Bothell Office

(425) 402-4787

Monroe Office

(425) 402-4787

Erectile Dysfunction

What Is Erectile Dysfunction?

Sexual dysfunction caused by the inability to develop or maintain an erection of the penis during sexual performance.1


ED is usually multifactorial, but is typically caused by psychological  causes or vascular disease. Some causes include:

  • Psychological - depression, performance anxiety, stress
  • Lifestyle - tobacco or illicit drug use, excessive alcohol consumption, lack of exercise
  • Medical Conditions - epilepsy, neurologic disease, spinal cord injury, atherosclerosis, peripheral vascular disease, hypogonadism, diabetes, thyroid disease, hypertension, hyperlipidemia, chronic disease, trauma or injury, benign prostatic hyperplasia or penile plaques/ scarring and some medications1

How do Erections Occur?

  • Erections occur due to response to stimuli
  • Stimulation causes a release of nitric oxide synthase which stimulates nitric oxide production
  • This produces cyclic guanosine monophosphate (cGMP) and cyclic adenosine monophosphate (cAMP), which relaxes the smooth muscle in the arteries of the erectile tissue, therefore increasing blood flow and causing erection 
  • PDE5 inhibitors (tadalafil, sildenafil) work on the conversion of cGMP to GTP which causes flaccidity allowing for an erection to occur1,2


Treatment Options 

  • PDE5 Inhibitors - Examples include tadalafil (Cialis) or sildenafil (Viagra)
    • Tadalafil is taken daily while sildenafil is taken 60 minutes before sexual activity
  • Testosterone Replacement Therapy (TRT)
  • Regenerative Therapies, such as stem cells1

Potential Side Effects of PDE5 Inhibitors 

  • Common: muscle aches in the back (resolve in a few weeks, diarrhea, headache, myalgias, flushing and dyspepsia
  • Rare: severe hypotension, stroke, vision or hearing loss, seizures or priapism
  • These cannot be taken with nitrates1

Contact us at [email protected] or call 425-402-4787 to schedule a free consultation. 


Bothell Regenerative Medicine

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18920 Bothell Way NE # 100, Bothell, WA 98011

14090 Fryelands Blvd #274, Monroe, WA 98272

(425) 402-4787