When ED is caused by a medical problem, it is crucial that you and your physician work together to determine the specific cause. Medical treatment will vary depending on this determination. For example, ED caused by neurologic impairment from prostate surgery will be treated differently from than ED caused by a loss of interest in sex resulting from an abnormal level of the hormone testosterone. Medications like Viagra may be effective treatments for neurologic impairment, whereas abnormally low testosterone is treated with testosterone injections or gel or transdermal patches applied at the skin.
Determining the source of testosterone deficiency is essential, because abnormally low testosterone may result from different sources, ranging from physical or emotional exhaustion, side effects of medication, chemical abuse, testicular cancer, a pituitary tumor, or even misuse of hair lotions for baldness. Testosterone replacement therapy does not benefit men with normal serum levels. In fact, in men with ED with normal serum levels, testosterone can compound the problem by increasing sexual desire without increasing performance. Testosterone therapy is indicated in men whose testosterone values are below normal levels. This treatment is focused on increasing desire and, indirectly, increasing erectile capacity.
It is crucial to evaluate general medical conditions, especially vascular, neurological, and hormonal function. It is just as crucial to evaluate psychological and relationship factors that subvert sexual function as well as those that promote healthy sexuality - especially valuing sex as an intimate, interactive process and seeing the woman as your erotic friend, not someone to perform for or be afraid of.