Erectile Dysfunction Treatment

Erectile dysfunction is common and treatable, and it can be an early sign of other health problems worth catching. We talk with you privately, look for the cause, and help you find a treatment that is safe for you.

Become a Patient

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Understanding Erectile Dysfunction

Erectile dysfunction (ED) means trouble getting or keeping an erection firm enough for satisfying sex, often enough that it becomes a problem. It is very common and becomes more common with age, but it is not an inevitable part of getting older, and younger men can have it too. ED can strain confidence, relationships and quality of life, and many men wait a long time before mentioning it. It is a medical condition like any other, and talking about it is the first step toward treating it.

An erection depends on healthy blood vessels, nerves, hormones and mood working together, so many things can interfere. Narrowed or stiff blood vessels are the most common physical cause, and the same risk factors that affect the heart, such as high blood pressure, high cholesterol, diabetes, smoking and excess weight, affect erections too. Low testosterone, medication side effects (including some blood pressure medicines and antidepressants), heavy alcohol use, poor sleep, nerve damage, prostate surgery, stress, anxiety, depression and relationship strain can all play a role, and often more than one is involved.

Professional care matters because ED is often an early warning sign of heart or blood vessel disease, sometimes appearing years before chest pain or a heart attack. It can also be the first clue to diabetes, high blood pressure or low testosterone. A clinician can check for these, review your medicines, and choose a treatment that is safe with your other conditions. Pills sold online without a prescription, and supplements marketed for sexual performance, can contain hidden drug ingredients that interact dangerously with heart medicines.

Signs & Symptoms of Erectile Dysfunction

Trouble getting an erection. Difficulty becoming firm enough for sex, even when aroused.
Trouble keeping an erection. Losing firmness before or during sex.
Softer erections. Erections that are less firm than they used to be.
Fewer morning erections. Fewer erections on waking can point toward a physical cause.
Lower sex drive. Less interest in sex can travel with ED and may point to low testosterone or mood changes.
A gradual change. A slow change over months or years often has a blood vessel cause.
A sudden or situational change. ED that starts suddenly, or happens in some situations but not others, can point to stress, anxiety or a medicine.
Worry about sex. Performance anxiety can make ED worse and feed a cycle.

What to Expect

A private video visit to talk through symptoms, health history, medicines and relationships
Labs at a local lab to check blood sugar, cholesterol, testosterone and other causes when needed
A look at heart health, since ED can be an early warning sign
Medicines such as sildenafil and tadalafil when appropriate, never with nitrate medicines
Attention to stress, mood, sleep and lifestyle factors that affect erections
Referral to urology when other treatments are needed

How We Treat Erectile Dysfunction

Assessment

We talk privately by video about your symptoms, when they started, your health history, medicines, alcohol and tobacco use, sleep, mood and relationships. We ask you to share home blood pressure readings if you have them, and may order labs at a local lab, such as blood sugar, cholesterol and a morning testosterone level. Because ED can be an early sign of heart disease, we look at your heart risk too. If a physical exam is needed, we will help you arrange an in-person visit.

Treatment Plan

When appropriate, we prescribe a medicine such as sildenafil or tadalafil, send it to your pharmacy, and explain how to take it and what to expect. These medicines are never safe with nitrate medicines, such as nitroglycerin, and we check your other medicines carefully. We also treat contributing conditions, adjust medicines that may be affecting erections, and talk through lifestyle steps that help.

Ongoing Care

We check in on how treatment is working and adjust the dose or the medicine as needed. If pills are not enough, or are not safe for you, we refer you to urology for other options. Follow-up also keeps your blood pressure, cholesterol and blood sugar on track.

Benefits

Private, Respectful Care

Visits happen by video from a private space, and we talk about ED plainly and without judgment.

A Look at the Whole Picture

We check for heart, blood sugar, hormone and medication causes, not just the symptom.

Safe Prescribing

We review every medicine you take so treatment is safe for you, and prescriptions go to your pharmacy.

Men's Health in a Family Practice

Brooke Tuttle, FNP-C, is a board-certified family nurse practitioner who has practiced family medicine since 2017, and men's health, including ED and testosterone concerns, is part of the care she provides.

