Erectile Dysfunction


Erectile Dysfunction

ED is a condition where men have difficulty achieving or maintaining an erection sufficient for pleasurable sexual activity or penetration. Surprisingly, a large percentage of men suffer from erectile dysfunction. ED can progressively worsen with time and is often a sensitive and difficult topic of discussion for many patients. Erectile function depends on an intricate communication between sensory nerves, brain, spinal cord, genitalia and its blood supply, and disruption in any of these pathways can lead to poor erectile function. The following five main etiologies of erectile dysfunction are often seen:

  1. Psychogenic: satisfactory erection depends on physical and mental presence. Depression, stress, anxiety, psychiatric disorders, or marital issues can tremendously impact erectile and sexual function. A psychologist, family therapist or sex therapist may help improve psychogenic ED
  2. Vasculogenic: history of diabetes, heart disease, pelvic surgery (prostate or colorectal surgery) or pelvic trauma can negatively affect the blood flow to the penis and result in ED
  3. Neurogenic: history of diabetes, alcohol use, neurologic conditions (MS, SCI) or pelvic surgery can negatively impact erectile function
  4. Endocrinologic: thyroid disorder, hypogonadism, testicular failure, low Testosterone, or hyperprolactinemia can lead to ED
  5. Medication-induced: certain blood pressure medications (beta-blockers, diuretics, clonidine, methyldopa), antidepressants, antipsychotics, sedatives, anticholinergics, alcohol and tobacco use can cause ED.

Treatment options

Workup of erectile dysfunction includes a thorough history and physical exam and cardiovascular risk assessment. Your physician may request additional laboratory tests based on your history. Prior to starting any therapy, let your physician know if you have any heart disease, chest pain, exercise tolerance and list of medications you use as it may impact treatment options available to you. Treatment options for ED include:

  • Behavioral modifications
  • Counseling
  • Oral Medications
  • Penile injections
  • Vacuum erection device
  • Inflatable penile prosthesis (IPP)

You do not have to live with ED and affordable treatment options are available. Call our office to schedule your consultation today.


Kiavash Nikkhou MD
415 Rolling Oaks Drive, Suite 260
Thousand Oaks, CA 91361
Phone: 805-309-2555
Fax: 805-371-4713

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