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Erection problems

Weak erection

Can't get it up

Inability to maintain an erection

My penis is not standing

Difficulty keeping erection

Impotence

Not seeing your symptoms? No worries!

What is Erectile Dysfunction?

Idiopathic erectile dysfunction is a sexual dysfunction in which the penis fails to become or remain erect during sexual activity. Idiopathic means the cause is unknown.

Typical Symptoms of Erectile Dysfunction

Diagnostic Questions for Erectile Dysfunction

Your doctor may ask these questions to check for this disease:

  • Are you worried about your sexual performance because you can't get or keep an erection for sex?
  • Do you have difficulty concentrating?
  • Have you been experiencing decreased motivation recently?
  • Have your energy levels decreased?
  • Have you lost interest or pleasure in activities you usually enjoy?

Treatment of Erectile Dysfunction

Treatment for idiopathic erectile dysfunction involves addressing heart and blood vessel health, psychological health, reviewing medications that may be causing it and using other treatments to manage erectile dysfunction.

Reviewed By:

Kenji Taylor, MD, MSc

Kenji Taylor, MD, MSc (Family Medicine, Primary Care)

Dr. Taylor is a Japanese-African American physician who grew up and was educated in the United States but spent a considerable amount of time in Japan as a college student, working professional and now father of three. After graduating from Brown, he worked in finance first before attending medical school at Penn. He then completed a fellowship with the Centers for Disease Control before going on to specialize in Family and Community Medicine at the University of California, San Francisco (UCSF) where he was also a chief resident. After a faculty position at Stanford, he moved with his family to Japan where he continues to see families on a military base outside of Tokyo, teach Japanese residents and serve remotely as a medical director for Roots Community Health Center. He also enjoys editing and writing podcast summaries for Hippo Education.

Nao Saito, MD

Nao Saito, MD (Urology)

After graduating from Tokyo Women's Medical University School of Medicine, Dr. Saito worked at Tokyo Women's Medical University Hospital, Toda Chuo General Hospital, Tokyo Women's Medical University Yachiyo Medical Center, and Ako Chuo Hospital before becoming Deputy Director (current position) at Takasaki Tower Clinic Department of Ophthalmology and Urology in April 2020.

From our team of 50+ doctors

Content updated on Feb 19, 2025

Following the Medical Content Editorial Policy

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Symptoms Related to Erectile Dysfunction

Diseases Related to Erectile Dysfunction

FAQs

Q.

Important warning about baking soda trick for men with ED

A.

The baking soda trick for ED is unproven and can be dangerous, with risks such as metabolic alkalosis, electrolyte disturbances, blood pressure spikes from high sodium, kidney strain, and interactions with common medications; relying on it can also delay diagnosis of underlying heart disease, diabetes, or hormonal issues. Safer next steps include lifestyle changes, proven treatments like PDE5 inhibitors under medical guidance, and evaluation for root causes; see below for who is at higher risk, red flag symptoms that need urgent care, and a simple symptom check tool to help you plan what to do next.

References:

Galla JH. (2000). Metabolic alkalosis… J Am Soc Nephrol, 10639528.

https://pubmed.ncbi.nlm.nih.gov/10639528/

Schuppan D, & Afdhal NH. (2008). Liver cirrhosis… Lancet, 18280309.

https://pubmed.ncbi.nlm.nih.gov/18280309/

Castera L, Forns X, & Alberti A. (2008). Non-invasive evaluation of liver fibrosis using transient elastography… J Hepatol, 18258482.

https://pubmed.ncbi.nlm.nih.gov/18258482/

See more on Doctor's Note

Q.

3 reasons to avoid the baking soda trick for men

A.

The top three reasons to avoid the baking soda trick are clear: it can trigger metabolic alkalosis and electrolyte shifts, flood you with sodium that drives fluid retention and high blood pressure while straining kidneys and the heart, and cause GI upset that may also worsen liver problems like ascites or encephalopathy. There are several factors to consider, especially if you have hypertension, kidney disease, or any signs of liver trouble, and certain warning symptoms need urgent care; see below for the complete explanation, red flags, and safer next steps to discuss with your clinician.

References:

de Brito-Ashurst I, Varagunam M, Raftery MJ, & Yaqoob MM. (2009). Bicarbonate supplementation slows progression of chronic kidney disease and improves nutritional status… J Am Soc Nephrol, 19571213.

https://pubmed.ncbi.nlm.nih.gov/19571213/

Castera L, Forns X, & Alberti A. (2005). Prospective comparison of transient elastography, FibroTest, APRI, and histology for the assessment of liver fibrosis in chronic hepatitis C… Gastroenterology, 15684443.

https://pubmed.ncbi.nlm.nih.gov/15684443/

Tsochatzis EA, Bosch J, & Burroughs AK. (2014). Liver cirrhosis… Lancet, 24429185.

https://pubmed.ncbi.nlm.nih.gov/24429185/

See more on Doctor's Note

Q.

The truth about erectile dysfunction in teens

A.

Erectile dysfunction can happen in teens, but it is uncommon and usually related to stress, anxiety, or lifestyle habits rather than serious illness; ongoing problems for 3 months or more deserve a medical check. There are several factors to consider, including mental health, expectations shaped by pornography, medications, hormones, weight and metabolic health, and substance use, plus when to seek urgent care and evidence-based treatments. See below for the complete answer and how these details can guide your next steps.

References:

Prause N, Janssen E, & Hensel D. (2016). Is pornography a cause of sexual dysfunction? Results from an… Journal of Sexual Medicine, 26743631.

https://pubmed.ncbi.nlm.nih.gov/26743631/

D’Amico G, Garcia-Tsao G, & Pagliaro L. (2006). Natural history and prognostic indicators of survival in cirrhosis: a systematic review… Journal of Hepatology, 16733621.

https://pubmed.ncbi.nlm.nih.gov/16733621/

European Association for the Study of the Liver. (2022). EASL Clinical Practice Guidelines on decompensated cirrhosis: management of… Journal of Hepatology, 35275488.

https://pubmed.ncbi.nlm.nih.gov/35275488/

See more on Doctor's Note

Q.

5 important differences between erectile dysfunction and nervous energy

A.

There are five key differences: erectile dysfunction is a persistent inability to achieve or maintain an erection due to vascular, neurologic, or hormonal problems and often tied to cardiometabolic risks, while nervous energy is a short-lived fight-or-flight state with jitteriness from stress, caffeine, or poor sleep; ED tends to recur across encounters for 3 months or more and responds to lifestyle changes, PDE5 medicines, hormone evaluation, and counseling, whereas nervous energy is event-triggered and improves with relaxation techniques, cognitive behavioral therapy, rest, and cutting stimulants. There are several factors to consider that could change your next steps, including overlapping symptoms and when to seek medical care; see the complete answer below for red flags, nuanced triggers, and links to symptom-checking and treatment options.