Your Treatment Journey

First Visit (Week 1)

We talk through symptoms and history by video, review your medicines, and order labs at a local lab when needed.

Weeks 2 to 4

We review results and, if appropriate, start a medicine. It often takes several tries on different days to judge how well a dose works.

Months 2 to 3

We adjust the dose or switch medicines if needed, and follow up on any heart, blood sugar or hormone findings.

Long-Term Care

We keep the conditions behind ED under control, review your medicines over time, and refer you to urology if more options are needed.

Warning Signs That Need Prompt Care

An erection lasting more than 4 hours. A prolonged, painful erection is an emergency that can cause permanent damage. Call 911 or go to the nearest emergency room.

Chest pain during or after sex. Call 911 or go to the nearest emergency room. Tell the emergency team which ED medicine you took and when, because nitrate medicines are not safe soon after these medicines.

Sudden loss of vision or hearing. Sudden vision loss in one or both eyes, or sudden hearing loss, after taking an ED medicine needs emergency care.

Fainting or severe dizziness. These can mean blood pressure has dropped too low and need prompt care.

A new curve, lump or pain in the penis. These can be signs of Peyronie disease or another problem and should be evaluated.

ED after an injury. ED that starts after a pelvic, back or genital injury needs prompt evaluation.

Shortness of breath or chest discomfort with activity. New symptoms with exertion deserve a heart evaluation.

Low mood or thoughts of self-harm. Call or text 988, the Suicide and Crisis Lifeline, or call 911.

If you recognize these signs, help is available. Early treatment leads to better outcomes.

Evidence-Based Treatment for ED

Medicines called PDE5 inhibitors, such as sildenafil and tadalafil, are the first-line treatment for most men and work with sexual stimulation, not on their own. They must never be taken with nitrate medicines, such as nitroglycerin, because the combination can cause a dangerous drop in blood pressure, and they need care with some blood pressure and prostate medicines. Common side effects include headache, flushing, a stuffy nose and indigestion. Healthy changes such as more activity, weight loss, quitting smoking, limiting alcohol and better sleep can improve erections and heart health at the same time. Counseling or sex therapy helps when stress, anxiety or relationship strain play a part. When pills are not enough or not safe, a urologist can offer other treatments, such as vacuum devices, injections or surgery.

Common Questions About Erectile Dysfunction

Is erectile dysfunction common?

Yes. ED is very common and becomes more likely with age, though it can happen at any adult age. It is a medical condition, not a personal failing, and most men can be helped.

Can ED be treated by telehealth?

Often, yes. Talking through symptoms, reviewing medicines, ordering labs at a local lab and prescribing treatment when appropriate all work well by video for patients physically located in Utah at the time of the visit. If a physical exam is needed, we will help you arrange an in-person visit. Our in-person clinic is being planned in Cache County, Utah.

Why does ED matter for my heart?

The blood vessels in the penis are small, so they can show narrowing before larger vessels do. ED can appear years before heart symptoms, which makes it a useful early warning. Checking blood pressure, cholesterol and blood sugar gives you a chance to lower your risk.

Are ED medicines safe?

For most men they are safe when prescribed after a review of your health and medicines. They are never safe with nitrate medicines, and they need care with some blood pressure and prostate medicines and in men with certain heart conditions. Common side effects include headache, flushing, a stuffy nose and indigestion.

What if the medicine does not work?

Let us know. A different dose, timing or medicine may help, and it can take several tries to judge one fairly. We also look again for causes such as low testosterone. If pills do not work or are not safe for you, we refer you to urology for other options.

Does insurance cover ED treatment?

Sagebrooke Family Medicine is an insurance-based practice, and we are in the process of joining insurance plans. What you pay depends on your plan, including any copay, deductible or coinsurance. Contact the practice to check whether your plan is accepted, and check with your insurer about coverage for ED medicines and labs, since coverage for these medicines varies widely.

Get Help for Erectile Dysfunction

ED is common and treatable. Request a private telehealth visit and we will look for the cause and a treatment that is safe for you.