Men’s Health

Men’s Health

Ed Doctor in Cleveland, OH

Known as ED, Erectile Dysfunction is a men’s sexual health condition that affects many men. 

Dr. Nannan Thirumavalavan is a fellowship-trained urologist specializing in the diagnosis and treatment of erectile dysfunction. Dr. Thirumavalavan uses the most advanced technology and procedures to provide his patients with the best results. If you suspect you may be experiencing symptoms of ED, Call our urology clinics in Cleveland at (216) 285-5036.

Do I have Erectile Dysfunction?

Ask yourself two questions:

  1. Are you happy with your erections?
  2. Are you as hard as you want to be, for as long as you want to be?

If the answer is no, then you may have ED. 

What Causes ED?

One in two men over the age of 40 has erectile dysfunction, so you are not alone! As you get older, erectile dysfunction becomes more common. Certain medical conditions like high blood pressure, high cholesterol, elevated blood sugars/diabetes, and smoking can all make it worse. These conditions can damage your small blood vessels, which are key for erections. 

Low Testosterone can also contribute to erectile dysfunction, so we recommend that everyone has their testosterone levels checked with a blood test.

How do I Improve or Treat my Erections?

The good news is that there are well proven, successful solutions for ED:

  • Lifestyle Changes: Diet, exercise, and quitting smoking can all help your erections and stop them from declining! We recommend this for all my patients. 
  • Pills (Cialis, Viagra, etc): These medicines work by increasing blood into the penis. You take the medicines 1-2 hours prior to wanting to have an erection. You still need some stimulation to start an erection, and then the pills kick in. Side effects include headaches, flushing, back pain, and rarely a prolonged erection over 4 hours, which could be dangerous. If you take nitroglycerin for chest pain, you cannot take these medications.

    • Viagra (Sildenafil): Take this 1 hour before sex, on an empty stomach
    • Cialis (Tadalafil): Take this 2 hours before sex. 

  • Penile Implants: When your erectile bodies are not working properly, an outpatient procedure can place cylinders inside the penis that take over the function of your erectile bodies. The implant is all inside of your body and there is a small pump by your testicles that you can use to activate your implant. This treatment has a high satisfaction rate since it does not depend on your own blood flow and can reliably give you a hard, long lasting erection quickly. Penile implants are usually covered by your health insurance. 
  • Arterial Stenting: In some instances, a specific arterial blockage leads to poor blood flow to the penis. If an ultrasound shows arterial issues, you could be a candidate for arterial stenting to open these arteries and improve erections. 
  • Penile Injection Therapy (Trimix): In this treatment, we teach you to give yourself an injection in the penis 5 – 20 minutes before you want to have an erection. The medicine is called Trimix and is stronger than any of the pills. The medicine does not work for everyone, so a test injection is done in the office along with an ultrasound of penis to evaluate blood flow in the penis.  Based on the test injection and the ultrasound, we determine a starting dose at home, and you can increase the dose slowly each time you use it until you are happy with the effect. For use at home, the medicine costs about $80 to $120 for a vial, and it is shipped to your house from a pharmacy.
  • Vacuum Pumps: In this treatment, men use an external pump to “suck” blood into your penis, and then a ring is applied to the base of the penis to trap the blood in the penis. This works for some men, but only part of the penis becomes erect, as most of your penis is inside the body. This can lead to an unstable erection. 

The good news is that advances in men’s health have developed well-proven, successful solutions for ED. We will work together to find the best solution for you.

What is Erectile Dysfunction?

Erectile Dysfunction: It’s common, and it’s treatable.

If you are dealing with erectile dysfunction (ED), you are not alone: nearly one in every four men over sixty-five will experience some degree of erectile dysfunction.1 Younger men often struggle with ED as well. By taking the time to educate yourself about ED, you’ve made an important first step in finding a solution to erectile dysfunction (impotence).

Erectile Dysfunction is the consistent inability to sustain an erection sufficient for sexual intercourse.

Erectile Dysfunction can be:

  • A total inability to achieve an erection – You can never get an erection.
  • An inconsistent ability to do so – You can only occasionally get an erection.
  • A tendency to sustain only brief erections – You can get an erection, but can’t keep it long enough for satisfying sex.

What Causes ED?

As a result of recent medical research, it is now known that more than 80% of men suffering from ED can trace its origin to a physical problem or disorder.

For most men, the cause of ED can now be fairly easily identified. Once identified, proper treatment can be recommended that may help you return them to a satisfying sex life.

ED can be caused by physical disorders such as:

  • An injury (i.e. brain or spinal cord)
  • A disease (i.e. diabetes, high blood pressure, or high cholesterol)
    • Various studies have estimated that between 20% – 71% of individuals with diabetes suffer from erectile dysfunction.2
  • An operation (i.e. prostate gland removal)
  • Substance use (i.e. tobacco, drugs, alcohol or medications)

Other facts about Erectile Dysfunction (Impotence):

  • Approximately 30 million American men suffer from erectile dysfunction.
  • Most men with erectile dysfunction still have the ability to have an orgasm and father a child, but often have difficulty doing these things because they can’t get or sustain an erection.
  • Erectile dysfunction is not normal and is by no means an inevitable consequence of aging.
  • Most men at one time or another during their sexual lives are unable to get or keep an erection. This is normal and does not indicate a problem. However, millions of men of all ages experience this inability as a continuing problem.
  • In most cases, erectile dysfunction can be overcome.

  1. Rosen R, et al. The process of care model for evaluation and treatment of erectile dysfunction. Int’l J. Impotence Research. 1999; 11, 59-74,
  2. Penson D, et al. Erectile Dysfunction in Diabetic Patients. Diabetes Spectrum. 2004, Vol 17, No. 4, 225-230.

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Dr. Nannan Thirumavalavan is expertly trained in diagnosing and treating ED. If you are experiencing symptoms of ED, contact our urology clinics in Cleveland, Hudson, or Lyndhurst at (216) 285-5036.

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