June 6, 2025

When Should You See a Urologist for Erectile Dysfunction?

Carroll Milne June 3, 2025
do-urologists-treat-erectile-dysfunction

Erectile dysfunction (ED) can be an uncomfortable topic—but if you’re experiencing it, you’re far from alone. It affects an estimated 30 million men in the United States, and it’s especially common as men age. Still, many men delay seeking help—either out of embarrassment or the hope that it will resolve on its own.

But ED isn’t just a quality-of-life issue—it can be a window into your overall health. And in many cases, a urologist is the key to identifying the root cause and offering real, lasting solutions.

So when should you stop brushing it off—and make an appointment with a specialist?

What Is Erectile Dysfunction?

Erectile dysfunction is defined as the consistent or recurring inability to achieve or maintain an erection firm enough for sexual intercourse.

It can occur:

  • Occasionally (situational ED)

  • Frequently (chronic ED)

  • Suddenly or gradually over time

It may affect your sex life, self-esteem, relationships, and even your mental health. And while some causes are temporary or psychological, others reflect underlying medical conditions that need to be addressed.

Common Causes of Erectile Dysfunction

ED can stem from physical, psychological, or combined factors. Here are some of the most common:

Physical Causes:

  • Cardiovascular disease

  • Diabetes

  • High blood pressure

  • High cholesterol

  • Low testosterone (Low T)

  • Obesity

  • Smoking or alcohol use

  • Peyronie’s disease (penile curvature due to scar tissue)

  • Side effects of medications

  • Pelvic surgery or trauma

  • Nerve disorders (e.g., Parkinson’s, multiple sclerosis)

Psychological Causes:

  • Anxiety, depression, or stress

  • Relationship issues

  • Performance anxiety

  • History of sexual trauma

Even sleep apnea can contribute to ED—many men are surprised to learn that treating it can restore sexual function.

When Should You See a Urologist?

Primary care doctors often start the conversation about ED and may prescribe oral medications like Viagra or Cialis. But if you’re experiencing persistent, worsening, or complex symptoms, it’s time to see a urologist. You should consider a specialist if:

  • ED has lasted more than 3 months

  • You don’t respond to oral medications

  • You have low libido or other signs of hormonal imbalance

  • You have a known cardiovascular or metabolic condition

  • You’ve experienced penile trauma or curvature

  • You’re younger than 40 with unexpected ED

  • You want to explore non-drug treatment options

  • You’re worried about your fertility in conjunction with ED

A urologist offers a deeper dive into the cause and a broader range of treatments than most general practitioners.

What to Expect at a Urology Appointment

It’s normal to feel a little nervous—but rest assured, urologists have these conversations daily. The goal is not just to restore your sexual health, but to investigate and treat any underlying medical issues.

Your visit may include:

  • Medical history and symptom review

  • Physical exam, including genital and prostate exam

  • Hormone testing, including testosterone and other markers

  • Blood work to assess cardiovascular risk factors

  • Nocturnal penile tumescence test (to see if erections occur during sleep)

  • Penile Doppler ultrasound (to evaluate blood flow in the penis)

This comprehensive evaluation helps pinpoint the true cause of your ED—so you don’t waste time on treatments that won’t work for your specific issue.

Treatment Options Beyond the Pill

Urologists can offer a wide range of evidence-based treatment options, especially for men who don’t respond to oral medications:

1. Lifestyle Modifications

  • Exercise

  • Weight loss

  • Smoking cessation

  • Diet changes
     These steps not only improve ED but also boost heart health, energy, and overall wellness.

2. Testosterone Replacement Therapy (TRT)

For men with low testosterone, TRT can improve libido, mood, and erectile function—although it’s not always a standalone ED treatment.

3. Penile Injections

Medications like alprostadil can be injected directly into the penis to create an erection. It’s effective, fast-acting, and suitable for men who can’t take pills.

4. Vacuum Erection Devices (VEDs)

These noninvasive devices create suction to draw blood into the penis. A constriction ring is then used to maintain the erection.

5. Urethral Suppositories

This involves inserting medication into the urethra to promote blood flow and trigger an erection.

6. Shockwave Therapy (experimental)

Low-intensity shockwaves may help improve blood flow in some men with ED, although it’s still under research and not yet widely adopted.

7. Penile Implants

For men with severe or medication-resistant ED, penile prosthetic surgery can be life-changing. These internal devices allow for spontaneous, reliable erections and have high satisfaction rates.

Why ED Should Never Be Ignored

While ED is often treatable, it can also be a warning sign of something more serious—such as heart disease, diabetes, or hormonal imbalance. In fact, ED may show up years before other symptoms of these conditions appear.

Addressing ED early not only restores your sex life—it could literally save your life.

Final Thoughts

Erectile dysfunction is common, treatable, and—most importantly—nothing to be ashamed of. Whether it’s caused by stress, aging, or a medical condition, you have options. And a urologist can guide you toward the most effective and personalized solution.

If ED is affecting your quality of life or relationships, don’t wait. Schedule a consultation with a urologist and take the first step toward confidence, connection, and control. We recommend urologist brooklyn.