You aren’t alone if you encounter the inability to get or keep an erection. In fact, 40 percent of men over age 40 experience erectile dysfunction (E.D.), according to Jeanette Lain MHS, PA-C with Advanced Urology Institute in Deland, Fla. “The first thing you need to know is that you should not be embarrassed to talk to a health care professional,” she advises.

“Men are much more stoic than women. They don’t go into the locker room and brag they can’t get an erection,” adds Dr. Nikhil L. Shah, DO MPH, and co-director of Urology at Minimal Access & Robotic Surgery at Piedmont Health Care in Atlanta. “It is an issue that should be brought out in the open. The urologist office can be a safe haven for men.”

Solutions are out there

Factors that can contribute to E.D. include smoking, diabetes, high blood pressure, medications, alcohol, stress, fatigue, low testosterone and prostate cancer treatment. Addressing the underlying condition through lifestyle changes, like quitting smoking or losing weight, can sometimes eradicate the condition.

“‘It is an issue that should be brought out in the open. The urologist office can be a safe haven for men.’”

For others, the answer is as simple as taking an impotence pill (phosphodiesterase type 5 inhibitors). And there’s promising news for patients who have undergone radiology or surgical treatment for prostate cancer that results in E.D.—although not all prostate cancer leads to E.D., clarifies Lain.

Treating after a surgery

Shah, who performs all of his prostatectomies robotically, has seen excellent results with therapies combining E.D. prescription medicines, a vacuum constriction pump and natural supplements.

“When there is trauma, blood flow is diverted to the area that needs healing,” Shah says. The use of the pump helps get blood flowing back to the penis. “We like to tell men it is like going to the gym,” he adds, explaining the pump requires 30 minutes of daily practice.

The third component is a supplement, such as EDOX, an antioxidant pill he likens to “eating a bowl of berries every morning.” Shah said, a three-pronged program, when patients are compliant for at least three months, has produced successful results in his practice. Further, he concludes, the avenue for those who don’t respond is a penile implant.