Understanding Erectile Dysfunction
Difficulty achieving or maintaining an erection affecting confidence and connection.
ED is often a vascular and hormonal signal, not just a sexual one. We assess hormones, cardiovascular and metabolic health, and mood, then build a discreet, medically sound plan — addressing the root cause, not just the symptom.
What's actually happening
ED is difficulty achieving or maintaining an erection, and it's often a vascular and hormonal signal — not just a sexual one. It can be an early warning of broader cardiovascular and metabolic issues.
How it progresses
ED tends to worsen gradually and to affect confidence and connection, and the underlying vascular or hormonal drivers tend to progress alongside it.
When lifestyle isn't enough
Lifestyle changes help, but when ED persists, assessing hormones, cardiovascular and metabolic health, and mood — then building a discreet, medically sound plan — addresses the root cause, not just the symptom.
Who We Typically See
Usually a man in his 30s to 60s who is otherwise healthy and frustrated that something that used to be automatic now isn't. Some notice it slowly, some after a stressful stretch. Many are quietly worried it means something bigger, and sometimes it does: ED is often an early signal of vascular or metabolic change.
Treatment Options at a Glance
Treating the cause, not just the moment.
Fast-acting options help tonight. Vascular, hormonal, and metabolic care helps for years.
PDE5 inhibitors
What it targets
Penile blood flow on demand or daily.
First-line and effective for most men. Daily low-dose options reduce planning and performance pressure.
PT-141 (bremelanotide)
What it targets
Central arousal pathways in the brain.
An option when PDE5 inhibitors aren’t enough or arousal, not just blood flow, is part of the problem.
Testosterone optimization
What it targets
Libido, morning erections, and response to other treatment.
Low testosterone can make PDE5 inhibitors work poorly. We treat it when labs confirm it.
Vascular & metabolic workup
What it targets
Blood pressure, lipids, insulin resistance, and inflammation.
The same issues that narrow arteries elsewhere show up here first.
Performance anxiety support
What it targets
The anxiety loop that keeps the problem going.
Coordinated with our mental health team when stress or anxiety is driving it.
Options are prescribed only when clinically appropriate, after evaluation by a licensed provider.
The Roadmap
What working with us actually looks like.
01 — Deep diagnostics
Hormones, cardiovascular and metabolic markers, and mood.
02 — Root-cause plan
We address the vascular and hormonal drivers, not just the symptom.
03 — Active treatment
Hormones, lifestyle, and medical support as indicated.
04 — Sustain
Ongoing care that protects function and the cardiovascular health behind it.
Why PracticeRx
Conventional care vs. the PracticeRx approach.
Conventional care
- 10-minute visits and TSH-only labs
- “Your levels are normal” — even when you don’t feel normal
- Treats the symptom: a prescription or “lose weight”
- One specialist per system, none talking to each other
- Reactive — wait until something breaks
- Generic protocols based on demographics
PracticeRx
- 100+ biomarker bloodwork and full hormone & thyroid panels
- Hormones, peptides, and metabolic medicine guided by your data
- Integrated mental and physical care in one practice
- Preventative — full-body MRI screening and early detection
- 7-day access to your care team — no waiting until Monday
- A plan built around your biology, not a protocol
The evidence
ED affects roughly 30 million U.S. men and can precede cardiovascular events by years; the 'artery size' hypothesis links ED to vascular health.
Source: NIH; Montorsi et al., 2003
Medically reviewed by
Justin Cooper, PA-C
PRX Physician Associate · Men’s Health
Army-trained physician associate and former aeromedical provider, leading men’s health care: testosterone and hormone optimization, sexual health, and preventative screening.
Stop guessing. Start with the labs.
You don't have to keep guessing what's wrong. We'll run the deep labs, find what's actually driving this, and build a plan around your biology.
100+ biomarker bloodwork
The labs conventional care usually skips.
Integrated care, one team
Mental and physical health under one roof.
7-day access
Your care team, when you actually need them.