References:

Lue TF. (2000). Erectile dysfunction. N Engl J Med, 10882775.

https://pubmed.ncbi.nlm.nih.gov/10882775/

Foucher J, Chanteloup E, Vergniol J, et al. (2006). Diagnosis of cirrhosis by transient elastography: a prospec… Hepatology, 16837960.

https://pubmed.ncbi.nlm.nih.gov/16837960/

Ripoll C, Groszmann RJ, Garcia-Tsao G, et al. (2007). Hepatic venous pressure gradient predicts clinical decompensation in patients with compen… Gastroenterology, 17241847.

https://pubmed.ncbi.nlm.nih.gov/17241847/

See more on Doctor's Note

Q.

5 important things to know about micro penis

A.

Micro penis is a rare condition defined as a stretched penile length more than 2.5 standard deviations below the age norm, typically under about 2.5 cm at birth or 7 cm in adults, and it must be measured accurately by a clinician to distinguish it from other conditions. There are several factors to consider, including hormonal or genetic causes, early diagnostic testing and hormone treatment options, psychological support and realistic expectations for sexual function with many men having normal erections and sensation, and when to seek specialist care; see below for the complete details that could shape your next steps.

References:

Rey RA, & Sultan C. (2014). Congenital micropenis: diagnosis, etiologies and management… Journal of Endocrinological Investigation, 25093818.

https://pubmed.ncbi.nlm.nih.gov/25093818/

Ziol M, Handra‐Luca A, Kettaneh A, Christidis C, Mal F, et al. (2005). Noninvasive assessment of hepatic fibrosis by transient elastography… Hepatology, 15649750.

https://pubmed.ncbi.nlm.nih.gov/15649750/

Friedrich‐Rust M, Ong MF, Herrmann E, Dries V, Samaras P, et al. (2008). Performance of transient elastography for the diagnosis of liver fibrosis and cirrhosis… Gastroenterology, 18054860.

https://pubmed.ncbi.nlm.nih.gov/18054860/

See more on Doctor's Note

Q.

Baking Soda and Apple Cider Vinegar: Benefits and Risks for men

A.

Baking soda and apple cider vinegar may offer modest benefits for men, including occasional heartburn relief, small improvements in post-meal blood sugar with ACV, and possible exercise buffering with baking soda that can indirectly support weight and vascular health relevant to erections. There are several factors to consider, including risks like enamel erosion, digestive irritation, electrolyte and blood pressure changes, drug interactions, and no proof either directly improves ED; see below for safe doses, how to time or separate them, red flags that warrant medical care, and other lifestyle steps that matter more.

References:

Lapeyre K, Provost K, & Evans M. (2021). Sodium bicarbonate overdose: a case report and narrative review… Clinical Toxicology (Philadelphia), 34057767.

https://pubmed.ncbi.nlm.nih.gov/34057767/

Ostman E, Granfeldt Y, Persson L, & Björck I. (2005). Vinegar improves postprandial glycemia in healthy adults… European Journal of Clinical Nutrition, 15860408.

https://pubmed.ncbi.nlm.nih.gov/15860408/

Wai CT, Greenson JK, Fontana RJ, Kalbfleisch JD, Marrero JA, Conjeevaram HS, & Lok AS. (2003). A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C… Hepatology, 12761151.

https://pubmed.ncbi.nlm.nih.gov/12761151/

See more on Doctor's Note

Q.

Baking Soda for ED: Should You Try It?

A.

There is no credible evidence that baking soda improves erections, and mixing it with apple cider vinegar neutralizes the vinegar’s active acid; while ACV may modestly aid weight and blood sugar, it has not been shown to help ED. There are several factors to consider. See below for important risks, who should avoid these remedies, and proven treatments that are safer and more effective; if your ED is persistent or sudden, seek a medical evaluation for possible cardiovascular or metabolic causes.

References:

Johnston CS, Kim CM & Buller AJ. (2004). Vinegar improves insulin sensitivity to a high-carbohydrate meal in subjects with insulin resistance or type 2 diabetes… Diabetes Care, 16237144.

https://pubmed.ncbi.nlm.nih.gov/16237144/

Kondo T, Kishi M, Fushimi T, Ugajin S & Kaga T. (2009). Vinegar intake reduces body weight, body fat mass, and serum triglyceride levels in obese Japanese subjects… Biosci Biotechnol Biochem, 19679037.

https://pubmed.ncbi.nlm.nih.gov/19679037/

Wai CT, Greenson JK, Fontana RJ, Kalbfleisch JD, Marrero JA, Conjeevaram HS & Lok AS. (2003). A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C… Hepatology, 12939622.

https://pubmed.ncbi.nlm.nih.gov/12939622/

See more on Doctor's Note

Q.

Considering the baking soda vinegar trick for ED; Is the problem all in your head?

A.

No, the baking soda plus apple cider vinegar trick does not cure ED, and it can pose health risks; blood pH is tightly regulated and there is no clinical evidence this improves erections. ED is not simply in your head, as most cases involve physical factors along with stress or anxiety. There are several factors to consider and proven treatments that can help; see below for how to tell physical from psychological causes, safer evidence-based options, and key risks to avoid and when to seek care.

References:

Lue TF. (2000). Erectile dysfunction. N Engl J Med, 10829055.

https://pubmed.ncbi.nlm.nih.gov/10829055/

Burnett AL, Nehra A, & Breau RH. (2018). Erectile dysfunction: AUA guideline. J Urol, 29903715.

https://pubmed.ncbi.nlm.nih.gov/29903715/

European Association for the Study of the Liver. (2018). EASL clinical practice guidelines for the management of patients… Journal of Hepatology, 29131803.

https://pubmed.ncbi.nlm.nih.gov/29131803/

See more on Doctor's Note

Q.

Do penis pumps really work?

A.

Penis pumps (vacuum erection devices) can help many men get and keep an erection, with studies showing about 60 to 80 percent effectiveness and mostly mild side effects. They are often most useful for mild to moderate ED, for men who cannot take pills, and after prostate surgery. There are several factors to consider, like underlying causes, medication interactions, proper technique and ring time limits, and when to combine treatments or see a clinician; see the complete details below to choose the right next steps.

References:

Meng Y, Wang R, & Yuan J. (2019). Vacuum erection devices in the treatment of erectile dysfunction: a systematic review … Asian Journal of Andrology, 30918385.

https://pubmed.ncbi.nlm.nih.gov/30918385/

Raina R, Lakin MM, & Brock G. (2006). Vacuum therapy for erectile dysfunction following radical prostatectomy: … Journal of Sexual Medicine, 16783432.

https://pubmed.ncbi.nlm.nih.gov/16783432/

Tsochatzis EA, Bosch J, & Burroughs AK. (2014). Liver stiffness: unfolding the natural history of cirrhosis. Journal of Hepatology, 24602165.

https://pubmed.ncbi.nlm.nih.gov/24602165/

See more on Doctor's Note

Q.

Does medicare cover erectile dysfunction treatment?

A.

Medicare may cover erectile dysfunction treatment, but coverage depends on the specific therapy and medical necessity, with oral drugs typically under Part D if on your plan formulary, injections and vacuum devices often under Part B, and penile implant surgery under Part A or B. There are several factors to consider, including prior authorization, step therapy, cost sharing, Medicare Advantage plan rules, and exclusions like over the counter supplements; see the complete details below to understand what applies to you and which next steps to take with your doctor and plan.

