Erectile Dysfunction

Erectile Dysfunction: Causes and Treatment Options in Clear Lake & Houston, TX

What is Erectile Dysfunction?

Erectile dysfunction (ED) is the inability to achieve or maintain an erection sufficient for satisfactory sexual performance. While occasional difficulties in getting or keeping an erection can be normal, persistent issues may indicate an underlying problem requiring medical attention.

Dr. Travis Green is a urologist in Clear Lake and Houston, TX who specializes in treating erectile dysfunction. Dr. Green can help you find the underlying cause of ED and suggest the best treatment options. Call our office today at 281-957-9658 to schedule an appointment.

Causes of Erectile Dysfunction

Understanding the causes of ED is the first step towards effective treatment. The causes can be broadly categorized into physical, psychological, and lifestyle-related factors.

Physical Causes

Cardiovascular Diseases:  Conditions like hypertension, diabetes, high cholesterol, and atherosclerosis (clogged blood vessels) can impede blood flow to the penis. Blood flow is necessary for an effective erection and any issues with blood flow can lead to erectile dysfunction.

Diabetes: High blood sugar levels can damage the blood vessels and nerves essential for an erection.

Hormonal Imbalances: Low testosterone levels or other hormonal disorders can affect sexual function.

Neurological Disorders: Diseases like Parkinson’s, multiple sclerosis (MS), and spinal cord injuries can interfere with nerve signals.

Peyronie’s Disease: Development of scar tissue inside the penis can cause painful erections and lead to ED.

Medications: Certain drugs for high blood pressure, depression, and other conditions can have side effects that include ED.

Prostate Conditions: Treatments for prostate cancer or an enlarged prostate can affect erectile function.

Psychological Causes

Stress and Anxiety: High stress levels can interfere with sexual arousal and performance.

Depression: Mental health disorders can reduce sexual desire and cause ED. In addition, common treatments for mental health conditions can worsen erectile function

Relationship Issues: Poor communication or unresolved conflicts with a partner can contribute to ED.

Performance Anxiety: Worrying about sexual performance can itself cause ED.

Lifestyle Factors

Smoking: Tobacco use restricts blood flow to veins and arteries, causing decreased blood flow to the penis and worsening erectile function.

Alcohol: Excessive drinking can cause low testosterone and/or temporary or long-term erectile dysfunction

Obesity: Being overweight can lead to ED through a combination of vascular problems and hormonal imbalances.

Lack of Exercise: A sedentary lifestyle can contribute to ED by causing poor cardiovascular health.


To find the correct diagnosis and the right treatment plan, Dr. Green will typically start with a thorough medical history and physical examination. Based on the results, there are a variety of tests that he may order depending on each individual case. 

Laboratory Studies

Hormone Levels: Testosterone, luteinizing hormone (LH), prolactin, and thyroid-stimulating hormone (TSH) to check for hormonal imbalances.

Metabolic Profile: Blood glucose, HbA1c, and lipid profile to check for diabetes and dyslipidemia (high cholesterol).

Complete Blood Count (CBC): Checking blood cell counts to rule out anemia or other systemic conditions.

Urinalysis: Checking the urine to detect signs of diabetes, kidney disease, or urinary infections. 

Specialized Testing

Nocturnal Penile Tumescence (NPT) Test: This test evaluates erections during sleep. Healthy men usually have 3-5 erections per night. Absence or reduced frequency of erections while sleeping may indicate a physical cause.

Intracavernosal Injection Test: A medication is injected into the penis to induce an erection. The response helps determine if the cause is physical/structural.

Penile Doppler Ultrasound: This imaging test assesses blood flow in the penile arteries and veins, helping to identify vascular problems.

Psychological Evaluation: If psychological factors are suspected, referral to a psychologist or psychiatrist may be recommended. This may include assessments for depression, anxiety, and other mental health conditions.

Treatment Options

Treatment for ED depends on the underlying cause. A comprehensive approach typically involves lifestyle changes, medication, therapy, and/or other interventions.

Lifestyle Modifications

Exercise: Regular physical activity improves blood flow and reduces stress.

Healthy Diet: A balanced diet supports cardiovascular health and proper hormone levels.

Quit Smoking: Stopping tobacco use can significantly improve ED.

Limit Alcohol: Reducing alcohol intake can help restore erectile function.

Weight Management: Achieving a healthy weight can improve symptoms, especially if obesity is a factor.


Oral Medications: Phosphodiesterase-5 inhibitors like sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra) enhance blood flow to the penis.

Hormone Therapy: Testosterone replacement therapy (TRT) may be prescribed if low testosterone levels are detected.

Injection Therapy: Medications injected directly into the penis can produce an erection.

Intra-urethral suppositories: Medication delivered into the urethra can increase blood flow.

Devices and Surgery

Vacuum Erection Devices: A pump creates a vacuum that pulls blood into the penis. These are often used in combination with a restrictive ring to maintain an erection.

Penile Implants:  Surgical insertion of devices can provide a permanent and extremely effective solution for ED.

Vascular Surgery: In rare cases, surgery can correct blood vessel blockages if that is the cause of the ED.

Psychological Counseling

Therapy: Counseling can address stress, anxiety, depression, and relationship issues.

Sex Therapy: Specialized therapy can help improve sexual confidence and performance.

Schedule an Erectile Dysfunction Appointment in Clear Lake & Houston, TX Today

If you are experiencing symptoms of erectile dysfunction (ED), consult with a specialist such as Dr. Green. A thorough evaluation will determine the underlying cause and the right treatment plan for you. Addressing ED is not only about improving sexual performance but also enhancing overall health and well-being.

For more information or to schedule an appointment, contact our Clear Lake or Houston, TX office today at 281-957-9658.