If you’re experiencing erectile dysfunction (ED), you may be wondering which doctor you should call. A good place to start is with your primary care doctor. Depending on your specific health concerns they may then refer you to a specialist in men’s health or urology (urologist), or a hormone specialist (endocrinologist).
So what is erectile dysfunction, anyway?
Erectile dysfunction is a very common condition that over 3 million Americans experience each year. ED, otherwise known as impotence, is when a person struggles to get or maintain a firm erection.
It can often be self-diagnosed, with symptoms including:
- Being able to get an erection sometimes, just not every time you want to have sex
- Being able to get an erection, but unable to maintain it long enough to have sex
- Unable to achieve an erection at any time
That said, many men seek medical advice to identify the underlying cause of their erectile dysfunction, which allows them to start the most effective treatment.
Sexual health is a complex business, involving muscles, nerves, hormones, blood vessels, and the brain. This means it can be caused by a number of factors, including:
- Medical conditions, like heart disease, diabetes, high cholesterol, or high blood pressure
- Psychological issues, such as stress, anxiety, and depression
- Lifestyle choices, like obesity, excessive alcohol, smoking, using illicit drugs
- Medications, such as antidepressants, antihistamines, and beta blockers are just a few of the medications that can cause erectile dysfunction
A common myth is that age causes ED. Age, however, doesn’t cause erectile dysfunction, but the condition is more common in older men. That said, no matter your age, you can experience issues with erectile function.
Fortunately, the majority of ED cases are treatable and curable. Even if your particular case cannot be totally cured, there are many effective treatment options to alleviate symptoms so you can enjoy a healthy sex drive.
What doctor can help with erectile dysfunction?
Your primary care doctor, a urologist, or an endocrinologist are all capable of diagnosing and treating erectile dysfunction. Although their areas of expertise differ, they’ll all likely perform a physical examination, and ask questions about your medical history.
Primary care physician
Primary care physicians (PCPs) are generally considered the first entry point into the healthcare system. They’re trained to diagnose a wide range of conditions, so they are a great place to start when you have any health concerns.
Your PCP will likely ask some questions about your symptoms and medical history. These are a few examples of questions they may ask:
- Are you currently taking any medications or supplements? If so, what are they?
- Do you use illicit drugs?
- Do you have any chronic illnesses?
- Do you drink alcohol or smoke?
- How often do you exercise?
- Describe the difficulty with your erections.
They will likely conduct a physical exam as well. It’s common for doctors to listen to your heart and test your blood pressure, as well as examine your penis, testicles, and prostrate for abnormalities.
Blood and urine tests are often used to check your cholesterol, blood sugar, triglycerides, testosterone, etc.
Your PCP can prescribe medications for your ED or refer you to specialists if needed.
Your PCP may refer you to a urologist if assistance is needed with diagnosis or treatment.
A urologist is a doctor that specializes in the urinary tract and male reproductive system. Not only do they treat sexual dysfunction, but they also treat diseases of the kidney, bladder, prostate, urethra, and pelvic muscles, including cancer kidney stones, incontinence, and infection.
Though your urologist will likely ask many of the same questions as your PCP, a urologist has more in-depth training to treat complicated erection problems, including those that need surgery. As uncomfortable as talking about your sexual health may feel, it’s best to be as open and transparent as possible with your doctor so he or she can better help.
Whenever you visit a doctor, you may want to prepare some questions, such as:
- Is this condition temporary?
- What is causing it?
- What are the treatment options?
- How long until I see improvement?
- Are there any side-effects to treatment?
In addition to the tests your PCP conducts, your urologist may also use additional tests such as:
- a penile ultrasound
- blood tests for hormone levels
- nocturnal penile tumescence (NPT).
NPT is an overnight test that uses sensors to monitor if you’re having (very common and normal) involuntary erections while sleeping.
A urologist may also perform a digital rectal exam to determine if there are any abnormalities of the prostate. Don’t worry, these are usually only mildly uncomfortable.
A urologist can prescribe medications to treat your ED, as well as offer other treatments like surgery and implants.
An endocrinologist is a doctor that specializes in the endocrine system. In other words, a hormone doctor.
Your primary care may refer you to an endocrinologist if your erectile dysfunction is caused by a disease of the endocrine system, such as diabetes or hypogonadism (when your body doesn’t produce enough of the male sex hormone, testosterone).
If the cause of your erectile dysfunction is diabetes, the endocrinologist may prescribe a 25, 50, or 100 mg dose of sildenafil.
If you have low testosterone levels, an endocrinologist may start you on hormone replacement therapy.
What about mental health professionals?
A mental health professional, such as a counselor, psychologist, or psychiatrist, can help determine if a psychological condition is causing your ED. They also help treat these conditions.
Your doctor may refer you to a mental health professional if you’re experiencing any of the following symptoms in conjunction with your erectile dysfunction:
- Intense stress
- High levels of fatigue
- Symptoms of depression, including difficulty focusing, loss of interest in activities, suicidal thoughts, or feeling tired all the time
- Relationship problems and communication issues
- Performance anxiety
Therapists will ask you questions about your personal life, history, and relationships, to determine the extent of any mental health conditions. They may even have you complete a questionnaire.
Depending on the diagnosis, mental health professionals may recommend prescription medication to treat mental illness, which will also help alleviate the symptoms of your ED. They also may suggest lifestyle changes, like meditation, exercise, and a clean diet.
How do you treat erectile dysfunction?
The most popular, first-line therapy for erectile dysfunction is prescription medication, such as:
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Can I get an online prescription for Cialis, Viagra, or another ED medication?
If you’re too uncomfortable to speak to your doctor face-to-face about ED, many clinics and insurance companies offer online or over-the-phone doctor consultations so it’s possible to get your prescription without needing to visit an office in person. If you decide to buy your medication online however, be sure it’s from a reputable and certified pharmacy to avoid counterfeit drugs.
What is the best natural remedy for erectile dysfunction?
Another option for people who feel embarrassed speaking to their doctor about their sexual health is to start with either over-the-counter or natural treatments. These are some of the most popular and effective that men try first:
Lifestyle changes for ED
- Reducing illicit drug and alcohol intake
- Quitting smoking
- Losing weight
- Increasing exercise
- Working through relationship issues
- Reducing stress
Natural treatments for ED
- Emotional therapy
- Vitamins and supplements
For best results, many doctors recommend combining some of these natural remedies with a prescription medication.
Other treatment options include:
- Penile implants and vacuum devices
- Hormone therapy and penile injections/suppository (e.g., alprostadil)
- Changing medication