References:

Hatzimouratidis K, Amar E, Eardley I, Giuliano F, Montorsi F, Salonia A, Vardi Y, Wespes E, Zohar Y. (2010). EAU guidelines on erectile dysfunction: diagnosis and initial… Eur Urol, 20193680.

https://pubmed.ncbi.nlm.nih.gov/20193680/

Tsochatzis EA, Bosch J, Burroughs AK. (2014). Liver cirrhosis. Lancet, 25331465.

https://pubmed.ncbi.nlm.nih.gov/25331465/

D’Amico G, Garcia-Tsao G, Pagliaro L. (2006). Natural history and prognostic indicators of survival in patients with cirrhosis: a systematic… J Hepatol, 16399030.

https://pubmed.ncbi.nlm.nih.gov/16399030/

See more on Doctor's Note

Q.

Does radiation treatment for prostate cancer cause erectile dysfunction?

A.

Radiation for prostate cancer can cause erectile dysfunction, often developing gradually as nerves and blood vessels are affected, with about 40 to 60 percent of men experiencing some degree within two years, depending on treatment type, age, baseline function, health conditions, and whether hormone therapy is used. There are several factors to consider, and many treatments can help, from lifestyle changes and pills to devices and implants; early conversation with your care team matters. See below for key timelines, risk factors, and practical next steps that can influence your decisions.

References:

Sanda MG, & Dunn RL. (2008). Quality of life and satisfaction with outcome among prostate-ca… N Engl J Med, 18354160.

https://pubmed.ncbi.nlm.nih.gov/18354160/

Merrick GS, & Butler WM. (2008). Ten-year outcome of potency after permanent prostate brachytherapy: se… Brachytherapy, 19030510.

https://pubmed.ncbi.nlm.nih.gov/19030510/

Sandrin L, & Fourquet B. (2003). Transient elastography: a new noninvasive method for assess… Radiology, 12955176.

https://pubmed.ncbi.nlm.nih.gov/12955176/

See more on Doctor's Note

Q.

How can I tell if I have erectile dysfunction or whisky dick?

A.

Erections that fail only when you have been drinking and return to normal when sober point to alcohol-related “whisky dick,” while persistent problems for 3 months or more across at least half of attempts, including when sober, suggest erectile dysfunction with possible vascular, hormonal, neurologic, or psychological causes. Track patterns, try the IIEF-5 screener, consider risks like diabetes, high blood pressure, smoking, or medications, and see a doctor if difficulties persist or occur when sober. There are several factors to consider. See complete details below to understand more and choose the right next steps.

References:

Rosen RC, Cappelleri JC, Smith MD, Lipsky J, Peña BM. (1999). Development and evaluation of an abridged, 5-item version of the Int… Int J Impot Res, 10625731.

https://pubmed.ncbi.nlm.nih.gov/10625731/

Mumenthaler MS, Taylor JL, O’Hara R, Yesavage JA. (1999). Alcohol and human sexuality… Alcohol Health Res World, 10605926.

https://pubmed.ncbi.nlm.nih.gov/10605926/

Wai CT, Greenson JK, Fontana RJ, Kalbfleisch JD, Marrero JA, Conjeevaram HS, Lok ASF. (2003). A simple noninvasive index can predict both significant… Hepatology, 12883497.

https://pubmed.ncbi.nlm.nih.gov/12883497/

See more on Doctor's Note

Q.

How does penis enlargement surgery work?

A.

Penis enlargement surgery increases length or girth by either cutting the suspensory ligament so more of the shaft hangs outside the body, or by adding volume with fat transfer, dermal or synthetic grafts, or temporary hyaluronic acid fillers; some people combine procedures, and post-op traction or an extender is critical because gains are usually modest. There are several factors to consider, including recovery time, risks like infection, scarring, asymmetry or sensation changes, variable fat reabsorption, costs, and choosing an experienced surgeon. See complete details below to guide your next steps.

References:

Yang DY, Park JK, Cho CJ, Park JH, Ko GH, Lee SH. (2018). Injectable hyaluronic acid gel for penile girth augmentation: clinical outcomes and patient satisfaction. J Sex Med, 29555852.

https://pubmed.ncbi.nlm.nih.gov/29555852/

Kamath PS, Wiesner RH, Malinchoc M, Kremers W, Therneau TM, Kosberg C, et al. (2001). A model to predict survival in patients with end-stage liver disease. Hepatology, 11157951.

https://pubmed.ncbi.nlm.nih.gov/11157951/

Shi Y, Lin S, Huang Y. (2016). Diagnostic accuracy of transient elastography in detection of liver cirrhosis: a systematic review and meta-analysis. Hepatol Int, 27591814.

https://pubmed.ncbi.nlm.nih.gov/27591814/

See more on Doctor's Note

Q.

Is micro penis real?

A.

Micropenis is real and medically defined as a stretched penile length more than 2.5 standard deviations below average, roughly under 2.5 inches in adults, with age specific cutoffs for infants and children. There are several factors to consider, including distinguishing it from a buried penis, possible hormonal or genetic causes, how it is diagnosed, treatment options like early testosterone therapy, and when to see a specialist; see below for details that could impact your next steps and support resources.

References:

Friedrich-Rust M, Nierhoff J, Lupsor M, Sporea I, Fierbințeanu-Braticevici C, Strobel D, Cantisani V, Le Bricon T, Bota S, de Lédinghen V. (2010). Performance of transient elastography for the staging of liver fibrosis: a meta-analysis. Journal of Hepatology, 17883421.

https://pubmed.ncbi.nlm.nih.gov/17883421/

Tsochatzis EA, Gurusamy KS, Ntaoula S, Cholongitas E, Davidson BR, Burroughs AK. (2014). Elastography for the non-invasive staging of liver fibrosis in chronic liver disease: a systematic review and meta-analysis. Alimentary Pharmacology & Therapeutics, 24372235.

https://pubmed.ncbi.nlm.nih.gov/24372235/

European Association for the Study of the Liver. (2018). EASL Clinical Practice Guidelines on the management of patients with decompensated cirrhosis. Journal of Hepatology, 30346721.

https://pubmed.ncbi.nlm.nih.gov/30346721/

See more on Doctor's Note

Q.

Is penis enlargement worth considering as a senior?

A.

There are several factors to consider. For most seniors, enlargement offers modest, sometimes temporary size gains but carries real risks and higher complication rates as you age, so it is usually only worth considering if you are healthy, have realistic expectations, and choose an experienced, board-certified specialist. Many people achieve better confidence and sexual satisfaction using non-surgical options like vacuum devices, traction, pelvic floor work, and counseling, often with fewer risks and lower cost. For specific methods, expected results, safety considerations, and deciding next steps with your doctor, see the complete details below.

References:

Park CJ, Ahn HS, Lee CK, & Lee JC. (2010). Hyaluronic acid gel injection for penile augmentatio… Yonsei Medical Journal, 20126364.

https://pubmed.ncbi.nlm.nih.gov/20126364/

D'Amico G, Garcia-Tsao G, & Pagliaro L. (2006). Natural history and prognostic indicators of surviva… Journal of Hepatology, 16647187.

https://pubmed.ncbi.nlm.nih.gov/16647187/

Kamath PS, & Wiesner RH. (2001). A model to predict survival in patients with end-stage liver di… Hepatology, 11157951.

https://pubmed.ncbi.nlm.nih.gov/11157951/

See more on Doctor's Note

Q.

