Understandably, talking to your doctor about erectile dysfunction, or the inability to achieve and maintain an erection firm enough for sex, can be embarrassing for men. But it doesn’t have to be. It’s a relatively common problem. In fact, about 52% of men between the ages of 40 and 70 have some degree of ED. It can occur in younger men as well. If it’s a one-time event, there’s probably not much to worry about. But if it’s a chronic issue, it should be discussed with your doctor. ED is not just about your sex life. In a way, the penis can act like a barometer for the body--a measure that more serious issues exist or could be on the way. Sometimes ED is the initial warning sign for cardiovascular disease, high blood pressure, or diabetes. So if you’re feeling uneasy about broaching the subject, try asking if it might be an indicator of something more serious. If you’re experiencing any combined symptoms (loss of vision, inability to urinate, or abnormal penile curvature, which often indicates Peyronie’s disease), then it’s even more essential that you talk to your doctor. Your sex life doesn't have to suffer or end because of ED. There are a number of treatment options, based on your personal situation and personal preference. For younger guys, ED is often stress related--changing jobs, starting a new relationship, moving, anything that’s affecting sleep patterns--which means it’s usually not permanent. This can be addressed with a change in lifestyle, increased exercise, getting more sleep, and eating right. It may also be caused by a medication that’s being taken for another condition, in which case I recommend switching that medication. If medical treatment is still needed, there are a number of options. The most common and well- known treatment is oral medications, taken on an as-needed basis 30 to 60 minutes before sexual activity. Be aware that patients taking nitrates to treat heart disease might not be a candidate for this type of regimen. But there are other options, such as intraurethral suppositories and injectable medications, as well as vacuum erection devices that go directly over the penis and pull air out, causing blood to rush into the penis from the vacuum. If all of these fail, are unsatisfactory, or are unavailable for whatever reason, then surgery is an option. The surgery involves implanting a penile prosthesis to achieve an erection. Since this a permanent procedure, it is usually reserved as a last option, when more conservative therapies fail. Most importantly, though, don’t hesitate to bring it up with your doctor--you have everything to gain. Many of my patients wait until the very last minute of their appointment and then mention it in passing. That’s the wrong way to approach it, because the physician may give you a quick prescription, rather than devote the entire appointment to discussing your ED and the best treatment options. If you don’t feel comfortable discussing ED with your primary care physician, there are always urologists, or even urology male health specialists (andrologists) like me who talk about ED every day. Just remember that erectile dysfunction is very common and it can be a significant indicator of your overall health. If you don’t give it the attention it deserves, you may be doing yourself a real disservice.