Erectile Dysfunction Diagnosis & Treatment in Queens, NY

Erectile dysfunction (ED) is a common condition that can affect men at any age, leading to challenges in achieving or maintaining an erection. At Medex Diagnostic and Treatment Center in Queens, we offer a compassionate approach to erectile dysfunction diagnosis and treatment. Our team of skilled primary care physicians and urologists provide thorough medical evaluations, advanced testing, and personalized treatment plans designed to address the underlying causes of ED. Whether it’s through lifestyle changes, medications, or other therapies, we’re dedicated to helping you restore your confidence and improve your sexual health.

What is erectile dysfunction?

Erectile dysfunction (ED) is the inability to get or maintain an erection firm enough for sexual intercourse. It’s a common condition that can be caused by physical issues like poor blood flow, nerve damage, or hormonal imbalances, as well as psychological factors such as stress, anxiety, or depression. ED can also be linked to underlying health problems like heart disease, diabetes, or high blood pressure. Treatment options include lifestyle changes, medications, therapy, and medical procedures.

Can a primary care doctor help with erectile dysfunction?

A primary care physician may be able to do a sexual history review, physical exam, mental health assessment, and order blood and urine tests. If necessary, your primary care doctor can refer you to a urologist for additional testing and treatment as needed.

Top Primary Care Doctors in Queens, NY

David Khasidy, MD  Internal Medicine, Primary Care Doctor 718.275.8900. Forest Hills, NY

Patient Experience

“Dr. Khasidy in medex diagnostic is incredible. His team takes great care of my health. Every appointment he is honest and finds the best treatment plan for my care. It’s rare to find a doctor that has good bedside manners with personal care for his patients. HIGHLY recommend.” – Mazol Ily

Emotions significantly impact the ability to achieve and maintain an erection. Feeling relaxed, confident, and aroused is crucial. However, it’s normal to experience occasional difficulties. Factors such as stress, anxiety, frustration, or fatigue can contribute to erection problems. Alcohol consumption, substance use, certain medical conditions, medications, and cancer treatments may also play a role.

If you are experiencing difficulty getting or maintaining an erection, it’s a good idea to schedule an appointment with a healthcare provider for further evaluation.

In many cases, ED can be an early sign of an underlying condition, such as heart disease. It’s important to consult with a healthcare provider if issues with erections persist.

*Erectile dysfunction is also referred to as Impotence and Impotency.

What are the types of erectile dysfunction?

Erectile dysfunction (ED) can be categorized into several types, each with different causes:

1. Vascular Erectile Dysfunction: This is the most common type of ED and occurs when issues affect the blood vessels that supply blood to the penis, or the valves that help retain blood in the penis to maintain an erection.
   
2. Neurogenic Erectile Dysfunction: This type is caused by nerve problems that interfere with signals from the brain to the penis. It can result from trauma, pelvic surgery, radiation therapy, or neurological conditions like stroke, spinal stenosis, or multiple sclerosis (MS).
   
3. Hormonal Erectile Dysfunction: This type of ED occurs due to hormonal imbalances, such as testosterone deficiency or thyroid problems, which can impact sexual function.
   
4. Psychogenic Erectile Dysfunction: This type is linked to psychological conditions, including stress, anxiety, or depression, which can affect the ability to achieve or maintain an erection.
   

Erectile dysfunction is a common condition, especially as men age or develop other health issues.

When does erectile dysfunction typically occur?

Healthcare providers and researchers estimate that erectile dysfunction affects more than 50% of individuals assigned male at birth between the ages of 40 and 70. The actual numbers may differ, as many people don’t seek help due to embarrassment or shame.

Erectile Dysfunction: Symptoms and Causes

What are the symptoms of erectile dysfunction?

The symptoms of erectile dysfunction include:

1. Difficulty getting an erection on some occasions before sexual intercourse.
2. Being able to get an erection but struggling to maintain it during sexual intercourse.
3. Complete inability to get an erection.
4. Needing excessive stimulation to maintain an erection.

The most common cause of ED is related to conditions that affect blood flow to the penis, often due to vascular issues or circulatory problems.

Erectile dysfunction (ED) can have various causes, often related to systems in the body that influence blood flow, nerve function, and hormone levels. Here are some key factors that can contribute to ED:

1. Circulatory System Issues
   The circulatory system, which includes the blood vessels that transport blood throughout your body, plays a crucial role in achieving and maintaining an erection. The penis needs adequate blood flow to become erect, and valves in the penis help keep blood in place. When these blood vessels or valves are damaged or dysfunctional, ED can occur.
   