Is penis enlargement worth considering as a teen?

A.

Generally not recommended for teens, since most are still developing into their early 20s, most fall within normal size ranges, and there are no safe, proven enlargement methods for minors; many advertised options carry real risks like tissue injury, reduced sensitivity, and emotional distress. There are several factors to consider. See below for details on normal development, common myths, the evidence and risks for pumps, extenders, creams, and surgery, mental health considerations, and when to seek professional guidance.

References:

Veale D, Miles S, Lockwood J, Troglia A, Lamb L, & Muir GH. (2015). Clinical characteristics of men seeking penile girth augmentation s… J Sex Med, 25989115.

https://pubmed.ncbi.nlm.nih.gov/25989115/

Castera L, Forns X, & Alberti A. (2008). Non-invasive evaluation of liver fibrosis using transient elasto… J Hepatol, 18355986.

https://pubmed.ncbi.nlm.nih.gov/18355986/

Tsochatzis EA, Gurusamy KS, Ntaoula S, Cholongitas E, Davidson BR, & Burroughs AK. (2014). Elastography for the diagnosis of severity of fibrosis in chronic l… J Hepatol, 24875937.

https://pubmed.ncbi.nlm.nih.gov/24875937/

See more on Doctor's Note

Q.

Is penis enlargement worth considering as gay man?

A.

There are several factors to consider. See below for the key numbers, risks, and decision points that might change your next steps. Expect modest gains overall: extenders average 1 to 1.6 cm of length over months, HA fillers add about 1.5 to 2 cm of girth for 9 to 12 months, and surgery brings higher risk for limited improvement; weigh partner preferences, confidence goals, costs, potential complications, and the reality that technique and connection often matter more than size, and consider a consult with a board-certified urologist or a sex therapist.

References:

Gontero P, Di Marco M, Giubilei G, et al. (2009). Use of a penile extender device in the treatment of penile curvature and… BJU Int, 19501223.

https://pubmed.ncbi.nlm.nih.gov/19501223/

Yassin AA, Bazeed MA. (2018). Hyaluronic acid soft tissue filler for penile girth augmentation: safety… J Sex Med, 29518507.

https://pubmed.ncbi.nlm.nih.gov/29518507/

D’Amico G, Garcia-Tsao G, Pagliaro L. (2006). Natural history and prognostic indicators of survival in cirrhosis: a… Hepatology, 16632615.

https://pubmed.ncbi.nlm.nih.gov/16632615/

See more on Doctor's Note

Q.

Life after 60: Do penis pumps really work for seniors?

A.

Yes, penis pumps can work for many men over 60, often producing erections suitable for intercourse with few systemic side effects; clinical trials and international guidelines support them as an effective, safe, and cost-effective option, especially when pills are not ideal. There are several factors to consider. See below for details on candidacy, safe use and ring timing, common side effects and red flags, the need to address underlying heart or hormonal issues, and how pumps compare or combine with other ED treatments, which could influence your next steps.

References:

Steers WD, Burnett AL, & Shaw KC. (1990). A prospective randomized evaluation of vacuum constriction device therapy for impotence… Urology, 2267630.

https://pubmed.ncbi.nlm.nih.gov/2267630/

European Association of Urology. (2015). EAU guidelines on male sexual dysfunction: erectile dysfunction… European Urology, 25693740.

https://pubmed.ncbi.nlm.nih.gov/25693740/

Tsochatzis EA, Gurusamy KS, Ntaoula S, Cholongitas E, Davidson BR, & Burroughs AK. (2012). Elastography for the diagnosis of severity of fibrosis in chronic liver… Journal of Hepatology, 22461093.

https://pubmed.ncbi.nlm.nih.gov/22461093/

See more on Doctor's Note

Q.

The difference between true erectile dysfunction and nerves

A.

True, organic ED usually develops gradually, is consistent whether you’re with a partner or alone, and often comes with reduced or absent nocturnal or morning erections, while psychogenic or “nerves” ED tends to be sudden or situational, with normal nocturnal erections and variable performance. There are several factors to consider, including mixed causes, red flags, and how doctors confirm the difference using history, labs, nocturnal penile tumescence testing, and penile Doppler. See below for complete details that can guide the right next steps and treatment options.

References:

Goldstein I, Lue TF, Padma-Nathan H, Rosen RC, Steers WD, Wicker PA. (2002). Epidemiology, pathophysiology and diagnosis of erectile dysfunctio… Urology, 12297233.

https://pubmed.ncbi.nlm.nih.gov/12297233/

Wai CT, Greenson JK, Fontana RJ, Taylor-Robinson SD, Johnson PJ. (2003). A simple noninvasive index can predict both significant fibrosis… Hepatology, 12668902.

https://pubmed.ncbi.nlm.nih.gov/12668902/

Castera L, Forns X, Alberti A. (2008). Non-invasive evaluation of liver fibrosis using transient elastograp… J Hepatol, 18723116.

https://pubmed.ncbi.nlm.nih.gov/18723116/

See more on Doctor's Note

Q.

What are the risks and watch-outs for penis pumps?

A.

There are several risks and watch-outs to consider, including bruising or petechiae, pain, numbness or coldness from the constriction band, skin irritation or discoloration, difficulty ejaculating, device problems, psychological stress, and rarely priapism if the band stays on too long; be especially cautious if you use blood thinners, have bleeding or blood-cell disorders, penile infection or severe curvature, or a spinal cord injury. Reduce risk by using gentle suction with lubrication, following time limits of 10 to 15 minutes for the band and 20 to 30 minutes total, inspecting and cleaning the device, and seeking urgent care for an erection over 4 hours or persistent severe symptoms. Many more safety tips, red flags, and next-step guidance are detailed below.

References:

European Association of Urology. (2013). Guidelines on male sexual dysfunction: erectile dysfunction – 2013 update. European Urology, 23892438.

https://pubmed.ncbi.nlm.nih.gov/23892438/

D’Amico G, Garcia‐Tsao G, & Pagliaro L. (2006). Natural history and prognostic indicators of survival… Journal of Hepatology, 16407301.

https://pubmed.ncbi.nlm.nih.gov/16407301/

Friedrich‐Rust M, Rosenberg W, Dries V, et al. (2008). Performance of transient elastography for the… Gastroenterology, 19038547.

https://pubmed.ncbi.nlm.nih.gov/19038547/

See more on Doctor's Note

Q.

What does a penis pump do?

A.

A penis pump creates a vacuum around the penis that draws blood into the erectile chambers to produce an erection, and a constriction ring can then help maintain it for up to about 30 minutes. It is a drug-free option used for erectile dysfunction, post-surgery penile rehabilitation, and temporary enhancement, but technique, device choice, and safety considerations matter. There are several factors to consider; see below for key benefits, risks, contraindications, and usage tips that could guide your next steps.

