The Erection Expert

An interview with Joshua R Gonzalez, MD, an L.A. based urologic surgeon, on erectile dysfunction.


Dr. Gonzales—let’s get right to it—what causes erectile dysfunction.

Erectile dysfunction (ED) can be caused be by a number of different issues. Erections are dependent on four factors working together: hormones, blood flow, nerves, and psychology. It is my job to figure out which of those four factors may be problematic and contributing to your particular ED. Once we have diagnosed the problem, then we can begin to talk about appropriate treatments.

Can erectile dysfunction be prevented?

Men can prevent erectile dysfunction as much as possible by leading healthy lives. In general, we say that what’s good for the heart is good for the penis. That means eating healthy and regularly exercising.

Smoking cigarettes is also a sure way to kill your erections. One of the first things I suggest is smoking cessation in patients who smoke and are starting to have erection problems. There is evidence to suggest that you can regain erectile function simply by quitting.

Is erectile dysfunction a normal part of aging?

There is definitely a correlation between age and ED, meaning ED is more common as men get older. But it is in no way normal! Older men experience ED more than younger men not simply because they are older but because generally they have more risk factors, such as high blood pressure, depression, and obesity, than younger men. ED is never normal, but is usually the sum of multiple other medical conditions. It’s not something you simply have to accept as part of getting older.

There are a number of treatment options for ED depending on the cause and severity. It’s my job to find the treatment option that is best suited for each individual patient.

How is erectile dysfunction treated?

There are a number of treatment options for ED depending on the cause and severity. It’s my job to find the treatment option that is best suited for each individual patient. There are medical treatments such as pills and injections. There are hormonal options that can sometimes help. And there is even surgery, which has the highest satisfaction rate of any of the ED treatments out there.

Does insurance cover ED treatment?

Insurance covers some ED treatments. When the oral medications are covered, there is usually a limit on the number of pills you can get per month. Insurance companies limiting the number of times you can have sex in a month just seems ridiculous. But it’s because the cost of these drugs has become so outrageous. When men pay out of pocket sometimes they are spending $40-50 per pill! Thankfully penile implant surgery, which is the oldest treatment we have for ED, is covered by Medicare and most commercial insurance plans.

Is there anything we haven’t asked that you would like to share with our readers?

If there’s one thing I think every guy needs to know it’s that ED is common. You’re definitely not alone. There’s an estimated 30 million American men experiencing the very same thing. We just don’t do a great job talking about it. There’s nothing to be ashamed of so say something. Seek out help as soon as possible. Because when it comes to erections, if you don’t use ‘em you lose ‘em.

To learn more about this topic visit Dr. Gonzalez’s website: or
call (323) 607-2895.

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