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Erectile Dysfunction & ED Treatment Options

Resources for Primary Care Providers

What you can do for your ED patients?

According to the Association of American Medical Colleges, there is a shortage of physicians in the U.S., particularly PCPs.

A new study states that there could be a shortage of 55,200 PCPs by 2032.1

Not only is there a shortage, but there is also an increase in the number of patients over age 65.2

Figure 1. Visit rates, by selected demographics: United States, 2016

Many of these patients are coming in due to chronic

Figure 3. Major reason for office-based physician visit, by age: United States, 2016

80% of adults 65 and older have at least one chronic condition

68% have two or more

These are the most common conditions of adults over the age of 653





Ischemic/Coronary Heart Disease




Many of these chronic conditions are associated with ED

Erectile Dysfunction Etiologies4


Up to




Up to




Up to


Pelvic Surgery/Trauma
(ie: prostatectomy)


Up to



*Note that many etiologies are concomitant and will not equal 100%

In 80% of cases, ED Is caused by a physical problem or disorder.5

Up to 50 million men in the U.S. suffer from erectile dysfunction.6

40% of men

by the age of 40 are affected by ED6

Erectile Dysfunction:
It’s common and treatable.


While ED is common, it is not an inevitable part of aging, and in most cases, it can be overcome.7

Why is it important to inquire about ED?



of patients say that ED
negatively impacts their
everyday life8



of patients say that ED
lowers their



Studies have reported
that exposure to
ED increases the risk
of depression9

Primary Care Providers are the first line of treatment for ED8

An estimated 69% of patients first consult a GP/PCP for ED treatment.

About half of patients feel negative emotions when first seeking ED treatment with patients reporting feeling ashamed, embarrassed, humiliated, disappointment, and frustrated/angry.

Primary Care Providers have been shown to be the most influential resource for patients seeking ED treatment.

American Urology Association (AUA) recommendations on ED diagnosis10






Perform a thorough medical, sexual, and psychosocial history; ​a physical examination; ​and selective laboratory testing Validated questionnaires are recommended to assess the severity ​of ED, to measure ​treatment effectiveness, ​and to guide ​future management Men should be counseled that ​ED is a risk marker ​for underlying cardiovascular disease (CVD) and other health conditions that may warrant evaluation ​and treatment Morning serum total testosterone levels should be measured For some men with ED, specialized testing and evaluation may ​be necessary to ​guide treatment

AUA recommendations for ED treatment options10



Vaccuum Erection



Typical patient ED treatment pathways


Oral Medication


of patients start with pills as

a first line ED therapy11



50% of patients discontinue treatment in the first year due to reasons such as medication failure, cost, and concerns about long-term safety12

77% of patients who try a second treatment move onto another brand of pills13 and it is estimated that for 40% of cases pills are not effective13


Penile Injections


of patients who try a second

treatment try penile injections13



It is estimated that for 30% of cases, injections fail to work or men experience priapism (erection lasting 4 hours or more)13


When pills and injections no longer work, a penile implant may be an effective solution for your patients’ ED. Some patients may move to it right away.10

Penile implants – an effective ED solution

A penile implant (inflatable and malleable) is a medical device implanted through a surgical procedure that is designed to help a man get an erection. It is completely hidden inside the body.14 Most men return home the same day and are able to resume sexual activity upon his doctor’s clearance, typically between 4-6 weeks.15


  • Removes the hassle of timing pills and needles14
  • Is a long-term ED solution16
  • Puts the man back in control of his body and can be used at any time14
  • Restores patient’s spontaneity and confidence14

Penile implants are a long-term ED treatment16 with high patient satisfaction.14

Penile implants are also the most cost-effective ED treatment over a 10-year period.13


Patient satisfaction with the Titan penile implant for erectile dysfunction14


Partner satisfaction with the Titan penile implant for erectile dysfunction17

How does the Titan penile implant work?

Looking for an ED treatment cost comparison?

What can you do?

1-bullet Initiate the conversation about ED. Ask questions such as:

  • How are your erections?
  • Are they strong enough for you to have sex/intercourse?
2-bullet Utilize a diagnostic tool: Sexual Health Inventory for Men (SHIM)18 is an ED quiz filled out by patients that can be a helpful tool in the diagnosis of ED. The SHIM can be uploaded into EMR or added to patient intake form.

Click to download the SHIM

3-bullet Treat when appropriate.
4-bullet Monitor the effectiveness of their other ED therapies like pills. Set a follow-up appointment to determine the effectiveness of treatment.
5-bullet When necessary, such as if first line therapies fail, send patients to a specialist for a comprehensive evaluation.

Sending patients to the right specialist


Not all urologists specialize in ED – help your patients get to the right urologist – a urologist who specializes in Men’s Sexual Health and ED


Urologists with this specialty will be able to:

  • Conduct a full comprehensive evaluation and diagnostic work up
  • Develop a treatment pathway
  • Assess ongoing effectiveness of prescribed treatment (all other care remains with primary providers)
  • Provide a written follow up communication to patient’s primary physician

To find a specialist for your ED patients near you, click here.