Category: Erectile Dysfunction

Male Sexual Problems Over 65: What to Know

Anyone over 65 can relate to you in excruciating detail all their aches, pains, and health problems that come with aging. What they won’t admit is that their sex drive and sexual function may have decreased a bit (or more than a bit) over the years. It’s not surprising that they wouldn’t want to admit that, but it’s a topic that should be addressed. There are many, many reasons this occurs. Male sexual problems over 65: what to know.

Continue reading “Male Sexual Problems Over 65: What to Know”

How Is Erectile Dysfunction Diagnosed?

It is typically done through the process of elimination. There are so many factors involved in getting and maintaining an erection firm enough to have sexual relations, Dr. Brant will test one possibility at a time to finally reach the real cause. Only then can proper treatment be provided.

Process of Elimination

When there is difficulty getting and/or keeping an erection long enough for satisfactory sex and intimacy, that is erectile dysfunction. Many people think it’s only when it doesn’t work at all, but that’s not the case.  When everything is working right, erections can come and go without a thought. You never think about everything that has to go “right” to get and keep one.

There happen to be multiple parts of your body and mind that have to be in sync. With occasional ED or if it becomes more common, suddenly you need to become aware of “what parts” need to be in sync. man talking to his doctor.

Contacting our board-certified urologist, Dr. William Brant for an erectile dysfunction appointment in Salt Lake City, is your first step toward getting the answers. Call us today at (801) 965-2767.

The causes of ED can be due to physical issues, mental/psychological issues, or emotional problems.

Erectile Dysfunction Diagnosis: The Physical Test

Your urologist will begin by taking your medical history and asking lots of questions.

Blood tests and a physical exam will indicate any physical issues that can cause ED like the following:

  • Diabetes
  • Heart disease
  • High blood pressure
  • High cholesterol
  • Obesity
  • Kidney disease
  • Low testosterone

Any of these can contribute to erectile dysfunction. If one or more are identified, Dr. Brant may begin treating those particular issues. Several of these physical problems can affect blood flow throughout your body. This, in turn, can be a significant cause of ED.

Dr. Brant may recommend additional tests beyond the blood tests and physical exam.

If a more thorough diagnosis is required, a doppler ultrasound may be recommended.  This is a series of ultrasounds (typically 3), which do not require radiation, that evaluate the blood flow.  Getting a view of how blood gets into the penis and how the penis is able to store it can provide a lot of information.

Erectile Dysfunction Diagnosis: Emotional and Mental Issues

Depression, stress, and anxiety can contribute a great deal to erectile dysfunction.

Dr. Brant will discuss these issues with you and give you a psychological screening test for depression.

Erectile Dysfunction Diagnosis: Other Risk Factors

Smoking, drinking to excess, lack of exercise, and use of recreational drugs can also contribute to ED. Being over the age of 50 can be a contributing factor, but men in their 80s can still have a satisfactory sex life.

There may not be only one cause of ED, but a combination of factors.  Fortunately, no matter what the cause, there is usually a treatment that can take care of it.

Getting a thorough evaluation from our urologist in Salt Lake City will help pinpoint the cause and provide direction on which treatment option is best for you.

Contact our board-certified urologist, Dr. William Brant in Salt Lake City to schedule an appointment for tests and treatment if you are experiencing symptoms of erectile dysfunction. Call our urology clinic in Salt Lake City at (801) 965-2767.

How Does Viagra Help With ED?

Viagra is likely the most written-about drug in the last 25 years and for a good reason. This medication gave the baby boomers from the 60s and 70s, plus many other men, a lifeline if they developed erectile dysfunction. When it was introduced in the late 90’s, it completely changed how men thought about and communicated about their health.  But how exactly does Viagra and medications like it help men with ED?

If you want to explore treatment options for erectile dysfunction contact our highly trained urologist, Dr. William Brant. Call our urology clinic in Salt Lake City, UT today at (801) 965-2767.

What Causes Erectile Dysfunction?

