Erectile dysfunction can be a difficult problem to discuss with your partner or even your doctor. However, it needn't be because erectile dysfunction, which causes sexual performance issues for men, is a very common and highly treatable condition. 

It affects approximately half of all men over age 40. While erectile dysfunction is usually a physical problem, it can also have psychological roots. More often than not, it is a combination of both. And help is available. 

“We have a treatment for everyone,” says Stanton Honig, MD, a director of the Yale Medicine Male Reproductive Health Program. “It's just a matter of what option you choose.” 

At Yale Medicine, we take a multidisciplinary approach to determine the underlying causes of your erectile dysfunction, and we understand the relationship between erectile dysfunction and other health issues. We regularly collaborate with colleagues across different areas of medicine to help patients who we treat.

Erectile dysfunction, also known as impotence or ED, is the inability to achieve or maintain an erection sufficient for sexual intercourse. Almost all cases of erectile dysfunction are treatable, says Dr. Honig.

Reluctance to seek treatment remains the major barrier to restoring full sexual function for men who have erectile dysfunction.

Erectile dysfunction often has more than one cause. Many diseases can cause blood flow problems, damage nerves, arteries and muscles, which can impair erectile function.

These diseases include high blood pressure, diabetes, clogged arteries, heart and blood vessel disease, high cholesterol, and chronic kidney disease. Other possible causes include:

• Nerve injury: The penis, spinal cord, prostate, bladder or pelvis may have sustained a physical injury that needs to be treated. This includes a large group of men who have had surgery or radiation treatment for prostate cancer.
• Unhealthy lifestyle: This includes smoking, excessive alcohol use, obesity and not exercising.
• Mental health: Depression, stress and anxiety surrounding sexual failure can all lead to erectile dysfunction.
• Medications: Some medications, including antidepressants, can cause sexual side-effects.
• Hormones: A small number of erectile dysfunction cases result from low levels of the male hormone testosterone.

Yale Medicine Urology offers many advanced medical and surgical options to address erectile dysfunction. The department is guided by personalized care to treat the patient.

“We listen to the patient and partner, understand the cause of the problem and work with the couple to start treatment that works best for the patient,” says Dr. Honig.

These treatments include:

• PDE-5 inhibitors: These are medicines which relax muscle cells in the penis and increase blood flow.
• Vacuum erection device: This pulls blood into the penis, causing an erection. The erection is maintained by placing an elastic ring at the base of the penis.
• Injection therapy: Doctors use a very small needle to inject medication directly into the side of the penis. This relaxes the muscle allowing for blood flow and is a highly successful.
• Minimally invasive penile implant surgery: which our experienced physicians routinely perform. Most patients recover full sexual function in six to eight weeks. Yale Medicine Urology has extensive experience in standard and complicated penile implant surgery.

In many situations, identifying an underlying minor physical problem relieves the anxiety component of erectile dysfunction, and many patients see improvement without further intervention.

Erectile dysfunction is very common and so are the misconceptions surrounding it. For instance, erectile dysfunction is not necessarily a result of aging and is often the result of an underlying physical health problem.

It's also important to know that drinking alcohol won't help you maintain an erection. In fact, excessive alcohol use can be a  cause of erectile dysfunction. 

Having erectile dysfunction isn't something you just have to live with. Almost all cases of erectile dysfunction are treatable, and treatment can lead to better overall physical and emotional health for nearly every patient as well as improve intimacy for couples.

We understand your concerns and can answer your questions about male sexual issues. We’ve heard it all before, and we can find the answers—and the treatment—that is personally best for you.

Often, erectile dysfunction can be a symptom of a heart condition, diabetes, or high blood pressure. To address this, Yale Medicine established the Male Reproductive Health/Sexual Medicine Program, a collaboration between the specialties of cardiovascular medicine and urology.

Our patients often undergo a full body exam to determine whether they have early cardiovascular disease, vascular disease or a metabolic condition such as diabetes.

Our doctors, including Dr. Honig, are leaders in the field and stand at the forefront of research in men's health issues.

Dr. Honig is an internationally recognized speaker on issues related to sexual health and conducts research into experimental treatments of erectile dysfunction. Our researchers are studying the links between erectile dysfunction and cardiovascular disease.