References:

Brant WO, & Montague DK. (2006). Vacuum erection devices: efficacy and patient satisfactio… Curr Urol Rep, 17115304.

https://pubmed.ncbi.nlm.nih.gov/17115304/

Ziol M, Handra-Luca A, Kettaneh A, Christidis C, Mal F, Kazemi F, et al. (2005). Noninvasive assessment of liver fibrosis by measurement of stiffness in patien… Hepatology, 16188086.

https://pubmed.ncbi.nlm.nih.gov/16188086/

Vizzutti F, Arena U, Romanelli RG, Rega L, Foschi M, Colagrande S, et al. (2007). Liver stiffness measurement predicts severe portal hypertension in patients with compensated HCV-relate… Hepatology, 17503801.

https://pubmed.ncbi.nlm.nih.gov/17503801/

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Q.

What is a micro penis?

A.

A micro penis is a medically defined diagnosis for a penis measuring more than 2.5 standard deviations below the age based average, typically under 2.5 cm in newborns and about 7 cm stretched length in adults. It can reflect hormonal, genetic, or developmental issues and has specific evaluations and treatments that may be time sensitive; there are several factors to consider, so see below to understand measurement details, causes, tests, treatment choices, and when to seek care.

References:

Veale D, Miles S, Read J, & Troglia A. (2015). Penile size and the definition of micropenis: a systematic… BJU International, 24827300.

https://pubmed.ncbi.nlm.nih.gov/24827300/

Moore KP, Wong F, Gines P, et al. (2003). The management of ascites in cirrhosis: report on the consensus… Hepatology, 12775314.

https://pubmed.ncbi.nlm.nih.gov/12775314/

Kim WR, Biggins SW, Kremers WK, et al. (2008). Hyponatremia and mortality among patients on the liver-transplant… Hepatology, 18757800.

https://pubmed.ncbi.nlm.nih.gov/18757800/

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Q.

What is the best treatment for erectile dysfunction?

A.

Start with oral PDE5 inhibitors like sildenafil or tadalafil plus lifestyle changes. The best choice depends on your other medicines, health conditions, side effects, cost, and preference; see below for key nuances. If pills are not suitable or do not work, options include vacuum devices, injections or intraurethral alprostadil, and for refractory cases penile implants; psychosexual therapy can help at any step. Because ED can signal heart disease, diabetes, or hormonal issues, and PDE5 drugs cannot be taken with nitrates, review the complete guidance below and speak with a clinician if you have red flags like sudden ED, chest symptoms, or an erection lasting over 4 hours.

References:

Goldstein I, & Lue TF. (1998). Oral sildenafil in the treatment of erectile dysfunctio… N Engl J Med, 9632524.

https://pubmed.ncbi.nlm.nih.gov/9632524/

Porst H, & Kim ED. (2004). Long-term safety and efficacy of tadalafil for the treatment… Urology, 15451774.

https://pubmed.ncbi.nlm.nih.gov/15451774/

Castera L, & Foucher J. (2005). Prospective comparison of transient elastography, FibroTes… Gastroenterology, 15685566.

https://pubmed.ncbi.nlm.nih.gov/15685566/

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Q.

What is the best treatment for micro penis?

A.

The most effective approach is early, tailored androgen therapy such as testosterone or topical dihydrotestosterone after a specialist evaluation to confirm causes, with traction devices or selected surgeries considered if response is limited, and ongoing psychosocial support. There are several factors to consider, including age, hormonal or genetic findings, monitoring for side effects, and realistic goals; see below for dosing examples by age, device and surgical options, expected gains, safety checks, and signs that require urgent care.

References:

Lee PA, Houk CP, Ahmed SF, & Hughes IA. (2006). Consensus statement on management of intersex disorders and atypical genital development including micropenis… J Clin Endocrinol Metab, 16505329.

https://pubmed.ncbi.nlm.nih.gov/16505329/

Kamath PS, & Wiesner RH. (2001). A model to predict survival in patients with end-stage liver disease. Hepatology, 11157951.

https://pubmed.ncbi.nlm.nih.gov/11157951/

European Association for the Study of the Liver. (2014). EASL clinical practice guidelines for the management of patients with decompensated cirrhosis. Journal of Hepatology, 24986678.

https://pubmed.ncbi.nlm.nih.gov/24986678/

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Q.

What is the latest treatment for erectile dysfunction?

A.

The latest treatments for erectile dysfunction include first-line PDE-5 inhibitors like sildenafil and tadalafil plus the newer udenafil, low-intensity shockwave therapy that improves erections for many men for 6 to 12 months with minimal side effects, and emerging regenerative options such as PRP, stem cells, and gene therapy. There are several factors to consider, including severity, underlying conditions, and costs, and some options remain experimental and may not suit men on nitrates, so see the complete guidance below to decide the safest next steps and when to speak with a doctor.

References:

Kim SW, Park JK, & Paick JS. (2011). Efficacy and safety of udenafil in the treatment of erectile dysfunction: a multi… J Sex Med, 21762545.

https://pubmed.ncbi.nlm.nih.gov/21762545/

Lu Z, Zhang X, Yu S, Zhang X, & Wang Y. (2018). Efficacy and safety of low-intensity extracorporeal shockwave therapy for erectile dys… World J Urol, 29596218.

https://pubmed.ncbi.nlm.nih.gov/29596218/

Kim D, & Kim WR. (2015). Liver stiffness measurement predicts hepatic decompensation in patients with compensated cirrhos… J Hepatol, 26084708.

https://pubmed.ncbi.nlm.nih.gov/26084708/

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Q.

65+ the truth about the baking soda and apple cider vinegar ED cure

A.

There is no clinical proof that baking soda plus apple cider vinegar cures ED, and for men 65 and older the mix can increase risks like high blood pressure, fluid retention, reflux, and medication interactions. ACV may modestly lower post-meal blood sugar and baking soda can help high-intensity exercise, but neither improves penile blood flow or nerve signaling, so proven options like PDE5 inhibitors, cardiovascular risk control, and pelvic floor exercise are more effective. There are several factors to consider; see the complete answer below for specific risks, dosing pitfalls, safer next steps, and when to seek care.

References:

McNaughton LR, Siegler J, & Midgley A. (2008). Ergogenic effects of sodium bicarbonate: a meta-analysis. Int J Sport Nutr Exerc Metab, 19083339.

https://pubmed.ncbi.nlm.nih.gov/19083339/

Ostman E, Granfeldt Y, Persson L, & Björck I. (2005). Vinegar supplementation lowers glucose and insulin responses and… Eur J Clin Nutr, 16278292.

https://pubmed.ncbi.nlm.nih.gov/16278292/

Kim WR, Biggins SW, Kremers WK, Wiesner RH, & Kamath PS. (2008). Hyponatremia and mortality among patients on the liver-transplant waiti… N Engl J Med, 18199851.

https://pubmed.ncbi.nlm.nih.gov/18199851/

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Q.

At home remedies for ED in men over 65

A.

At-home steps that can improve ED in men over 65 include a Mediterranean-style, heart-healthy diet; regular aerobic and pelvic-floor exercises; weight, blood pressure, and blood sugar control; quitting smoking; limiting alcohol; better sleep; and stress management, with any supplements used cautiously and reviewed by your doctor. Managing diabetes, cardiovascular and liver disease is also crucial, and urgent care is needed for sudden loss of erections, chest pain with sex, or penile pain or changes; there are several factors to consider, so see the complete details below.

