Erectile Dysfunction

What is Erectile Dysfunction?

Erectile Dysfunction (ED) is the inability to achieve or maintain an erection firm enough for sexual activity. This can be:

  • Not getting it up at all

  • Getting an erection inconsistently

  • Getting an erection that doesn’t stay hard enough for sex

It is a common condition, more than people care to admit or discuss, and it is nothing to be embarrassed about. ED is not “in your head”, it’s a physical condition that deserves attention – no different to a broken arm.

Dr Ross Calopedos - Erectile Dysfunction

STATISTICS

2.5m

ED affects approximately 2.5 million adult Australian men

40%

of all Australian males

>50%

of all Australian men
over the age of 40.

Symptoms that can be linked to Erectile Dysfunction

Losing your regular morning erections is a sign that your erectile function may be changing.

Men experiencing ED may also notice:

  • Reduced sexual desire

  • Inability to reach orgasm or delayed ejaculation

  • New deformity or penile curvature

  • Penile shortening, loss of girth or atrophy

Occasional difficulties with erections are normal and can be linked to factors such as stress, fatigue, distraction, alcohol consumption, or anxiety. However, when erection difficulties become persistent, it may indicate an underlying medical condition requiring treatment.

If ED is happening to you, it is important to seek medical advice, because:

  • Proactive management can prevent progression and avoid the need for surgical treatments

  • You do not have to live with these problems or resign yourself to hanging up your boots. There are effective, evidence-based options available to you.

  • There are things we can do to help if you want it

  • ED can be a sign of other health conditions such as cardiovascular disease or diabetes. In many cases, early detection of ED has helped prevent heart attacks, as blockages in the penile blood vessels often mirror issues in the arteries supplying the heart (and vice versa). Proactive care prevents problems.

Dr Ross Calopedos - Causes of Erectile Dysfunction

Causes of Erectile Dysfunction

Erectile dysfunction (ED) is a symptom, not a diagnosis. It can stem from a range of factors, including medical conditions, lifestyle habits, substance use, and past surgeries.

Men’s health is about optimising all the interconnected factors that contribute to overall well-being. The penis often acts as a ‘light bulb indicator’ for broader health concerns, signalling underlying issues that may require attention.

Addressing ED isn’t a one-size-fits-all approach. Effective treatment involves identifying and managing the root causes to improve both sexual function and overall health.


What is the root cause?

Vascular erectile dysfunction is often considered one type or entity.

There are 2 key subtypes with very different treatments:

  • Arteriogenic (related to an issues with blood inflow)

  • Veno-occlusive dysfunction or “venous leak” (related to an inability to trap the blood once it gets there)

Patients with venous leak often respond well to medications initially, however the effect can quickly fade over time. This is because increasing inflow can overwhelm the leak phenomenon, but as the leak gets worse symptoms persist despite maximum medical therapy.

Men with venous leak also have a higher risk of experiencing penile atrophy - where the length and girth decrease, and shape can permanently change. It is essentially essential to differentiate men with arteriogenic and veno-occlusive dysunction, as the latter are best managed with a penile implant.

Penile duplex ultrasound is the only test that reliably determines the underlying vascular cause of erectile dysfunction. Dr Ross Calopedos performs this quick study in his clinic as part of the assessment where appropriate. Understanding the difference means that patients are provided with ED treatments that work.

Dr Ross Calopedos - Erectile Dysfunction

Treatment

Erectile Dysfunction (ED) is highly treatable, and men experiencing persistent symptoms should not hesitate to seek medical assistance.

A consultation with a Urologist who is experienced in evaluating and treating ED is the best starting point, as they will be able to explain the cause of the problem, investigate it correctly, and offer a range of treatments.

Dr Ross Calopedos is a highly specialised urologist in Sydney with a dedicated focus on erectile dysfunction and men’s health, offering tailored treatments to support men’s well-being at every stage of life. Make an appointment to discuss your personal situation and the options available to you. We do not require a referral from your GP (although it allows us to provide a Medicare rebate for the cost of the consultation).

Treatment options

Choosing the right approach is a personal decision best made in consultation with your partner and a specialist.

A one-size-fits-all approach often leads to suboptimal results. Dr Ross takes the time to understand your individual goals, your partner’s needs, and helps you navigate the benefits and limitations of each option to ensure the best possible outcome for you.

