Erectile Dysfunction

We are one of few centers that can offer all proven treatment options for ED.

Men’s Health Manhattan prides itself on a well-earned reputation as a center of excellence providing world-class care in the medical and surgical management of erectile dysfunction. We have published multiple studies in the medical literature on this, and serve as a peer reviewer for a number of prominent medical journals for studies on erectile dysfunction.

Erectile dysfunction, or ED, is a common medical condition affecting over 30 million American men. It is defined as the inability to either achieve, or to maintain an erection that is satisfactory for sexual activity - meaning either the man is not getting hard enough, or is not able to stay hard enough. It is noted in about 50% of men over the age of 50, and is seen in 70% or more of men over the age of 70. It is also often noted to affect younger men, and it is not unusual to see men in their twenties presenting with this issue.

While ED is common and is seen with some frequency, it should not be considered a “normal part of aging”, and it certainly does not mean that someone is any less of a man or less virile if presenting with this condition. Very often, ED is a result of the other conditions associated with men as they get older, including obesity, high blood pressure, high cholesterol, diabetes, heart disease, smoking...the list goes on and on. In some men, ED is more related to a performance anxiety issue, where concern over poor erections causes worsening symptoms and leads to a vicious cycle.

For full details on the various medical implications and management of erectile dysfunction, please feel free to see our various textbook chapters:

Berookhim, Boback M, et al. “Medical implications of erectile dysfunction.” The Medical clinics of North America vol. 95,1 (2011): 213-21. doi:10.1016/j.mcna.2010.08.020

https://doi.org/10.1016/j.mcna.2010.08.020

Berookhim BM, at al. (2018) Chapter 192: Erectile Dysfunction. In: Rutherford’s Textbook of Vascular Surgery and Endovascular Therapy, 9th Edition (pp. 1208-20). A Sindawi and B Perler (Editors). Philadelphia, PA: Elsevier.

What are the steps in diagnostic study?

At Men’s Health Manhattan, our significant experience and subspecialty training allow us to provide a state of the art, world class diagnostic evaluation. Very often, a thorough medical history will help us to clearly identify medical issues or medications that are contributing to the issue. The IIEF form (https://menshealthmanhattan.com/iief-form/) will help to quantify the extent of the issue and can often help guide our treatment. In addition, sometimes we will send additional lab work to help better understand the cause of ED.

Penile Color Doppler Sonography

In some men, a penile doppler ultrasound will help us to clearly understand the cause of ED and help to better delineate the appropriate treatment options. For full details on the performance of this study, we recommend our patients review our step by step guide to penile doppler ultrasound that was written to train urologists and other physicians, published in the authoritative journal in this field, the Journal of Sexual Medicine. Please search reference on pubmed.gov: Berookhim, Boback M. “Doppler Duplex Ultrasonography of the Penis.” The Journal of Sexual Medicine vol. 13,4 (2016): 726-31. Surgical Techniques Doppler Duplex Ultrasonography of the Penis In this diagnostic study, the patient is brought into a comfortable and private, climate controlled room. A penile injection is then administered with a very small, 29 gauge needle (this is tiny! - most of our patients will say they don’t feel the injection). The goal of the injection is to induce an erection in the office setting. Once the medication has taken effect, an ultrasound is performed to evaluate the quality of the blood flow to the penis. This has two benefits: It will help us to accurately identify if this is a vascular or blood flow issue or is more likely a performance anxiety issue It will help us to identify those patients who are more likely to respond to pills, injectables or to surgical management options.

Insurance covered procedures

While ED is common and is seen with some frequency, it should not be considered a “normal part of aging”

Why Men’s Health Manhattan - Diagnostic Evaluation

At Men’s Health Manhattan, our significant experience and subspecialty training allow us to provide a state of the art, world class diagnostic evaluation. Very often, a thorough medical history will help us to clearly identify medical issues or medications that are contributing to the issue. The IIEF form will help to quantify the extent of the issue and can often help guide our treatment. In addition, sometimes we will send additional lab work to help better understand the cause of ED.

Do I have ED?