2. Nervous System Problems
   The nervous system, including the brain, spinal cord, and nerves, is essential for sending electrical impulses that help you feel and move, including in the penis. Conditions that affect the nervous system can interfere with the signals required for an erection.
   
3. Endocrine System Imbalances
   The endocrine system includes glands that produce hormones, such as testosterone. Hormones help regulate various functions in the body, and low testosterone levels can hinder blood flow to the penis, contributing to ED.
   

Common Medical Conditions Linked to ED:

1. Diabetes and related neuropathy
   
2. High blood pressure (hypertension)
   
3. High cholesterol (hyperlipidemia)
   
4. Vascular disease
   
5. Chronic kidney disease
   
6. Atherosclerosis
   
7. Peyronie’s disease (abnormal curvature of the penis)
   
8. Stroke
   
9. Epilepsy
   
10. Low testosterone (testosterone deficiency)
    

Injuries and Surgeries:

Injuries to the penis or surrounding areas can also cause ED, including:

• Penile fractures
  
• Trauma to the pelvis, including hip bones, sacrum, tailbone, bladder, prostate, and spinal cord
  
• Pelvic surgeries such as prostate, colon, or bladder cancer surgery
  
• Radiation therapy
  

Medications:

Many prescription drugs list ED as a potential side effect, such as:

1. Antidepressants
   
2. Anti-anxiety medications
   
3. Blood pressure medications
   
4. Diuretics
   
5. Antihistamines
   
6. Chemotherapy drugs
   
7. Parkinson’s disease medications
   
8. Prostate cancer drugs
   
9. Muscle relaxers
   
10. Sedatives
    
11. Anti Seizure medications
    

Substance Use:

Certain substances, especially those with addiction potential, can contribute to ED by affecting the central nervous system and damaging blood vessels:

• Alcohol
  
• Amphetamines
  
• Barbiturates
  
• Cocaine
  
• Marijuana
  
• Methadone
  
• Nicotine
  
• Opioids
  

Psychological and Emotional Factors:

Psychological conditions can also cause or exacerbate ED, including:

• Depression
  
• Anxiety
  
• Stress
  
• Fear of sexual intercourse or intimacy (genophobia)
  
• Low self-esteem

Who is at Risk for Erectile Dysfunction?

The risk of developing erectile dysfunction (ED) may be higher if you:

• Are 40 years old or older
• Have diabetes
• Have a body mass index (BMI) over 25
• Struggle with depression
• Are physically inactive
• Smoke

How is Erectile Dysfunction Diagnosed?

A healthcare provider can diagnose erectile dysfunction (ED) by reviewing your medical history and performing a physical exam. They will ask questions about your personal and sexual history, which may feel awkward or embarrassing. However, being open and honest is important for determining the cause of ED quickly. Some common questions may include:

1. Are you currently taking any medications, including prescription, over-the-counter, herbal supplements, or nonmedical drugs?
   
2. Has a healthcare provider ever diagnosed you with depression or anxiety?
   
3. Do you often feel stressed?
   
4. Are you experiencing relationship problems?
   
5. How often are you able to get an erection?
   
6. How firm are your erections?
   
7. How long are you able to maintain an erection?
   
8. Do you lose your erection due to premature ejaculation?
   
9. When did you first notice ED symptoms?
   
10. What exactly happened when you first noticed ED?
    
11. Do you experience erections at night or in the morning?
    
12. What sexual positions do you typically engage in?
    

The provider may also want to talk to your sexual partner, as they may offer additional insights into potential causes.

Tests for Erectile Dysfunction

Your healthcare provider may order tests based on their suspicions about the cause of ED, which may include:

1. Blood tests, including complete blood count (CBC), lipid panel, liver and kidney function tests, thyroid tests, and testosterone test
   
2. Urinalysis (urine test)
   
3. Penile Doppler ultrasound
   
4. Penile biothesiometry (tests nerve responses in the penis)
   
5. Vasoactive injection (drugs that temporarily induce an erection)
   
6. Magnetic resonance angiogram (MRA)
   

Before conducting any tests, the provider will explain what they involve and answer any questions you may have. If you’re uncomfortable with a test, you have the right to decline it at any time.

Erectile Dysfunction Treatment

What is the best way to fix erectile dysfunction?

