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Erectile dysfunction

Many men have problems with sexual performance after first learning about their infertility, but this usually ameliorates with time.

Infrequent and poorly timed intercourse may result from incorrect advice, low libido, or the psychological reaction to infertility.

Erectile Dysfunction (ED)

Erectile dysfunction may be associated with low libido from androgen deficiency with primary or secondary hypogonadism. Erectile dysfunction related to vascular or neurologic abnormalities (diabetic autonomic neuropathy or pelvic nerve damage) is uncommon in men presenting with infertility. Selective impotence at the time of ovulation may indicate psychological problems and ambivalence.

The Erectile Dysfunction (ED) consultation – What to expect?

The main aim of your initial consultation with Dr. Barak will be to assess the severity of your sexual dysfunction and to look for physiological causes and / or psychological ones. In light of his findings, Dr Barak will discuss with you the potential treatment.

You can come alone in this consultation but it is highly important that your partner will be also involved as your partner’s support and collaboration are essential for the success of the treatment.

During your initial Sexual Dysfunction consultation Dr Barak will go through your medical history (chronic illness, medications, past surgeries and injuries) and will focus on your sex life (nature of your sexual disorder, implications on relationship, previous treatment, sexual desire etc.). This thorough discussion might make you feel bit embarrassed, but please remember, ED is a common medical condition, and Dr Barak who is highly specialized in this area is used to discussing it. Your concerns and expectations from the treatment will be thoroughly discussed during this consultation as well.

Important to know about ED!

ED may be an early symptom of more serious pathologies like cardiovascular and neurological conditions.

Infrequent ED is probably not a cause for concern. An ongoing ED, may need to be treated. ED is a common health problem, but many men are reluctant to seek help. However, treatment is effective for most of the men  and restoring their sexual function  can make a dramatic difference in their  quality of life.

Physical exam and lab tests
Dr Barak will also likely to perform a physical exam that includes checking your blood pressure, checking the circulation and nerves to your penis and testicles and a thorough examination of your genitalia.

In some cases, lab tests are needed to determine the exact cause of erectile dysfunction. These may include tests to make sure your erectile dysfunction isn’t related to diabetes, hyperlipidemia, low testosterone or other conditions.

Lab tests may include: Complete  blood count,  random glucose level, lipid profile, thyroid function, testosterone and other hormones.

Psychological causes of erectile dysfunction
Hormones, blood vessels, nerves, must all work together in order for erection to happen. The mind plays an important role in the initial arousal. In some cases, ED can have a psychological rather than a physical cause. In such cases, Dr Barak might decide to refer you to sexual counselling as part of his suggested treatment.

If your erectile dysfunction started suddenly rather than coming on gradually, your erections subside early during sexual contact, you have spontaneous erections at night or when you wake up in the morning, you have premature ejaculation, you have relationship problems, you have been going through stressful life events – a psychological cause might be the reason for your ED.


Oral medications such as sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis) are the most common treatment for erectile dysfunction. But these medications aren’t effective for all men and aren’t safe for men with some health problems or who take certain medications. Other treatments include medications injected into the penis before sex or vacuum constriction devices (penis pumps). Treating related health conditions, psychological counseling, or changing medications or lifestyle choices can help when issues such as stress or depression are involved. If the first treatment you try doesn’t work, your doctor may suggest trying something else. For some men, a combination of treatments works best.