Erectile Dysfunction

Erectile dysfunction (ED), or impotence, describes the inability to achieve or maintain an erection that is firm enough for sexual function. One of the most common sexual problems, ED affects about one half of American men over age 40. It can cause personal issues such as low self-esteem and depression and may affect relationships. Brigham and Women’s Hospital (BWH) integrates diagnostic medical and laboratory exams with one-to-one conversation to get to the root of the problem and offers several safe and effective ED treatments. Our goal is to help men resume sexual intimacy.

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Erectile Dysfunction Topics

Risk Factors for Erectile Dysfunction

Factors that contribute to an increased risk for developing erectile dysfunction include:

  • Age over 50
  • Diabetes
  • High blood pressure
  • High cholesterol
  • Cardiovascular disease
  • Enlarged prostate
  • History of prostate cancer
  • History of abdominal surgery
  • Psychological issues
  • Smoking
  • Medications
  • Alcohol and drug use
Diagnosis of Erectile Dysfunction

Finding the cause of the ED will help your urologists determine the best treatment options. Diagnostic procedures for ED may include the following:

  • Medical and sexual history
  • Physical examination
  • Psychosocial examination
  • Laboratory tests: blood counts, urinalysis, lipid profile, testosterone levels
  • Doppler ultrasound imaging
Treatment for Erectile Dysfunction

Some of the treatments available for ED include:

Non-Surgical Treatment for ED

  • Oral medications known as phosphodiesterase-5 inhibitors (PDE-5) relax muscle cells in the penis, producing a rigid erection.
  • Vacuum erection device draws blood into the penis, causing an erection.
  • Self-injection therapy uses a fine needle to encourage blood flow before intercourse.

Surgical Treatment for ED

  • Penile implants or penile prostheses are devices that are surgically implanted completely within the body. They may be inflatable or non-inflatable devices. Penile implants produce an erection-like state that enables normal sexual intercourse. Michael O’Leary, MD, director of the Men’s Sexual Health Clinic, performs more than 50 penile prosthesis implants each year.
  • Penile arterial revascularization: For men under 45 with no known risk factors for atherosclerosis, this procedure keeps blood flowing by rerouting it around a blocked or injured vessel.
Treatment for Peyronie's Disease

Penile implants can also be used to treat patients who have a curved or bent penis, a condition known as Peyronie’s disease. In select cases, surgical straightening is an option.

Patients may also benefit from penile injections, a minimally invasive approach that has achieved positive results in clinical trials. Xiaflex® was first approved for the treatment of Dupuytren’s contracture, a hand disease that affects the fingers. In 2013, the FDA approved Xiaflex®; for Peyronie’s disease after it was shown to break down the buildup of collagen that causes penile curvature. BWH’s participation in the national clinical trial of Xiaflex®; played an important part in getting this injection treatment approved as a viable option for patients with Peyronie’s disease.

Prevention of Erectile Dysfunction

Men can take charge of their overall medical and psychological health and adopt better lifestyle choices, a combination that may help improve sexual health.

What You Should Expect

You will receive a thorough diagnostic examination and receive clinically-proven treatment by a board-certified urologist who specializes in erectile dysfunction. Appointments are confidential and private

Multidisciplinary Care

Brigham and Women's Hospital practices a multidisciplinary approach to patient care, routinely collaborating with colleagues in other medical specialties. If your urologist discovers that an underlying illness has contributed to your erectile dysfunction, you will be referred to an appropriate BWH physician for an evaluation.


Go to our online health library to learn more about urology diseases and tests.

Visit the Kessler Health Education Library in the Bretholtz Center for Patients and Families to access computers and knowledgeable staff.

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