Erectile dysfunction is the persistent inability to achieve and then maintain an erection firm enough for sexual intercourse. It is a frustrating and depressing condition for millions of men.

There are a myriad of reasons why a man may have erectile dysfunction. There may be emotional, psychological, or physical reasons.  older couple smiling.

How Does Viagra Help?

The little blue pill, Viagra, helps ED with one of the physical issues. Viagra (or its generic namesake Sildenafil) increases blood flow to the penis which is one of the requirements for an erection. Although we will refer to it as Viagra in this blog, there are quite a few drugs (both brand name and generic) that work in the same manner so this information can be generalized to these medications.

When a man is aroused, the body releases nitric oxide, a molecule that triggers an erection. However, a protein or enzyme known as PDE5 intervenes to start getting rid of the erection. Viagra is a PDE5 Inhibitor, so it obstructs the enzyme and allows the erection to occur.

It improves firmness, frequency, and maintenance, and it is most effective for mild to moderate ED.

Viagra may also be effective for ED caused by diabetes and prostate surgery, but may not be as successful in these situations as it would be for other disease states.

Basic and Cautionary Facts About Viagra

FDA-approved for men over the age of 18, there are some important facts to know if you are considering Viagra for erectile dysfunction treatment.

  • Viagra only works if a man is sexually aroused.
  • Take Viagra one hour before sexual activity.
  • Only take one pill per day.
  • The drug comes in doses of 20mg. 25mg, 50mg, and 100mg. Only take the recommended dosage provided by Dr. Brant based on your age and general health.  Other medications have different doses (for example, Cialis/tadalafil typically comes in 5mg, 10mg, or 20mg doses)
  • Viagra works within one hour but can take between 30 minutes to 4 hours to have an effect. In some, its effects can last up to 12 hours.
  • You may get multiple erections during this time, but an erection should never last longer than 4 hours. If this happens, get medical attention immediately.  This usually occurs if other drugs (such as recreational drugs) are taken with the Viagra.
  • It is best to take Viagra on an empty stomach. Avoid fatty foods, excessive alcohol, and marijuana.
  • There are some common side effects like headache, flushing, abnormal vision, and cold-like symptoms, but generally these effects are mild and do not prevent usage. Talk with Dr. Brant about all possible side effects before taking Viagra.

Contact Dr. William Brant at (801) 965-2767 if you are having issues getting and keeping an erection. Our urology clinic in Salt Lake City, UT offers a comprehensive list of treatment options for erectile dysfunction—schedule an appointment to explore options that could be right for you.

Dr. William Brant Discusses Erectile Dysfunction: Causes and Treatment

Watch board-certified urologist Dr. William Brant discuss Erectile Dysfunction: Causes and Treatment. Gain valuable insights into the world of men’s health as Dr. Brant unravels the mysteries behind this condition and explores effective treatment options. Don’t miss out on this informative video that can empower you to take charge of your sexual well-being and improve your quality of life. Tune in now and unlock a wealth of knowledge on Erectile Dysfunction!




Schedule an ED Consultation with Dr. William Brant in Salt Lake City, UT

For personalized care and expert advice in Salt Lake City, UT, call us at (801) 965-2767 to schedule a consultation with Dr. Brant. Take the first step towards a happier, healthier you.

How Shockwave Therapy Helps Treat ED

Male sexual arousal involves a complex and coordinated effort among the brain, nerves, muscles, hormones, and ultimately, the blood vessels of the penis. If any physical part of the system doesn’t work properly, it can lead to erectile dysfunction (ED), the inability to achieve and maintain an erection for intercourse. In addition, psychological stressors and mental health issues can cause or worsen ED.

As an example, a physical problem that interferes with your arousal or impairs the ability to achieve an erection may cause you anxiety about your sexual abilities. The anxiety then causes a feedback loop, making you hesitant, slowing your response further, and ultimately worsening your ED.

Urologist and men’s sexual health physician Dr. William Brant understands that talking about erectile dysfunction may make you feel uncomfortable, but he and his staff want to assure you that you aren’t alone — the 1994 Massachusetts Male Aging Study found that about 52% of men experience some form of ED — and it’s nothing to be ashamed about. We offer a number of treatments that can help you regain your sexual function, including cutting-edge shockwave therapy. Here’s what you need to know.

