Erectile Dysfunction
Evaluation and Management of Erectile Dysfunction
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Erectile dysfunction (ED) is the persistent difficulty in achieving or maintaining an erection sufficient for satisfactory sexual performance. It is a common condition that can impact men’s confidence, relationships, and quality of life. While ED becomes more common with age, it is not an inevitable part of aging and can often be successfully treated.
At our Glens Falls practice, we offer a compassionate, stepwise approach to evaluating and managing erectile dysfunction. Our goal is to identify the underlying cause and tailor treatment to each patient’s needs and goals.
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Our Evaluation Approach
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Erectile dysfunction may be caused by a variety of physical, psychological, or lifestyle-related factors. Common causes include cardiovascular disease, diabetes, nerve damage, low testosterone, medication side effects, and stress or anxiety.
Your evaluation will begin with a thorough medical and sexual history, including discussion of any underlying health conditions, medications, and lifestyle factors. We will also perform a physical exam and may order:
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Blood tests: to check for testosterone or other hormone imbalances
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Additional tests: such as a penile Doppler ultrasound may be helpful in certain cases
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Throughout the evaluation process, we take time to explain findings and involve you in each decision, in keeping with our education-based approach to care.
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Treatment Options
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Treatment for ED follows a stepwise approach, starting with the least invasive options and progressing to more advanced therapies if needed:
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Lifestyle modifications: Addressing contributing factors such as smoking, alcohol use, obesity, and lack of exercise can significantly improve erectile function.
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Oral medications: PDE5 inhibitors (e.g., sildenafil, tadalafil) are often the first-line therapy and work well for many men.
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Vacuum erection devices: These mechanical pumps help draw blood into the penis and are an option for men who cannot take or do not respond to medications.
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Penile injection therapy: Medications injected directly into the penis can provide firm, reliable erections for many patients.
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Intraurethral therapy: A medicated pellet inserted into the urethra may also be used in select cases.
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Surgical therapy: For men who do not respond to other treatments or prefer a permanent solution, we offer inflatable three-piece penile implants, which provide a highly effective and discreet option for restoring erectile function.
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We understand that discussing ED can be difficult, and we strive to provide a respectful, comfortable environment for patients in Glens Falls, Saratoga, and the surrounding Adirondack and Capital regions. If you’re experiencing symptoms of erectile dysfunction, contact us to schedule a confidential consultation and explore your options for restoring confidence and intimacy.
Penile Curvature
Evaluation of Penile Curvature and Peyronie’s Disease
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Penile curvature, particularly when caused by Peyronie’s disease, is a condition that can affect a man’s confidence, sexual function, and overall quality of life. Peyronie’s disease occurs when scar tissue, or plaque, develops under the skin of the penis, causing it to bend or curve during erections. While mild curvature can be normal, significant bending—especially if painful or interfering with sexual activity—may require medical attention.
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Understanding Peyronie’s Disease
Peyronie’s disease often develops gradually. In many cases, it starts with pain during erections and the appearance of a noticeable bend. Some men may also feel a firm lump under the skin of the penis. Over time, the disease typically progresses through two phases:
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Acute Phase (first 6–12 months): This is when scar tissue forms, and curvature may worsen. Erections may be painful during this stage.
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Chronic Phase: Pain usually subsides, but the curvature becomes stable. Some men may develop erectile dysfunction as a result of the curvature or associated tissue changes.
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Not every case progresses, and some men see spontaneous improvement. However, for others, the condition can persist and significantly affect sexual performance.
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Our Evaluation Approach
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Evaluation begins with a thorough medical and sexual history. We discuss your symptoms, including when they began, any changes in curvature, and how it affects your sexual function. A physical exam is performed, and in some cases, an in-office injection may be used to induce an erection to better assess the curvature and plaque.
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We may also use imaging such as penile ultrasound to evaluate plaque size and penile blood flow, especially if erectile dysfunction is also present.
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Treatment Options
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Treatment depends on the severity of symptoms, degree of curvature, and the presence of erectile dysfunction. Options include:
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Observation: In mild cases with minimal curvature and no pain, no treatment may be necessary. We may monitor your condition during regular follow-ups.
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Traction therapy: Devices that stretch the penis may be recommended to reduce curvature and preserve length over time.
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Intralesional injections: Medications like Xiaflex can be injected directly into the plaque to help soften and reduce the curvature in select patients.