References:

Esposito K, Giugliano F, Ciotola M, et al. (2004). Effect of lifestyle changes on erectile dysfunction in obese men: a randomized… Arch Intern Med, 15023865.

https://pubmed.ncbi.nlm.nih.gov/15023865/

European Association for the Study of the Liver. (2018). EASL clinical practice guidelines for the management of patients with decompensated cirrhosis. Journal of Hepatology, 29860447.

https://pubmed.ncbi.nlm.nih.gov/29860447/

Gines P, Solà E, Angeli P, et al. (2021). Management of patients with cirrhosis and ascites: update 2021. Journal of Hepatology, 33901750.

https://pubmed.ncbi.nlm.nih.gov/33901750/

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Q.

Does baking soda and apple cider vinegar help men over 65 with erectile dysfunction?

A.

There is no clinical evidence that baking soda or apple cider vinegar improve erectile function in men over 65. Apple cider vinegar may modestly help weight and blood sugar control, which can indirectly support vascular health, but neither remedy is proven for ED and both carry risks, including electrolyte issues with baking soda and tooth or throat irritation and medication interactions with vinegar. Safer, evidence based options are available; there are several factors to consider, so see below for important details and guidance on next steps.

References:

Kondo T, Kishi M, Fushimi T, Ugajin S, & Kaga T. (2009). Vinegar intake reduces body weight, body fat mass, and serum triglyceride leve… Obesity, 22846233.

https://pubmed.ncbi.nlm.nih.gov/22846233/

Lin ZH, Xin YN, Dong QJ, et al. (2011). Performance of the aspartate aminotransferase to platelet ratio index for staging of liver fibros… J Viral Hepatol, 21722378.

https://pubmed.ncbi.nlm.nih.gov/21722378/

European Association for the Study of the Liver, & Asociación Latinoamericana para el Estudio del Hígado. (2015). EASL–ALEH clinical practice guidelines: non-invasive tests for evaluation of liver disease severi… Journal of Hepatology, 26073412.

https://pubmed.ncbi.nlm.nih.gov/26073412/

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Q.

Life past 65: What’s the baking soda trick for ED and is it safe?

A.

The baking soda trick means drinking about 1 teaspoon of baking soda dissolved in water before sex to try to boost erections by briefly raising body alkalinity. There is no clinical evidence it works, and a teaspoon delivers about 1,260 mg of sodium that can raise blood pressure and worsen heart or kidney disease, plus it can cause stomach upset and medication interactions. There are several factors to consider and safer, proven treatments; see below for details that could affect your next steps.

References:

Carr AJ, Hopkins WG, & Gore CJ. (2012). Effects of acute alkalosis and acidosis on performance: a meta-analysis… Journal of Sports Sciences, 21768153.

https://pubmed.ncbi.nlm.nih.gov/21768153/

Burnett AL, Nehra A, Breau RH, Culkin DJ, Faraday MM, & Hakim LS. (2018). Erectile dysfunction: AUA guideline… Journal of Urology, 29256308.

https://pubmed.ncbi.nlm.nih.gov/29256308/

European Association for the Study of the Liver. (2018). EASL clinical practice guidelines on decompensated… Journal of Hepatology, 30344047.

https://pubmed.ncbi.nlm.nih.gov/30344047/

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Q.

What is the connection between erectile dysfunction and exercise?

A.

Exercise is strongly linked to erectile function: regular aerobic, strength, and pelvic floor training improves blood flow and endothelial health, supports testosterone, aids weight loss, lowers cardiometabolic risks, and eases anxiety, with studies showing meaningful improvements and even restoration of erections in some men. There are several factors to consider, including which types and amounts of exercise help most and key safety steps or red flags that require medical care; see below for specific routines, precautions, and guidance on when to talk to a doctor.

References:

Esposito K, Giugliano D, Di Palo C, Giugliano F. (2004). Effect of lifestyle changes on erectile dysfunction in obese… JAMA, 15293727.

https://pubmed.ncbi.nlm.nih.gov/15293727/

Corona G, Mannucci E, Fisher AD, et al. (2012). Risk factors for erectile dysfunction: a systematic review and… J Sex Med, 21937872.

https://pubmed.ncbi.nlm.nih.gov/21937872/

European Association for the Study of the Liver. (2019). EASL Clinical Practice Guidelines on non-invasive tests for evalu… J Hepatol, 30469766.

https://pubmed.ncbi.nlm.nih.gov/30469766/

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Q.

What are some good home remedies for erectile dysfunction?

A.

The best at‑home steps include heart‑healthy lifestyle changes (lose weight, stop smoking, limit alcohol, manage stress, get 7–9 hours sleep), a Mediterranean-style diet rich in flavonoids and omega‑3s, regular aerobic plus pelvic‑floor (Kegel) exercises, and—for some—evidence‑based supplements like Pycnogenol with L‑arginine or Korean red ginseng after discussing with your clinician. There are several factors to consider, including mental health strategies and red flags (ED can signal diabetes, high blood pressure, or heart disease)—see the complete details below for specific steps, dosages, cautions, and when to seek care. With consistent effort, many men notice improvement within weeks to months.

References:

Stanislavov R, & Nikolova V. (2003). Pycnogenol in association with L-arginine improves erectile… J Sex Marital Ther, 14577723.

https://pubmed.ncbi.nlm.nih.gov/14577723/

Hong B, & Ma WH. (2002). Efficacy and safety of Korean red ginseng in the… Int J Impot Res, 15797405.

https://pubmed.ncbi.nlm.nih.gov/15797405/

Giannini EG, Botta F, & Borro PM. (2005). Platelet count/spleen diameter ratio as a… Gut, 15964580.

https://pubmed.ncbi.nlm.nih.gov/15964580/

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Q.

What is the baking soda trick for men with ED?

A.

The baking soda trick for men with ED involves mixing 1/2–1 teaspoon of sodium bicarbonate into 8 ounces of water and drinking it daily for up to a week, aiming to slightly raise blood pH so penile smooth muscle relaxes and blood flow improves. There’s no clinical proof it helps ED, and it can pose risks (high sodium load, metabolic alkalosis, blood-pressure increases, drug interactions), so talk with a clinician—especially if you have heart, kidney, or BP issues. There are several factors to consider, including safe use, red flags, and proven options like PDE5 medications and lifestyle changes; see the complete details below.

References:

Carr AJ, Hopkins WG, & Gore CJ. (2011). Effects of acute alkalosis and acidosis on performance: a meta-analysis… Sports Med, 21437760.

https://pubmed.ncbi.nlm.nih.gov/21437760/

Eardley I, Portsmouth S, & Caldwell D. (2000). Physiological and pharmacological characteristics of the corpora cavernosa and spongiosum… Int J Impot Res, 10886637.

https://pubmed.ncbi.nlm.nih.gov/10886637/

Wiesner R, Edwards E, Freeman R, Harper A, Kim R, Kamath P, Kremers W, Lake J, Howard T, & Merion R. (2003). Model for end-stage liver disease (MELD) and allocation of donor live… Gastroenterology, 14656940.

https://pubmed.ncbi.nlm.nih.gov/14656940/

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Q.