How does an erection occur?

An erection results from increased blood flow into your penis, which can be stimulated either by sexual thoughts or direct contact with the tissue.

When aroused, a man’s penis muscles relax, allowing for increased blood flow through the penile arteries. The blood fills two chambers, one on each side of the penis, stiffening the tissue into an erection. The erection ends when the muscles contract, squeezing the blood out through the penile veins.

What are some standard treatments for ED?

There are a number of options that are commonly used to treat ED.


Medications are typically the first line of treatment for erectile dysfunction. These include Viagra® (sildenafil), Levitra® (vardenafil), and Cialis® (tadalafil). All three are phosphodiesterase (PDE5) inhibitors, which means they block the action of phosphodiesterase, a chemical that prevents you from achieving an erection. The medications increase blood flow to your penis, helping you achieve and maintain an erection suitable for sexual activity.


If psychological or mental health issues are contributing to your ED, talk therapy may prove helpful. During your sessions, you and the therapist can discuss:

  • Your stress and anxiety factors
  • How you feel about sex
  • How you feel about your sexual performance
  • Subconscious issues that affect your sexual wellbeing
  • ED can take a toll on you and your partner’s relationship, so you might also want to speak with a couples’ counselor to help you reconnect emotionally. With greater openness and trust, you may feel more confident about your performance.

Penis injections

Some medications are injected directly into the penis. These drugs, including alprostadil (edex® and CAVERJECT®), as well as papaverine and phentolamine (TriMix or Bi-Mix), all widen and relax blood vessels, boosting blood flow to the penis.

So, how can shockwave therapy help my erectile dysfunction?

Low-intensity shockwave therapy (LiSWT) is already established as a treatment for healing wounds, bone fractures, and damaged or inflamed connective tissues. But now many doctors, such as Dr. Brant, are incorporating it as a non-invasive treatment for ED.

The treatment goes by several names — LiSWT, Gainswave, Acoustic wave, and True Pulse Protocol — and it can reduce your dependence on oral or injected medications. Dr. Brant and his team use the Li-ESWT (Low-intensity extracorporeal shockwave therapy) system for men who have mild-to-moderate blood flow-related ED and who’ve had success with PDE5 inhibitors.

Dr. Brant uses a wand-like device to deliver low-intensity sound waves into the deep tissues of your penis. The waves clear away any plaque buildup in the blood vessels that prevents flow into the two chambers, without affecting the skin around the treatment area. The waves also stimulate growth factors so that your body can build new, healthy blood vessels, improving the quality of your erections. The treatment requires no anesthesia or medication, is non-invasive, has no side effects, and takes only about 15 minutes per session. The number of sessions you need is customized to your body and your goals, but it’s fair to say that many men need one to two sessions per week for about six weeks for optimal results.

Schedule Your Erectile Dysfunction Consultation Today in Salt Lake City

To learn more about how shockwave therapy can help resolve your erectile dysfunction, call our office at 801-207-7922, or schedule your consultation online.

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Suffering from Erectile Dysfunction? Learn About Our Solutions

Sexual arousal is a complex process involving a coordinated effort on the part of the brain, hormones, nerves, muscles, and blood vessels. If any part of the system doesn’t function properly, the end result can be erectile dysfunction (ED).

ED is a sensitive subject for most men. But this problem, which causes a persistent inability to achieve and maintain an erection, is more common than you probably think — and it’s treatable. About 5% of men at age 40 have complete erectile dysfunction, increasing to about 15% at age 70. And mild-to-moderate ED affects around 10% of men per decade of life, so that by 50 years, close to 50% of men suffer some degree of dysfunction.

Board-certified urologist and men’s sexual health physician Dr. William Brant understands the impact any degree of erectile dysfunction can have on your quality of life, and he provides a number of evidence-based treatments to help you reclaim your health and your sexual confidence. And because ED can be an indication of an underlying disorder, he stresses the importance of seeking prompt medical attention if you experience any symptoms. Here’s what he wants you to know about the condition and its solutions.