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Penile plication: A procedure to straighten the penis by shortening the longer side
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Penile prosthesis implantation: For men with severe curvature and erectile dysfunction, this option addresses both issues simultaneously
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Our goal is to provide compassionate, expert care for men with Peyronie’s disease throughout Glens Falls, Saratoga, and the surrounding Capital and Adirondack regions. If you are experiencing penile curvature or related symptoms, contact us for a thorough evaluation and discussion of your treatment options.
Low Testosterone
Evaluation and Management of Low Testosterone
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Low testosterone (also known as hypogonadism or "Low T") is a condition in which the body does not produce enough of the hormone testosterone. Testosterone plays a key role in maintaining energy levels, muscle mass, bone density, mood, and sexual health. Low levels can affect men’s overall well-being and quality of life, but effective treatments are available.
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At our Glens Falls practice, we offer comprehensive evaluation and management of low testosterone with a patient-centered approach focused on education, safety, and individualized care.
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Understanding Low Testosterone
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Symptoms of low testosterone can vary but may include:
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Fatigue or low energy
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Decreased libido or sexual performance
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Erectile dysfunction
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Mood changes, irritability, or depression
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Loss of muscle mass or strength
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Weight gain or increased body fat
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Difficulty concentrating or memory changes
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These symptoms can overlap with other health conditions, making a careful evaluation essential.
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Our Evaluation Approach
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We begin with a detailed discussion of your symptoms and medical history, followed by a physical examination. To confirm a diagnosis, blood tests are required, since testosterone levels naturally fluctuate throughout the day.
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Typical evaluation includes:
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Morning blood tests: Testosterone levels are highest in the early morning, so we measure them at this time for accuracy. If levels are low, repeat testing is often performed for confirmation.
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Additional labs: These may include luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin, and other metabolic markers to identify underlying causes.
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Treatment Options
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Not all men with borderline testosterone levels need treatment, and therapy is only recommended for those with consistent low levels and bothersome symptoms. For men who are candidates, we offer several safe and effective replacement options to bring testosterone levels into the normal range establish by urologic guidelines:
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Topical gels or creams: Applied daily to deliver steady hormone levels
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Injections: Administered every 1–2 weeks or as longer-acting formulations
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Oral testosterone: Newer formulations are available that can be taken by mouth, offering a convenient alternative for some patients.
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Intranasal testosterone gel: Applied inside the nostrils several times a day, this option provides steady absorption with minimal impact on the skin or household contacts.
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During therapy, we closely monitor testosterone levels, blood counts, and prostate health to ensure safety and effectiveness.
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Long-Term Management
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Testosterone replacement therapy is not a one-size-fits-all solution. It requires careful follow-up and adjustments to optimize results while minimizing risks. For some men, addressing lifestyle factors such as weight management, sleep quality, and exercise may also improve testosterone levels naturally.
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We are committed to helping men in Glens Falls, Saratoga, and the surrounding Adirondack and Capital regions regain their energy, vitality, and quality of life. If you are experiencing symptoms of low testosterone, contact us to schedule a thorough evaluation and learn more about your treatment options.
Vasectomy
Vasectomy Evaluation and Information
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A vasectomy is a safe, effective, and permanent form of male birth control. It works by disrupting the vas deferens—the tubes that carry sperm from the testicles to the urethra—so that sperm is no longer present in the semen. While there are slight variations in how the procedure can be performed, the ultimate goal is always the same: to reliably and permanently prevent pregnancy.
At our Glens Falls practice, we provide comprehensive evaluation and education for men considering a vasectomy. We take time to explain the procedure, address any questions, and ensure that patients feel fully informed and confident in their decision.
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The Evaluation Process
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Before scheduling a vasectomy, we have a short consultation visit. This allows us to:
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Review your medical and surgical history
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Discuss your family planning goals and confirm that a vasectomy is the right choice for you
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Perform a brief physical examination to evaluate your anatomy and ensure you are a good candidate for the procedure
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This visit is also an opportunity for you to ask questions, learn about what to expect during and after the procedure, and discuss recovery and long-term outcomes.
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Learn more details about the vasectomy procedure at our Surgeries and Resources page.
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We are proud to provide expert vasectomy care to patients in Glens Falls, Saratoga, and the surrounding Adirondack and Capital regions. If you are considering a vasectomy, contact us to schedule your consultation and learn more about this safe and permanent option for family planning.