Erectile dysfunction means difficulty getting or keeping an erection firm enough for satisfying sex. It’s one of the most common reasons men see a urologist — and one of the most fixable. The first step is simply understanding why it’s happening.
Why it happens
An erection depends on healthy blood flow, nerves, and hormones all working together. ED can stem from any of these — and frequently from a combination:
- Cardiovascular factors that affect blood flow
- Diabetes or blood sugar issues
- Low testosterone or other hormonal changes
- Certain medications
- Stress, anxiety, and sleep
ED can be an early warning. Because the arteries that supply the penis are small, problems often show up here first — sometimes years before heart symptoms. Evaluating ED is also a chance to get ahead of bigger issues.
How we evaluate it
Dr. Shusterman takes a precision approach: rather than reaching straight for a prescription, he looks at what’s actually driving your ED. That may include focused bloodwork (including hormones), a review of your medications and health history, and a frank conversation about your goals. Treating the cause — not just the symptom — produces better, more durable results.
Treatment options
Address the underlying cause
When ED is driven by blood pressure, blood sugar, hormones, or a medication, correcting that often improves things substantially on its own.
Medication
Oral medications work well for many men and are a common starting point once any red flags are ruled out.
Beyond pills
For men who don’t respond to or can’t take oral medication, there are several effective modern options — including low-intensity shockwave therapy for ED (Li-ESWT) through our ErectionWave program. Dr. Shusterman will walk you through what fits your situation, discreetly and without judgment.
This conversation is confidential and routine for us. Many men wait years to bring it up. There’s no need — addressing it is one of the most common and most rewarding things we do.
Common questions
Is ED just a normal part of aging?
It becomes more common with age, but it’s not something you have to accept. It’s a medical condition with identifiable causes and effective treatment at any age.
Can ED signal a bigger health problem?
Often, yes. Because erections depend on healthy blood flow, ED can be an early sign of cardiovascular disease, diabetes, or hormonal issues — which is why a real evaluation matters.
What if pills haven’t worked for me?
Oral medication is only one option. There are several effective alternatives, and identifying the underlying cause often changes the picture entirely.
How private is this?
Completely. Your visit and records are confidential, and this is an everyday part of urologic care.