Erectile dysfunction basics

In many ways, ED is a blood flow issue. In order for an erection to occur, blood must flow uninterrupted into corpora cavernosa (masses of erectile tissue) and stay there until sex is complete. Anything that interrupts that flow, whether physical or psychological, can lead to some degree of erectile dysfunction.

Physical causes, which includes underlying medical conditions, are responsible for about 90% of ED cases. Atherosclerosis is one of the most common causes, because it narrows or clogs the arteries in the penis, preventing the necessary blood flow.

Other physical causes include:

  • Diabetes
  • High blood pressure or cholesterol
  • Obesity
  • Hormonal disorders, including thyroid conditions and testosterone deficiency (low T)
  • Structural or anatomical disorders of the penis, such as Peyronie’s disease
  • Parkinson’s disease
  • Multiple sclerosis
  • Injuries in the pelvic area

Numerous prescription medications can also cause ED by impacting blood flow, including high blood pressure and heart medications, antidepressants, sleeping pills, chemotherapy or prostate drugs, and illicit drugs and alcohol.

ED solutions

We offer a number of different treatments that help with ED. These include:


Oral medications including Viagra® and Cialis®, which are PDE-5 (phosphodiesterase-5) inhibitors, block a chemical that prevents sufficient blood flow, so you can achieve an erection. Essentially, these medications act to amplify the erections you already have.  However, these medications may be ineffective at helping conditions such as low T, Peyronie’s disease, or injury and should not be the only treatment method tried.

Vacuum erection device (VED)

This external device fits over your penis, and as you pump it up, it pulls blood into the penile tissue. A plastic ring placed at the base of your penis maintains the erection for up to 30 minutes.

Penile injections

Some medications that widen and relax blood vessels can be injected directly into the penis, increasing flow.

Penile implants

Penile implants are the most definitive solution, analogous to having a knee replacement for a knee that has failed conservative treatments.  If conservative ED treatments yield no joy, a penile implant procedure may be an option. Dr. Brant implants new hydraulic cylinders directly in the penis. This long-lasting solution provides firmer erections in a more natural manner.

Shockwave therapy

Low-intensity shockwave therapy (LiSWT) is already in use to heal wounds, bone fractures, and damaged connective tissues, but doctors are now viewing it as a potential treatment for ED, one that can reduce your dependence on medications.

Dr. Brant and his team use the Li-ESWT system for men who have mild-to-moderate vasculogenic (blood flow-related) ED and who’ve had success with the PDE-5 inhibitors.

Dr. Brant uses a wand-like device to deliver low-intensity sound waves into the tissues of the penis, clearing away plaque that may be blocking the blood vessels and preventing blood flow into the corpora cavernosa. In addition, the waves stimulate growth factors that allow your body to develop new, healthy blood vessels. The treatment is noninvasive and takes only about 15 minutes in-office to complete.

Schedule a Erectile Dysfunction Consultation with D. Brant Today

If you’re struggling with erectile dysfunction, don’t despair; we have solutions that will restore your performance in the bedroom and your self-confidence. Give our office a call at 801-207-7922 to schedule a consultation with Dr. Brant, or book online today.

Request Appointment

The Link Between Diabetes and Erectile Dysfunction

Erectile dysfunction, defined as the inability to maintain an erection sufficient for sexual intercourse, is a sensitive topic, one which many men are reluctant to discuss, even with their doctor. However, ED is also a common problem. Mild-to-moderate ED affects approximately 10% of men for each decade of life (i.e., 60% of men in their 60s, 70% of men in their 70s), and treatments are available that can give you back your sex life.

Board-certified urologist and men’s health physician, Dr. William Brant provides research-driven treatments for erectile dysfunction to his patients in Salt Lake City, Utah. He understands that ED can often be a symptom of an underlying medical condition and that prompt medical intervention is important so that you can regain your full sexual health. One condition that’s particularly linked to erection problems is diabetes. Here’s what you need to know about the problem — and the solution.

