Treatable at Any Age
Erectile Dysfunction
Erectile dysfunction (ED) affects tens of millions of American men, and nearly all of them can be helped. At Texas Regional Urology, our board-certified urologists identify what is actually causing your ED and match the treatment to it, at our offices in The Woodlands, Tomball, and Kingwood.
What is Erectile Dysfunction?
Understanding Erectile Dysfunction
Erectile dysfunction is the consistent inability to achieve or maintain an erection sufficient for satisfactory sexual activity. Occasional difficulty is normal and not a diagnosis; a persistent pattern is. An erection depends on healthy blood flow, intact nerves, adequate testosterone, and the absence of psychological interference, and ED can arise from a problem in any of those systems. The most common causes are vascular — the same conditions that narrow arteries elsewhere, including diabetes, high blood pressure, high cholesterol, and smoking, restrict blood flow to the penis as well. This is why ED is frequently an early warning sign of cardiovascular disease, sometimes appearing years before a heart attack or stroke. Evaluating ED is partly about your sex life and partly about your overall health.
How Would I Know If I Had ED?
Symptoms of Erectile Dysfunction
The core symptom is difficulty achieving an erection, difficulty maintaining one long enough for intercourse, or a noticeable decline in firmness. Many men also report reduced sexual desire, though desire and erectile function are separate systems and can be affected independently. The pattern matters diagnostically: gradual onset over months or years usually points to a physical cause such as vascular disease, while sudden onset — particularly when morning erections continue — more often has a psychological or medication-related component. Pain with erection or a new or worsening curve may indicate Peyronie's disease, a related condition that often occurs alongside ED and is treated differently — including with in-office Xiaflex injections.
How is ED Diagnosed?
How We Diagnose Erectile Dysfunction
Evaluation starts with an honest conversation about your symptoms, their onset and pattern, your medications, and your relationships — details that narrow the cause considerably before any test is run. We review your cardiovascular risk factors and perform a focused physical exam, including assessment of the penis, testicles, and secondary sexual characteristics. Blood work typically includes testosterone, blood glucose or A1c, lipids, and thyroid function, since ED is frequently the presenting sign of an undiagnosed metabolic or hormonal problem. When appropriate, penile duplex ultrasound assesses blood flow directly. Referral for cardiac evaluation is sometimes the most important outcome of an ED visit.
Why Choose Texas Regional Urology for ED Care?
Why Patients Choose TRU
Here is what we can do
ED Treatment Options at Texas Regional Urology
Nearly every man with ED can be treated successfully, and the options form a ladder. Most start with oral medication, which works well for a majority. When pills fail or cannot be taken, injection therapy and vacuum devices are highly effective and often underused because men were never told they existed. For men whose ED does not respond to anything else, a penile implant restores reliable function with high satisfaction rates. Addressing contributing factors — blood pressure control, diabetes management, weight, smoking, alcohol, and medication side effects — improves the results of every option on this list.
Oral Medication
PDE5 inhibitors such as sildenafil and tadalafil improve blood flow and are effective for many men. They require sexual stimulation to work and cannot be taken with nitrates, which is why a medication review is essential before starting.
Injection Therapy
Medication injected directly into the penis produces an erection reliably, including for many men who do not respond to pills. We teach the technique in-office, and most men find it far less daunting than it sounds.
Vacuum Erection Devices
A vacuum device draws blood into the penis mechanically and maintains the erection with a constriction ring. It involves no medication, making it a good option for men with contraindications to drug therapy.
Testosterone Therapy
When blood work confirms low testosterone is contributing, replacement therapy can improve desire and, in some men, erectile function. We monitor levels, PSA, and blood counts throughout treatment.
Penile Prosthesis
An inflatable penile implant is placed surgically and provides an erection on demand whenever desired. It is reserved for men who have not succeeded with other treatments, and it has among the highest satisfaction rates of any procedure in urology.
Answers to your ED Questions
Frequently Asked Questions
No — it's common but not inevitable.
ED becomes more prevalent with age because the conditions that cause it do, but it is a treatable medical condition rather than something to accept. Many men in their seventies and eighties have normal erectile function.
Sometimes — it may be Peyronie's.
A new or worsening curve can signal Peyronie's disease, scar tissue that often occurs alongside ED. We evaluate both at the same visit, and treatment options include in-office Xiaflex injections.
Possibly — it's an early warning sign.
The arteries supplying the penis are smaller than the coronary arteries, so vascular disease often shows up here first. ED can precede cardiac symptoms by several years, which makes evaluation genuinely worthwhile.
Several effective options remain.
Injection therapy, vacuum devices, and penile implants all work independently of oral medication and have high success rates. Pill failure is a reason to see a urologist, not a dead end.
Usually not — most ED is physical.
Psychological factors including anxiety, depression, and relationship stress genuinely contribute and often coexist with physical causes. The presence of a psychological component does not rule out a treatable medical one.
Coverage varies considerably by plan.
Diagnostic evaluation is generally covered, while medication and procedure coverage differs widely between carriers. Our staff can verify your specific benefits before you commit to a treatment.
Ready to do something about it?
