George W. Carroll, M.D.

Practice Limited exclusively to treating

Sexual Dysfunction since 1992

Central Florida's

Oldest and Most Respected

Men's Health Practice

Call for a Consultation




Maitland Office: 407-894-9959 | The Villages Office: 352-350-7411 | Medicare &Most Insurance Accepted

Erectile Dysfunction Causes



Cardiovascular Disease

Hardening of the arteries or atherosclerosis, as found in heart disease, is the number one cause of erectile dysfunction, because it causes narrowing of the blood vessels that supply blood to the penis. If blood flow to the penis is significantly restricted, it is impossible to develop a full erection. Many individuals who have undergone open heart surgery may experience erectile difficulties. You're not alone and you should know the following facts: 64% of men experience ED after a heart attack or surgery. This is directly related to the obstruction of arteries and its affect on blood circulation. Most heart and blood pressure medications can interfere with the erectile process. 98% of our patients are successfully treated with NO interaction with their blood pressure or heart medications.


Its important for you to know that having cardiovascular disease, a heart attack or having undergone heart surgery doesn't mean the end of a satisfying sex life. If you're like many men there's no reason why you can't resume sexual activity as soon as you feel fine and have checked with your cardiologist just to be sure. Such activity is usually allowed within a few weeks after a heart attack or heart surgery.


Although most people resume sex, others are less active. Some are afraid to resume sex because of anxiety, depression or lack of desire. Many medications prescribed for heart problems can affect sexual performance and desire. These include blood pressure medications, diuretics ("water" pills), tranquilizers, antidepressants and medications used for chest pain or irregular heartbeat.
Such medications may affect sex drive and normal sex function.


If sexual problems occur, don't stop taking your routine medication; instead consult your cardiologist. Often a change in drug type or dosage can remedy it. Most importantly, do not take oral impotence medications, like Viagra, Cialis or Levitra. It is potentially life threatening to anyone on nitroglycerine or nitrate- containing medications. Viagra, Cialis and Levitra are not an option for many heart patients. It is also not suitable for anyone taking more than one heart or blood pressure medication.


Poor Circulation

Hardening of the arteries, as found in heart disease, is the number one cause of erectile problems.  Many individuals who have undergone heart surgery may experience erectile difficulties. Arthrosclerosis causes narrowing of the blood vessels that supply blood to the penis. If blood flow to the penis is significantly restricted, it is impossible to develop a full erection.



Over 60% of diabetic men eventually develop erectile problems. There are several reasons why diabetics commonly develop ED. Diabetes may disrupt nerve signals transmitted from the brain to the penis. This is known as autonomic neuropathy and is due to the diabetic's inability to produce a key enzyme that tells the blood vessels to relax, expand and pour blood into the penis. Diabetes may also cause numbness or decreased sensation which may affect the penis. This process usually begins in the feet and is known as sensory neuropathy. Any decreased sensation in the genitals may keep a man from developing or maintaining an optimal erection. Occasionally, poorly controlled blood sugar can be the primary cause of worsening impotence. In these patients, better regulation of blood sugar may help improve erectile function.


Another potential complication of diabetes is atherosclerosis or hardening of the arteries.

60% of diabetic men over age 50 will experience erectile dysfunction.

In 12% of diabetic males, erectile dysfunction is the first sign of the disease.

98% success rate in diabetic cases through the use of medication alone.

Diabetics comprise 33% of our patient base. Diabetics of all ages have resumed a normal sex life with no side effects or complications. Virtually every patient with impotence can be helped. If diabetes has affected your sexual relationship, and you're ready to resume this important part of your life, we can help you achieve full function again.


Prostate Surgery for Prostate Cancer

Unfortunately, 95% of men who undergo radical prostatectomy and 65% of those who receive radiation treatment  will experience ED.
All current treatments for Cancer of the Prostate, including Surgical Removal, Radioactive Seed Implant and  External Beam Radiation cause severe injury to the nerve that begins the erectile process. Even in men who have undergone "Nerve Sparing Prostatectomy",
where the nerve has previously been mapped out, the ED rate still stays close to 70%.

This does not mean that you cannot resume an active sex life. For individuals who had a normal sex life prior to treatment, early resumption of sexual activity, with the help of medication, can often help a patient regenerate the damaged nerve and resume spontaneous erections on their own. Penile Rehabilitation is the fastest growing area of ED research. Studies show that the immediate and ongoing usage of oral medication is important to regaining healthy penile tissue.

For the vast majority of those individuals who were already having an impotence problem before their Prostate Cancer Treatment, ongoing medications are available to help you resume an active sex life without the need for further surgery or penile implantation.


Side Effects of Common Medications

Nicotine, alcohol, antidepressants, most bronchodiliators, nasal decongestants, and most high blood pressure medications may contribute to erectile problems. Your erection problem may lie in your medicine cabinet. 25% of ED is caused by side effects from everyday medications.


The most common problem drugs are those that are prescribed for high blood pressure, cardiovascular disease, asthma, COPD, decongestants, depression and anxiety. If you would like to receive a  etailed list of Common Medications that Can Cause ED, call us and we will gladly send it to you.


40% of our patients have heart disease and their erectile problems are often made worse because of heart medication side effects.

33% of our patients have diabetes and most have their impotence complicated further due to medication side effects. Most high blood pressure medications, especially the "Beta Blockers" will cause impotence. Often a change in drug type or dosage can remedy ED. If  that doesn't help or is not possible, you should know that 95% of our patients resume an active sex life through the use of medication alone.



Physical, emotional or financial stress, performance anxiety, depression or misinformation about sexuality can cause ED.