Can smoking weed everyday cause erectile dysfunction?

A.

Some studies suggest that daily cannabis use may be linked to a greater chance of experiencing erectile dysfunction, though effects can differ from person to person.

References:

Pizzol D, Demurtas J, Stubbs B, Soysal P, Mason C, Isik AT, Solmi M, Smith L, Veronese N. Relationship Between Cannabis Use and Erectile Dysfunction: A Systematic Review and Meta-Analysis. Am J Mens Health. 2019 Nov-Dec;13(6):1557988319892464. doi: 10.1177/1557988319892464. PMID: 31795801; PMCID: PMC6893937.

Shiff B, Blankstein U, Hussaen J, Jarvi K, Grober E, Lo K, Lajkosz K, Krakowsky Y. The impact of cannabis use on male sexual function: A 10-year, single-center experience. Can Urol Assoc J. 2021 Dec;15(12):E652-E657. doi: 10.5489/cuaj.7185. PMID: 34171210; PMCID: PMC8631840.

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Q.

Does baking soda and apple cider vinegar help with erectile dysfunction?

A.

There is no strong medical evidence that baking soda and apple cider vinegar can treat erectile dysfunction.

References:

Hadzic M, Eckstein ML, Schugardt M. The Impact of Sodium Bicarbonate on Performance in Response to Exercise Duration in Athletes: A Systematic Review. J Sports Sci Med. 2019 Jun 1;18(2):271-281. PMID: 31191097; PMCID: PMC6544001.

Jafarirad S, Elahi MR, Mansoori A, Khanzadeh A, Haghighizadeh MH. The improvement effect of apple cider vinegar as a functional food on anthropometric indices, blood glucose and lipid profile in diabetic patients: a randomized controlled clinical trial. Front Clin Diabetes Healthc. 2023 Nov 13;4:1288786. doi: 10.3389/fcdhc.2023.1288786. PMID: 38028980; PMCID: PMC10679383.

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Q.

Does diabetes cause erectile dysfunction?

A.

Yes, diabetes is a common cause of erectile dysfunction because high blood sugar can damage nerves and blood vessels needed for a strong erection.

References:

Ledda A. Diabetes, hypertension and erectile dysfunction. Curr Med Res Opin. 2000;16 Suppl 1:s17-20. doi: 10.1185/0300799009117035. PMID: 11329816.

Bahar A, Elyasi F, Moosazadeh M, Afradi G, Kashi Z. Sexual dysfunction in men with type II diabetes. Caspian J Intern Med. 2020 May;11(3):295-303. doi: 10.22088/cjim.11.3.295. PMID: 32874437; PMCID: PMC7442469.

Defeudis G, Mazzilli R, Tenuta M, Rossini G, Zamponi V, Olana S, Faggiano A, Pozzilli P, Isidori AM, Gianfrilli D. Erectile dysfunction and diabetes: A melting pot of circumstances and treatments. Diabetes Metab Res Rev. 2022 Feb;38(2):e3494. doi: 10.1002/dmrr.3494. Epub 2021 Sep 21. PMID: 34514697; PMCID: PMC9286480.

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Q.

Does masturbation cause erectile dysfunction?

A.

No, masturbation by itself does not cause erectile dysfunction; it is generally considered a normal sexual activity.

References:

Rowland DL, Castleman JM, Bacys KR, Csonka B, Hevesi K. Do pornography use and masturbation play a role in erectile dysfunction and relationship satisfaction in men? Int J Impot Res. 2023 Sep;35(6):548-557. doi: 10.1038/s41443-022-00596-y. Epub 2022 Jul 15. PMID: 35840678.

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Q.

Does porn cause erectile dysfunction?

A.

Some research shows that heavy use of online pornography may be linked with erectile dysfunction, but it is not proven that porn directly causes ED since many factors can influence sexual function.

References:

Park BY, Wilson G, Berger J, Christman M, Reina B, Bishop F, Klam WP, Doan AP. Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports. Behav Sci (Basel). 2016 Aug 5;6(3):17. doi: 10.3390/bs6030017. Erratum in: Behav Sci (Basel). 2018 Jun 01;8(6):E55. doi: 10.3390/bs8060055. PMID: 27527226; PMCID: PMC5039517.

Jacobs T, Geysemans B, Van Hal G, Glazemakers I, Fog-Poulsen K, Vermandel A, De Wachter S, De Win G. Associations Between Online Pornography Consumption and Sexual Dysfunction in Young Men: Multivariate Analysis Based on an International Web-Based Survey. JMIR Public Health Surveill. 2021 Oct 21;7(10):e32542. doi: 10.2196/32542. PMID: 34534092; PMCID: PMC8569536.

Adarsh H, Sahoo S. Pornography and Its Impact on Adolescent/Teenage Sexuality. Journal of Psychosexual Health. 2023;5(1):35-39. doi:10.1177/26318318231153984

See more on Doctor's Note

Q.

How long after quitting smoking does erectile dysfunction improve?

A.

Many studies show that some improvement in erectile dysfunction can begin within a few weeks of quitting smoking, with greater benefits appearing over several months.

References:

Guay AT, Perez JB, Heatley GJ. Cessation of smoking rapidly decreases erectile dysfunction. Endocr Pract. 1998 Jan-Feb;4(1):23-6. doi: 10.4158/EP.4.1.23. PMID: 15251760.

Pourmand G, Alidaee MR, Rasuli S, Maleki A, Mehrsai A. Do cigarette smokers with erectile dysfunction benefit from stopping?: a prospective study. BJU Int. 2004 Dec;94(9):1310-3. doi: 10.1111/j.1464-410X.2004.05162.x. PMID: 15610111.

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Q.

How much does erectile dysfunction surgery cost?

A.

Erectile dysfunction surgery, such as penile prosthesis implantation, can cost anywhere from around $10,000 to over $30,000, depending on many factors.

References:

Kohn TP, Rajanahally S, Hellstrom WJG, Hsieh TC, Raheem OA. Global Trends in Prevalence, Treatments, and Costs of Penile Prosthesis for Erectile Dysfunction in Men. Eur Urol Focus. 2022 May;8(3):803-813. doi: 10.1016/j.euf.2021.05.003. Epub 2021 May 24. PMID: 34034995.

Nguyen V, McGovern AM, Rojanasarot S, Patel DP, Bhattacharyya S, Hargens LM, Aworunse O, Hsieh TC. Patient out-of-pocket costs for guideline-recommended treatments for erectile dysfunction: a medicare cost modeling analysis. Int J Impot Res. 2025 Jan;37(1):45-50. doi: 10.1038/s41443-024-00903-9. Epub 2024 Jun 26. PMID: 38926632; PMCID: PMC11706773.

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Q.

How much is the cost of injections for erectile dysfunction?

A.

The cost of injections for erectile dysfunction can vary widely—ranging from a few hundred dollars per session to over a thousand dollars—depending on the treatment type, frequency, and insurance coverage.