The first step in treating erectile dysfunction (ED) is identifying the underlying cause. A healthcare provider will work with you to determine the best treatment options, which may include:

1. Cardiovascular Exercise: Vigorous cardiovascular exercise, such as brisk walking, jogging, swimming, bicycling, or jumping rope, for at least 45 minutes three times a week can help improve mild ED.
   
2. Quitting Smoking: For men with mild ED, quitting smoking may lead to improvement within several months.
   
3. Sex Therapy: Talking to a sex therapist may help address psychological factors contributing to ED.
   
4. Oral Medications: Medications like sildenafil (Viagra®), tadalafil (Cialis®), or avanafil (Stendra®) increase blood flow to the penis and typically start working within an hour.
   
5. Penile Low-Intensity Focused Shockwave Therapy (LiSWT): This noninvasive treatment uses sound waves to improve blood flow and can take up to two months to show improvement.
   
6. Injectable Medications: Medications like alprostadil (Caverject®), papaverine (Papacon®), phentolamine (Regitine®), or a combination of these are injected directly into the penis and typically work within 10 minutes.
   
7. Vacuum Constriction Device (Penis Pump): This device creates a vacuum around the penis to improve blood flow and works almost immediately.
   
8. Testosterone Replacement Therapy: Available as a gel, injection, patches, or pellets, testosterone replacement therapy can start to show results within four weeks.
   
9. Penile Implant Procedure: A surgeon may place a device in the penis to allow it to become erect. This procedure does not affect sensation, urination, or orgasm.
   

Will ED Go Away on Its Own?
ED is unlikely to resolve on its own without lifestyle changes or some form of treatment.

Erectile Dysfunction Prevention

Can ED be prevented?

Certain lifestyle changes can help lower your risk of developing erectile dysfunction, including:

How to Manage Erectile Dysfunction:

1. Reduce your cholesterol levels.
   
2. Increase physical activity, especially cardiovascular exercises like running, jogging, or cycling.
   
3. Maintain a healthy weight.
   
4. Get high-quality sleep.
   
5. Eat a balanced diet with low saturated fats, including fruits, vegetables, and whole grains.
   
6. Quit smoking.
   
7. Cut back or stop alcohol consumption.
   

Outlook / Prognosis:

What can I expect if I have erectile dysfunction?
The outlook for ED is positive, as it is a highly treatable condition. While some causes of ED may not have a cure, various treatment options can help you achieve and maintain an erection firm enough for sexual intercourse.

Living With ED:

When should I see a doctor?
If you suspect you have erectile dysfunction, consult with a primary care physician or urologist. They can diagnose ED, determine its cause, and suggest the most appropriate treatment. A urologist specializes in diagnosing and treating conditions affecting the reproductive and urinary systems.

When should I go to the ER?
If you are taking medication for ED and experience a painful erection lasting longer than two to four hours, go to the nearest emergency room. This may be a sign of priapism, which can lead to permanent damage if not treated promptly.

How Erectile Dysfunction Affects Emotions:

Erectile dysfunction (ED) can evoke many emotions, including embarrassment, frustration, guilt, shame, anger, and feelings of inadequacy. Over time, these feelings can lead to more serious issues like anxiety and depression. However, it’s important to remember that ED is common and does not define your worth as a person. There is support available through healthcare providers to help manage these emotions.

How to Support Your Partner with Erectile Dysfunction:

ED can be a sensitive subject for many. Here are some tips to help support your partner:

1. Encourage Open Communication: Reassure your partner that you care about their feelings and well-being. Choose the right moments to discuss ED in a way that doesn’t make them feel vulnerable.
   
2. Remind Them They’re Not Alone: Let your partner know that ED is a common issue, and treatment options are available. Therapists and support groups can also help them navigate their emotions.
   
3. Promote Healthy Habits: Encourage your partner to focus on the positive effects of regular exercise, a balanced diet, and reducing substances that may contribute to ED.
   
4. Get Informed: Equip yourself with accurate, up-to-date information on ED and treatment options. This will help your partner feel understood and supported.
   
5. Offer to Attend Appointments: If your partner is open to it, offer to accompany them to appointments. You can help them ask questions, take notes, and relay information to the healthcare provider. Respect their wishes if they prefer to go alone.
   
6. Express Intimacy in Other Ways: Remember, intimacy doesn’t solely rely on sexual intercourse. Show your partner affection through physical contact, such as holding hands or offering back rubs, spending quality time together, kissing, writing thoughtful notes, being patient, and being an attentive listener.