Erectile dysfunction (ED) - also known as impotence - is the inability to achieve and maintain an erection adequate for a satisfying sexual experience. At least 70 percent of the time, ED has a physical cause. ED can be linked to health issues, such as cardiovascular disease,, low testosterone levels and benign prostatic hypertrophy (BPH). ED is more common with aging, affecting up to 30 percent of men 65 and older to some degree<<mild, moderate, severe>>, but it can occur at any age. But no matter the age of onset, a wide range of treatments exist to effectively treat ED.

Premature ejaculation (rapid ejaculation) is one of the most common sexual concerns. "Premature" ejaculation refers to ejaculating within one minute or less of vaginal penetration. It may be inherent without known cause, or can be brought on by inflammation of the prostate or urethra, low testosterone levels, anxiety or stress. Effective treatments are available.

Watch Video on Causes and Concerns with Dr. Fred Grossman

Common Causes

Cardiovascular disease. There is growing evidence that sexual dysfunction can be an early sign of heart disease, in particular atherosclerosis, narrowing and hardening of the arteries which constricts blood circulation. The risk factors for cardiovascular disease are also linked to ED. These include hypertension, high cholesterol, obesity, diabetes, lack of physical activity, family history of early heart attack or stroke, and being a smoker. Often men at  high risk - whether it has been diagnosed or not - may also be experiencing ED as well. For that reason, instead of taking a just-treat-the-symptom approach, the Male Care Center does a comprehensive health assessment to determine if there are underlying medical issues that need to be addressed.

Benign prostatic hypertrophy , known as BPH, is often associated with erectile dysfunction and ejaculatory problems. With BPH the prostate is enlarged, which can obstruct the urethra and interfere with the normal flow of urine. BPH can cause such symptoms as frequent urination, difficulty or pain with urination, weak urine flow, increased urinary tract infections and it may worsen erectile dysfunction. If you think you may have BPH, assess your symptoms with a simple questionnaire, the American Urological Association (AUA) symptom score index (To take the self-test, go here). Medications, surgery or minimally invasive procedures are just some of the treatment options for BPH.

Low testosterone levels can dampen sex drive, cause impotence, fatigue, anxiety, memory loss, depression and difficulty with concentration. Testosterone is the most critical male hormone, and approximately 5 million American men may be deficient, yet remain undiagnosed. Symptoms can begin in the teens and persist throughout life.  Treatment for low testosterone can dramatically alleviate symptoms . 

Other Conditions that Affect Sexual Function 

Peyronie's disease is characterized by an abnormal curvature of the penis when erect, and sexual dysfunction can result. Peyronie's disease affects men of all ages, as young as 18, and is caused by scar tissue(plaque) in the erectile tissue that prevents the straightening of the penis.  The curve is usually upward.

Congenital penile curvature , also known as a curved penis, is a rare congenital malformation that occurs during an early stage of development, but might not be noticed until puberty when erections become more common.  The curve is most often downward.  No plaque is present. 

Multiple treatments exist for Peyronie's disease and congenital penile curvature, including the Egydio procedure, for which Dr. Grossman received advanced training from Dr. Paulo H. Egydio, the physician who developed the technique.   

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