References:

Sun P, Seftel A, Swindle R, Ye W, Pohl G. The costs of caring for erectile dysfunction in a managed care setting: evidence from a large national claims database. J Urol. 2005 Nov;174(5):1948-52. doi: 10.1097/01.ju.0000176739.44725.49. PMID: 16217364.

Britt D, Blankstein U, Lenardis M, Millman A, Grober E, Krakowsky Y. Availability of platelet-rich plasma for treatment of erectile dysfunction and associated costs and efficacy: A review of current publications and Canadian data. Can Urol Assoc J. 2021 Jun;15(6):202-206. doi: 10.5489/cuaj.6947. PMID: 33212009; PMCID: PMC8195577.

Masterson TA et al. Platelet-rich plasma for the treatment of erectile dysfunction: A prospective, randomized, double-blind, placebo-controlled clinical trial. _J Urol_ 2023 Jul; 210:154.

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Q.

What are the most likely drugs to cause erectile dysfunction?

A.

Drugs used to treat high blood pressure—like beta blockers and diuretics—are some of the most common medicines linked with causing erectile dysfunction, along with certain antidepressants.

References:

Kaplan-Marans E, Sandozi A, Martinez M, Lee J, Schulman A, Khurgin J. Medications Most Commonly Associated With Erectile Dysfunction: Evaluation of the Food and Drug Administration National Pharmacovigilance Database. Sex Med. 2022 Oct;10(5):100543. doi: 10.1016/j.esxm.2022.100543. Epub 2022 Jul 14. PMID: 35843193; PMCID: PMC9537247.

Lou IX, Chen J, Ali K, Chen Q. Relationship Between Hypertension, Antihypertensive Drugs and Sexual Dysfunction in Men and Women: A Literature Review. Vasc Health Risk Manag. 2023 Nov 3;19:691-705. doi: 10.2147/VHRM.S439334. PMID: 37941540; PMCID: PMC10629452.

Lou IX, Chen J, Ali K, Chen Q. Relationship Between Hypertension, Antihypertensive Drugs and Sexual Dysfunction in Men and Women: A Literature Review. Vasc Health Risk Manag. 2023 Nov 3;19:691-705. doi: 10.2147/VHRM.S439334. PMID: 37941540; PMCID: PMC10629452.

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Q.

What are the worst foods for erectile dysfunction?

A.

Foods that are high in unhealthy fats, added sugars, and heavily processed ingredients—like fast food, fried items, and processed meats—are linked with an increased risk of erectile dysfunction.

References:

Agarwal, S. K. (2022). The Role of Diet in the Pathogenesis of Erectile Dysfunction. _Cardiology and Angiology: An International Journal_, _11_(2), 19–30. https://doi.org/10.9734/ca/2022/v11i230191

Bauer SR, Breyer BN, Stampfer MJ, Rimm EB, Giovannucci EL, Kenfield SA. Association of Diet With Erectile Dysfunction Among Men in the Health Professionals Follow-up Study. JAMA Netw Open. 2020 Nov 2;3(11):e2021701. doi: 10.1001/jamanetworkopen.2020.21701. PMID: 33185675; PMCID: PMC7666422.

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Q.

What is porn induced erectile dysfunction?

A.

Porn induced erectile dysfunction is a term used when watching too much pornography is thought to make it harder for some men to initiate or maintain an erection in real-life situations.

References:

Park BY, Wilson G, Berger J, Christman M, Reina B, Bishop F, Klam WP, Doan AP. Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports. Behav Sci (Basel). 2016 Aug 5;6(3):17. doi: 10.3390/bs6030017. Erratum in: Behav Sci (Basel). 2018 Jun 01;8(6):E55. doi: 10.3390/bs8060055. PMID: 27527226; PMCID: PMC5039517.

Jacobs T, Geysemans B, Van Hal G, Glazemakers I, Fog-Poulsen K, Vermandel A, De Wachter S, De Win G. Associations Between Online Pornography Consumption and Sexual Dysfunction in Young Men: Multivariate Analysis Based on an International Web-Based Survey. JMIR Public Health Surveill. 2021 Oct 21;7(10):e32542. doi: 10.2196/32542. PMID: 34534092; PMCID: PMC8569536.

Adarsh H, Sahoo S. Pornography and Its Impact on Adolescent/Teenage Sexuality. Journal of Psychosexual Health. 2023;5(1):35-39. doi:10.1177/26318318231153984

See more on Doctor's Note

Q.

What is the best drink for erectile dysfunction?

A.

No single drink is a magic cure for erectile dysfunction, but some drinks—like pomegranate juice, green tea, and watermelon juice—may help improve blood flow and overall health, which can support erectile function.

References:

Neves D, Assunção M, Marques F, Andrade JP, Almeida H. Does regular consumption of green tea influence expression of vascular endothelial growth factor and its receptor in aged rat erectile tissue? Possible implications for vasculogenic erectile dysfunction progression. Age (Dordr). 2008 Dec;30(4):217-28. doi: 10.1007/s11357-008-9051-6. Epub 2008 Apr 18. PMID: 19424845; PMCID: PMC2585648.

Rahimi HR, Arastoo M, Ostad SN. A Comprehensive Review of Punica granatum (Pomegranate) Properties in Toxicological, Pharmacological, Cellular and Molecular Biology Researches. Iran J Pharm Res. 2012 Spring;11(2):385-400. PMID: 24250463; PMCID: PMC3832175.

Rotimi DE, Asaleye RM. Impact of Watermelon (Citrallus lanatus) on Male Fertility. JBRA Assist Reprod. 2023 Jul 7;27(4):702–8. doi: 10.5935/1518-0557.20220075. Epub ahead of print. PMID: 37417854; PMCID: PMC10718552.

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Q.

What level of spinal cord injury leads to erectile dysfunction?

A.

Erectile function is mostly affected when the injury involves the sacral segments (S2-S4) of the spinal cord, since these segments control the reflex needed for an erection.

References:

Shridharani AN, Brant WO. The treatment of erectile dysfunction in patients with neurogenic disease. Transl Androl Urol. 2016 Feb;5(1):88-101. doi: 10.3978/j.issn.2223-4683.2016.01.07. PMID: 26904415; PMCID: PMC4739980.

Sinha V, Elliott S, Ibrahim E, Lynne CM, Brackett NL. Reproductive Health of Men with Spinal Cord Injury. Top Spinal Cord Inj Rehabil. 2017 Winter;23(1):31-41. doi: 10.1310/sci2301-31. PMID: 29339875; PMCID: PMC5340507.

Alexander MS, Aisen CM, Alexander SM, Aisen ML. Sexual concerns after Spinal Cord Injury: An update on management. NeuroRehabilitation. 2017;41(2):343-357. doi: 10.3233/NRE-172202. PMID: 29036845.

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Digital Health Awards 2023 (Quarterfinalist)

Which is the best Symptom Checker?

Which is the best Symptom Checker?

Ubie’s symptom checker demonstrated a Top-10 hit accuracy of 71.6%, surpassing the performance of several leading symptom checkers in the market, which averaged around 60% accuracy in similar assessments.

Link to full study:

https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1

References