. Oftentimes, ED is a sign of an underlying health condition that needs to be treated. 


Disease-Related 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 (Benign prostatic hyperplasia)
  • Prostate Cancer treatment

Non-Disease Related Physical Causes:

  • Injury to the brain, spinal cord, pelvis, bladder, and/or penis
  • Surgery for prostate cancer and/or 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 (commonly depression and anxiety)
  • Stress
  • Exhaustion
  • Relationship troubles


Many factors may cause ED, therefore your doctor will have to conduct a comprehensive physical and mental evaluation to properly diagnose the problem. A diagnosis includes up to 6 different tests and evaluations.

Psychological Evaluation 

Your doctor will ask you various questions to screen for depression, anxiety, stress, and other psychological factors. 

Physical Evaluation

Your doctor will check for breast enlargement to rule out hormonal issues. They will also check your pulse to rule out any vascular issues (blood flow problems). 

Blood Test

A blood test will provide the doctor with your cholesterol, testosterone, and glucose levels. This will rule out low testosterone levels and diabetes. High cholesterol has also been shown to contribute to ED by limiting blood flow to the testicles.  

Urine Test

A urinalysis will rule out diabetes and other health conditions that may be stemming from the urethra and/or bladder. 


A Penile Doppler Ultrasound (or Penile Duplex) is used to check blood flow to the penis.

Overnight Erection Test

The RigiScan Monitor test measures the enlargement and rigidity of the penis. It utilizes loops, which tighten discreetly at intervals during the night as you sleep. 


Treatment for ED is heavily reliant upon the cause of the condition, whether it is physical, psychological, or both. A decrease in self-confidence can affect the process of keeping an erection; in some cases, a physical cause of ED can cause psychological distress, worsening the ED.

Sometimes, the best treatment approach is lifestyle changes. These may include: 

  • Quit smoking
  • Lose weight
  • Exercise regularly
  • Treat alcohol and drug abuse
  • Work out relationship issues (try couples therapy and/or sex therapy) 

If the cause of your ED is physical in nature and cannot be reversed by treating underlying conditions, your doctor may recommend other treatments. 

  • Medications
  • Penis pumps
  • Penile implants
  • Extracorporeal Shockwave Therapy (ESWT)
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