Erectile dysfunction (ED) is the inability to achieve or maintain an erection firm enough for satisfactory sexual activity. It is one of the most common men’s health concerns, affecting millions of men of all ages. While occasional difficulty with erections can be normal, persistent problems may impact confidence, intimacy and overall quality of life. At Glendale Whole Health, we take an integrative approach to ED that looks beyond temporary fixes to identify underlying causes and provide effective, personalized solutions.

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Causes of Erectile Dysfunction

Vascular causes

  • High blood pressure
  • Diabetes
  • High cholesterol
  • Atherosclerosis (narrowed arteries)
  • Venous leak
  • Peripheral artery disease

Physical and metabolic causes

  • Insulin resistance (IR) and prediabetes (PDM)
  • Diabetes (DM)
  • Obesity and metabolic syndrome
  • Peyronie’s Disease (penile curvature)
  • Prostate issues such as benign prostatic hyperplasia (BPH)
  • Prostate cancer and treatments (surgery, radiation, hormone therapy)

Neurologic causes

  • Spinal cord injury
  • Multiple sclerosis
  • Parkinson’s disease
  • Nerve damage from surgery or trauma

Hormonal causes

Lifestyle and substance-related causes

  • Tobacco use
  • Alcohol use
  • Substance abuse (including certain drugs)
  • Sedentary lifestyle and obesity

Toxins and environmental exposures

  • Heavy metals (mercury, lead, cadmium, arsenic)
  • Microplastics and endocrine-disrupting chemicals (phthalates, BPA, pesticides)
  • Mold toxins (mycotoxins)
  • Air pollution and oxidative stress
    👉 Learn more on our Detox page

Psychological causes

  • Stress
  • Anxiety
  • Depression
  • Relationship issues

Medication-related causes

  • Certain blood pressure drugs
  • Antidepressants (SSRIs and others)
  • Prostate medications

Comprehensive Workup at Glendale Whole Health

At Glendale Whole Health, we take a root-cause approach to evaluating ED. Your workup may include:

  • Detailed history and exam — including sexual history, medical history, medications and lifestyle history
  • Laboratory testing as part of comprehensive evaluation:
    • Hormones: total/free testosterone, estradiol, prolactin, thyroid panel, DHEA
    • Metabolic markers: fasting glucose, HbA1c, insulin
    • Lipid panel and cardiovascular risk panel
    • Inflammatory and oxidative stress markers
    • Specialized toxin panels if indicated (g., Total Tox Burden)
  • Specialized testing: Penile Doppler ultrasound (by referral) if significant vascular disease is suspected

Treatment Options

We build a personalized plan that may include:

Lifestyle and nutrition

  • Diet optimization for metabolic and vascular health
  • Exercise and weight management
  • Stress reduction, sleep optimization

Supplements & nutraceuticals

  • Arginine, citrulline, pycnogenol, Nitric Oxide Foundation, CoQ10, omega-3 fatty acids, antioxidants
  • Vitamin D, zinc, magnesium

Hormone optimization

  • Testosterone replacement (pellets, injections)
  • DHEA support
  • Thyroid optimization
  • Cortisol/adrenal balancing

Medications

  • PDE5 inhibitors: sildenafil (Viagra®), tadalafil (Cialis®), vardenafil (Levitra®)

Intracavernosal Self Injections (second-line therapy)

Safe and highly effective for stronger erections when oral medicines fail. These act locally to increase penile blood flow and can be an option when oral medications are ineffective. Onset is rapid and reliable, often used in post-prostatectomy recovery or advanced ED.

  • Trimix (alprostadil + papaverine + phentolamine)
  • Bimix (papaverine + phentolamine)
  • Alprostadil alone

Topical or Compounded Formulas for SSRI-Related Dysfunction

Men experiencing sexual side effects from antidepressants may benefit from custom compounded topical gels or creams (with testosterone, oxytocin, or other actives). These can be tailored to improve libido, sensitivity and erectile response.  Learn more here

Regenerative and Device-based

  • P-Shot® (Priapus Shot®) – PRP (platelet-rich plasma) to promote tissue repair, nerve regeneration and improved function
  • P-Shot-100® / Priapus Toxin® – combination of PRP with Botulinum Toxin Type A g., Botox®, to enhance blood flow and smooth muscle relaxation
  • Acoustic shockwave (Alma Duo): stimulates new vessel growth
  • Peptides that support circulation, nitric oxide and vascular repair
  • Penis pump therapy — improves the overall health of the penis as well as erectile function

Erectile Tissue Rehabilitation & Penis Pump Therapy

A vacuum erection device (penis pump) is one of the most underused but effective tools for penile health.

