Men’s health: erections, testosterone, and the bigger picture

Erectile dysfunction

Erectile dysfunction covers difficulty getting an erection, difficulty keeping one, and sometimes a drop in desire. Common contributors include heart disease, high cholesterol, diabetes, excess weight, substance use and stress or other psychological factors.

Erections rely on good circulation, so trouble in the bedroom can sometimes be the first hint of a heart problem. Dr. Dev Mally explains why in ED and your heart. If your risk factors point that way, we help you get to your primary care doctor or a cardiologist.

How we evaluate it: your medical and sexual history, an exam, lab tests, and in some cases night-time erection testing or imaging.

Treatment options at Advanced Urology include lifestyle changes, PDE5 inhibitor medicines, hormone therapy when testosterone is low, penile injections, vacuum erection devices, pelvic floor exercises, low-intensity shockwave therapy, and penile implants. Our urologists explain the trade-offs of each.

Low testosterone

Low testosterone can affect energy, mood and sexual function, so we start with testing rather than assumptions.

Testosterone replacement therapy (TRT)

If testing confirms low testosterone and treatment fits, options offered at Advanced Urology include testosterone gels or creams, injections, and testosterone pellets placed in a short in-office procedure. For younger men who want to protect fertility, there are other approaches, and our urologists will talk them through with you.

Topical testosterone should not touch women or children while it is still wet on the skin. Every treatment has side effects to weigh, and we review them with you before you start and at follow-up.

Prostate checks

Plenty of men first come in because a physical turned up a PSA number someone wanted checked. That number calls for a closer look; on its own it isn’t a diagnosis. See prostate cancer care and elevated PSA and the PSMA PET/CT guide.

Peyronie’s disease and vasectomy

We also care for Peyronie’s disease, a curve of the penis caused by scar tissue, and offer no-scalpel vasectomy at our Snellville surgery center.