The 411 on diabetes

Diabetes is a metabolic disease that causes high levels of sugar in the bloodstream. In a healthy individual, the hormone insulin moves sugar (glucose) from the blood into the body’s cells, either to be stored or to be used for energy. With diabetes, however, the body has a problem with insulin, so the sugar builds up in the blood.

There are two main types of diabetes. Type 1 is an autoimmune disease in which the immune system mistakenly attacks and destroys the beta cells in the pancreas, where insulin is produced. Without the cells, there’s no insulin available to regulate glucose. About 10% of diabetics have this type.

Type 2 occurs when your body becomes resistant to the insulin that’s produced, leading to a buildup of sugar in your blood. Being overweight or obese and not exercising are two primary causes of type 2 diabetes. Carrying extra weight, especially around your waist, makes your cells more resistant to insulin’s effect on your blood sugar.

The 411 on erectile dysfunction

Achieving an erection involves proper functioning of many different body systems, including the brain, nerves, hormones, muscles, and blood circulation. If there’s a problem with any of these systems, you may be unable to achieve or maintain an erection. Psychological factors such as stress and anxiety can cause or worsen the problem, as the brain plays a key role in sexual desire and controlling the body systems responsible for an erection.

What’s the diabetes-ED link?

It’s estimated that between 35-75% of men with diabetes will experience at least some degree of ED during their lifetime. In addition, diabetic men tend to develop ED 10-15 years earlier than men without diabetes, and the numbers only increase as the men age.

Medical research has identified several likely causes for ED in patients who have diabetes. These include:

Blood vessel damage

With high levels of glucose in the bloodstream, microvascular disease — damage to the small blood vessels — occurs. This is what leads to kidney damage, neuropathy, and loss of vision, among other things. To achieve an erection, blood must flow into the corpora cavernosa — healthy masses of erectile tissue in the penis — and stay trapped inside. In the presence of microvascular disease, though, blood flow is weak or impeded, leading to ED. Men with both diabetes and high blood pressure can also see an increased risk of ED because of further damage to the penile vessels.

Nerve damage

High levels of glucose may also cause nerve damage, especially in the nerves farthest away from the body.  Many diabetics have foot problems, but they often have problems with their hands and penis.  This can manifest as ED, loss of sensation, inability to climax, and other sexual issues. Having good glucose control may prevent this from worsening but typically once the damage is done, it does not spontaneously get better.

Low testosterone (T) levels

About 25% of men with diabetes have low T. Testosterone plays a role in sexual function in men, so low T can be responsible, in part, for ED.

Depression and anxiety

It can be anxiety-provoking or depressing to have to manage a difficult disease like diabetes, and depression is known to lead to various issues with having an erection. Depression can cause a lack of sleep, which itself results in a loss of morning erections, a natural occurrence in healthy men. And as we’ve seen, psychological factors can cause men to have difficulty achieving an erection or maintaining it during sex.

Medication side effects

Many men with diabetes depend on multiple medications to reduce complications from their disease and also their risk of heart problems. Some of these medications lower blood pressure or have physical and/or psychological side effects that make an erection difficult.

If you have diabetes and are also struggling with ED, there are treatments. They range from lifestyle choices like losing weight, exercising, lowering your blood pressure and cholesterol, and quitting smoking; to hormone replacement therapy, ED pills that increase blood flow to the penis, penis injections, and even penile implants.

Schedule a ED Consultation in Salt Lake City

To learn more about the diabetes-ED link and what you can do to reclaim your sex life, give our office a call at 801-207-7922, or schedule your consultation online.

Request Appointment

The Pros and Cons of Penile Implants

Penile implants may sound like an extreme solution for erectile dysfunction, but is it? Often, for men with ED, implants offer a safe option for regaining satisfaction in your sex life and have higher satisfaction rate than more conservative methods.