How do penis pumps work?

They create negative pressure around the penis, drawing blood into the erectile tissue. This can:

  • Improve erections for sexual activity
  • Support penile rehab after procedures (g., prostate surgery)
  • Improve blood flow and general penile health

Why we use them

  • Improves penile oxygenation and circulation
  • Helps maintain tissue health and prevent shrinkage or fibrosis
  • Aids recovery after P-Shot® or surgery
  • Can support erectile function even without medications
  • Drug-free option when pills are not desired or effective
  • Works with other therapies: PDE5s, PRP, shockwave
  • Helpful for Peyronie’s stabilization plans when directed by a specialist

Types of pumps

  • Manual: hand-squeeze bulb or lever; simple and durable
  • Electric: powered by a motor, provide consistent suction with push-button control, ideal for men with limited hand strength or those who want to multi-task

Rings and accessories

  • Constriction rings: multiple sizes and firmness levels; some have tabs for quick removal
  • Comfort inserts: soften the cylinder base for better seal on pubic bone
  • Lube: water-based for seal and comfort; avoid oils that degrade parts

Safety first

  • Use lowest vacuum that achieves an erection
  • Time limit: ring on no more than 30 minutes
  • Stop if pain, numbness, coldness, or dusky color appear
  • Caution with bleeding disorders, sickle cell disease, severe neuropathy, or anticoagulation; discuss with your clinician

Which brands of penis pumps does Glendale Whole Health offer?

We exclusively offer penis pumps by Dr. Joel Kaplan, a pioneer in men’s sexual health.

How much do the pumps cost?

  • Manual pumps: $250
  • Electric pumps: $450

What’s the difference between manual and electric pumps?

  • Electric pumps: powered by battery or motor, easier to use, ideal for men with limited hand strength
  • Manual pumps: user-powered, less expensive, no batteries required, but require more effort

How will I know what size pump to order?

Please use the guidelines below and tell us if you need size 1, 2, 3 or 4.

Pump Rehab Protocol

  • After the P-Shot® or P-Shot-100®, we recommend using the pump 10 minutes twice daily for 6 weeks, beginning the day of your procedure
  • Afterward, use 2–3 times per week to maintain results and penile health
  • Even without regenerative injections, pumps can improve erectile tissue health and help prevent progression of ED

FAQs

Do pumps hurt?

No — when used correctly. You should feel fullness and pressure, not pain.

How fast will I see results?

For intercourse, the effect is immediate. For rehab and vascular benefits, expect steady improvements over 8–12 weeks with regular use.

Can I use a pump with medications or PRP?

Pumps pair well with PDE5s, PRP P-Shot, and Alma Duo shockwave for synergistic gains.

Any men who should not use a pump?

Avoid if you have uncontrolled bleeding disorders, active skin infection, untreated Peyronie’s pain phase without guidance, or severe neuropathy. If on blood thinners, use extra caution and medical supervision.

👉 Click here for our Complete Guide for Penis Pumps

Other Modalities

  • Pelvic floor physical therapy, stress reduction and mind-body medicine
  • Urology referral for prosthesis if needed
  • BTL Emsella can strengthen pelvic floor muscles to improve erections, ejaculations and incontinence.

Ready to Take the Next Step to Address ED?

If you’re experiencing ED, you don’t have to live with frustration or quick fixes. At Glendale Whole Health, we identify the root causes and create a plan that blends functional medicine, regenerative therapies and proven devices to restore your sexual health and confidence so you can regain confidence and enjoy intimacy again.

👉 Call us today or request your consultation online.

Schedule Your Consultation

If you’re ready to address erectile dysfunction with a comprehensive, integrative approach, call us at (818) 551-0464 or email info@glendalewholehealth.com to request an appointment. At Glendale Whole Health, we’ll design a personalized plan that restores confidence, improves intimacy and supports long-term sexual health.

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