Treatment options may include:

Lifestyle Modifications

  • Quitting smoking and reducing alcohol consumption

  • Regular exercise and weight management

  • Stress reduction, improved sleep habits, treatment for sleep apnoea (OSA)

Medications

  • Oral medications (PDE5 inhibitors) such as Viagra and Cialis

  • Intraurethal and injectable medications that enhance blood flow to the penis

  • Hormonal therapy for testosterone deficiency

Surgical Treatments

  • Penile Implants (Prosthesis) – A permanent and highly effective solution. This is the best method in most cases as it is the only way to “cure” ED, stop atrophy, and return the penis to its normal, spontaneous functioning (remove full-stop to match the rest)

Medical Devices

  • Penis Pump – A vacuum erection device is a mechanical pump that can enhances blood flow to the penis. However, if used incorrectly, it can have the opposite effect.

  • Cock ring – Penile constriction devices can be used in conjunction with a penis pump and medication directly injected into the penile tissue to induce an erection

  • Penile traction therapy – can enhance blood flow and counteract effect of scar tissue. Often used as an adjunct to medical therapy and in cases of ED combined with Peyronie’s disease

Emerging Therapies

  • Low-Intensity Shockwave Therapy (LiSWT) – A non-invasive option that can stimulates blood vessel growth in men with mild arteriogenic ED

  • Regenerative Treatments and Clinical Trials – Ongoing research into stem cell therapy and platelet-rich plasma (PRP) injections

When to see a doctor

ED is not a normal or inevitable part of aging and it should not be ignored.

If you experience persistent difficulties with erections, seeking medical advice is crucial. ED can be a warning sign of cardiovascular disease, diabetes or other serious conditions.

Dr Ross Calopedos is an experienced urologist and men’s health specialist who provides expert diagnosis and treatment for erectile dysfunction. A consultation will help determine the underlying cause of your ED and provide access to tailored treatment options.

Ask Dr Ross.

If you are not ready to make an appointment, but would like to ask a question or get some more information, we are here for you.

BOOK A CONSULTATION TODAY

Early diagnosis and treatment can make a significant difference.

Contact us for a confidential discussion and take the first step toward effective care.

Frequently Asked Questions (FAQ)

  • While erectile dysfunction (ED) affects the ability to achieve or maintain an erection, it does not necessarily prevent orgasm. Many men with ED can still experience sexual pleasure through alternative forms of stimulation. However, some may also report reduced sensitivity or delayed ejaculation. This can be due to underlying factors contributing to ED—such as hormonal imbalances, nerve dysfunction, or impaired blood flow—or difficulty generating sufficient pressure in key areas to trigger the orgasm reflex.

  • While oral medications are often considered the quickest option, as they work rapidly to enhance blood flow, it depends on the underlying cause of ED. Remember – ED is not a diagnosis, it’s a symptom of the underlying problem and the most effective treatment depends on the individual's specific condition and underlying causes. Following a thorough evaluation—including a penile duplex ultrasound when necessary—you and Dr Ross will know the fastest way to treat your ED. For some, this may involve medications alone, while for others, a penile implant may provide the fastest and best long-term solution.

  • Regaining erectile strength often involves a combination of lifestyle changes, medical evaluation, and, in some cases, targeted treatments. While some men may see improvements through natural methods alone, others may require additional medical support. Here are key strategies to enhance erectile function naturally:

    1.  Optimise Your Lifestyle:

    • Engage in regular physical activity, especially cardiovascular and resistance exercises, which promote healthy blood circulation.

    • Maintain a balanced diet rich vegetables, healthy fats, and antioxidants to support vascular health.

    • Manage weight, as obesity is linked to reduced testosterone levels and impaired blood flow.

    • Improve sleep quality, as poor sleep can disrupt hormone regulation and increase stress levels.

    • Reduce stress through mindfulness, meditation, or therapy, as chronic stress can lead to elevated cortisol levels, which negatively impact erectile function.

    • Limit alcohol intake and avoid smoking, as both can impair blood vessel function and reduce nitric oxide levels essential for erections.

    • Manage Underlying Health Conditions:

    2. Manage Underlying Health Conditions:

    • Conditions such as diabetes, high blood pressure, high cholesterol, and cardiovascular disease can contribute to ED by affecting blood flow and nerve function.

    • Regular check-ups with a healthcare provider can help diagnose and manage these conditions effectively.

    • Optimising testosterone levels, if deficient, can also play a role in improving erectile strength.

    3.  Natural Erection Supplements:

    • While some natural supplements are thought to support vascular function, there is no evidence that these have any effect on erectile function.

    • If natural methods do not yield the desired results, medical treatments such as oral medications, vacuum erection devices, penile injections, or implants may be considered.