Erectile Dysfunction (ED)
What Is It?
Inability to achieve or maintain an erection sufficient for satisfactory sexual performance. Affects more than 30 million men in the US. Often a sign of cardiovascular disease.
How Is It Diagnosed?
Clinical history, IIEF questionnaire. Assess cardiovascular risk factors. Labs to rule out hypogonadism, diabetes, thyroid disease. Nocturnal penile tumescence if psychogenic vs. organic unclear.
How Is It Treated?
Lifestyle modification, treat underlying conditions. PDE5 inhibitors (sildenafil, tadalafil) first-line. Testosterone replacement if hypogonadal. Vacuum device, penile injections, or implant for refractory cases.
Tests and Imaging Typically Needed
Fasting glucose, HbA1c, lipid panel, total and free testosterone, TSH, prolactin, CBC, BMP.
Approximate Self-Pay Costs
Office visit: $95-$150. Labs: $60-$100. Sildenafil (generic): $10-$30/month. Tadalafil (generic): $15-$40/month.