Based in Salt Lake City, Utah, urology specialist William Brant, MD, FACS, FECSM is an expert at identifying the causes of erectile dysfunction and designing a personalized treatment plan to help restore your ability to have an erection. Dr. Brant is currently accepting new patients and will explain more about the pros and cons of penile implants, so you can decide if it’s right for you.

What are penile implants?

Penile implants is a general term that covers a wide array of implants designed to help you get and maintain an erection. If you’re worried that penile implants may be difficult to conceal under clothes, don’t fear — the most common implants only harden your penis when you’re ready to have an erection, otherwise, your penis will remain in a normal, flaccid state.

Some of the most popular types of penile implants include:

  • One-piece implant – This device is made up of semi-rigid cylinders that are placed in the area of your penis responsible for erections. This is the least complicated kind of prosthesis and easiest to use; however, it offers the least natural-looking and natural-feeling erection as compared to the other implants.
  • Two-piece implant – This implant adds a pump in your scrotum to fill the cylinders in your penis with fluid, creating an erection. You can drain the fluid out by bending your penis in a certain direction. Although it’s effective, this device is not the best at maintaining total flaccidity. It may not be a good option if you’re thin or have a larger penis.
  • Three-piece implant – This device involves the same mechanism as the two-piece, but the pump can both inflate and deflate the penis. The pump pulls the fluid from a reservoir placed in the lower abdomen area in order to create the erection and sends it back to the reservoir ro return your penis to a completely flaccid state.  These are, by far, the most commonly used implants in the U.S.

Dr. Brant typically recommends the three-piece penile implant to his patients, unless there is a safety or medical concern that prevents you from getting it. The three-piece device offers great rigidity and flaccidity, and most importantly, gives you total control over your erection as well as allowing you to be totally discreet about having an implant.

What should I consider before getting a penile implant?

Penile implants offer amazing benefits, but there are a few drawbacks you should consider before getting one. Here is the breakdown of the pros and cons.


Some of the pros for getting a penile implant include:

  • Allows you to control your erection
  • Long-lasting, good for up to 20 years, although this depends on a combination of use and luck
  • High patient satisfaction rate
  • Returns your penis to a flaccid state when not in use (by deflating for the two or three-piece or bending the semirigid cylinders for the one-piece)
  • Easy to use
  • Best solution for ED that either doesn’t respond to medication or other treatment, or if those treatments are unsatisfactory.

Each device also comes with its own added benefits. As previously mentioned, the three-piece implant creates the most natural-looking erections, offering both excellent rigidity and total flaccidity. The one-piece device has a very low chance of malfunction (due to its simple construction) and is great for patients with limited dexterity.

Cons of penile implants

The biggest drawback to penile implants is its permanence. In most cases, once you receive a penile implant, you will no longer be able to achieve an erection by natural means. This also applies if you were to have the implant removed.

Other cons of penile implants include:

  • Outpatient procedure, which involves recovery time at home
  • Higher chance of malfunction with the two or three-piece device
  • Less rigid erections (with the one-piece)
  • Constant pressure on the penis (with the one-piece), which may cause injury in certain kinds of patients
  • Slight risk of infection (very rare, as many modern implants come with an antibiotic coating to prevent this from happening).  Using modern techniques and protocols, Dr. Brant’s rate of infection is less than 1% (outside of unusual circumstances).

Dr. Brant takes the time to explore all nonsurgical treatment options for your ED, including medication and therapy, before suggesting penile implants. If you have concerns about penile implants, he answers all your questions and makes sure you understand both the pros and cons of penile implants before proceeding.

The procedure itself only takes about an hour, and you’ll be able to go home afterward. During the procedure, Dr. Brant makes a very small incision on the upper area of your scrotum to be able to insert the implant. The incision heals in about a week, and you’ll be recovered and able to resume having sex after two to six weeks (depending on the procedure and type of implant).

Schedule a Penile Implant Consultation in Salt Lake City

If you’ve been struggling with erectile dysfunction that just won’t respond to treatment, you may be a good candidate for penile implants. Contact our Salt Lake City, Utah, office by calling 801-207-7922 or by sending a message on our website to schedule a consultation with Dr. Brant.

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