Erectile Dysfunction

Sexual wellness is deeply intertwined with everything from how you feel in your body to how you feel about your body, and for most men, sexual health and wellness primarily centers on erectile function and testosterone levels. However, as many as 50% of men over the age of 40—and millions more younger than that—suffer from some form of erectile dysfunction (ED), a condition that prevents them from being their best in the bedroom and in life.

Although there is rarely a direct causal link to ED, it is often a critical indicator of overall health, and has been linked to broader health problems like systemic vascular disease, heart conditions, renal failure, high blood pressure, prostate cancer, depression, sleep apnea, and more. This means that successfully treating ED takes more than a simple, one-size-fits-all solution. It often requires an integrative, comprehensive approach that uses a variety of modalities and is tailored to each man’s unique needs.

At The Hormone Zone, led by renowned hormone and sexual wellness experts Dr. John Robinson and Dr. Cristina Bosch, we know that sexual wellness is just one part of living a fulfilled life, but it’s an important one. We also understand that dysfunction in one area of your health is typically linked to dysfunction in another, which is why we develop bespoke ED treatment plans that address all of your symptoms and help your body work better from the inside out for real, sustainable results in erectile function and sexual health. Our team of board-certified physicians has been at the forefront of men’s sexual health and wellness since 2006, and we’ve refined our ED offerings to include only the best in proven, effective, and research-backed modalities that can get your performance back in peak condition. Reclaim your youth and reignite your passion with bespoke sexual wellness solutions at The Hormone Zone.

An Education in Erections: How Everything Works

Achieving an erection involves the coordinated activation and suppression of various bodily systems, primarily within the parasympathetic nervous system. The parasympathetic nervous system is responsible for relaxing you and “undoing” the effects of the sympathetic system after a stressful situation, decreasing respiration and heart rate and allowing for the necessary cascade of responses required for an erection, ejaculation control, and orgasm.

When the PNS is activated during arousal, your brain sends impulses to the nerves in your penis, relaxing the smooth muscles around the corpora cavernosa—the two columns of spongy tissue that make up the shaft of the penis and are responsible for controlling blood flow and enabling erections—and allowing blood to flow into the tissue and create pressure. This pressure, which is what expands the penis, also compresses the veins and traps the blood in the tissue so the muscle can support and sustain the erection during sexual activities and intercourse. When you have healthy blood flow to the arteries in the corpora cavernosa, you are better able to achieve and maintain a strong erection and experience better orgasms.

However, for many men, it’s the sympathetic nervous system that activates during intimacy instead, triggering the “fight or flight” stress response and blocking communication to the PNS. This causes the corpora cavernosa to stiffen rather than relax, slowing or even altogether preventing the blood flow necessary to achieve and maintain an erection and resulting in erectile dysfunction.

Erectile dysfunction is as complex as it is common. It can be a symptom of more serious health problems like Peyronie’s disease, atherosclerosis, diabetes, sleep disorders, or metabolic syndrome. Erectile function is also sensitive to fluctuating or decreasing hormone levels as we age, as well as factors like certain medications, including blood pressure medications and antidepressants; health-related behaviors or lifestyle choices such as smoking or excessive alcohol use; and psychological or emotional health issues like anxiety, stress, and depression.

Effective ED Solutions for Proven Results

True sexual wellness requires a complete and comprehensive approach. That’s why the ED solutions available at The Hormone Zone are designed to improve your symptoms by improving how your body functions from the inside out. Our full complement of integrative and proven sexual wellness solutions can be used as stand-alone ED treatments or in conjunction with other treatments for maximum results. Our treatment plans are tailored to each patient and often include a combination of traditional and alternative therapies that go beyond what you need in the moment, such as:

  • PDE5i medications like Viagra and Cialis
  • The Priapus Shot, or P-Shot
  • TriMix injections
  • P-Shot® with Botox™
  • PiezoWave acoustic wave therapy
  • Bioidentical hormone replacement therapy (BHRT)/pellet therapy
  • Testosterone replacement therapy for low-T
  • Peptide therapy
  • PhalloFILL penile girth enhancement
  • HCG Therapy (Human Chorionic Gonadotropin)
  • Wellness Strategies
  • Testosterone Cypionate Injections
  • Nutritional Approaches for Libido and ED

At The Hormone Zone, our holistic approach to treating ED relies on proven therapies, measurable results, and effective implementation. We begin with in-depth testing and comprehensive analysis from the outset and track your progress at regular intervals to ensure our customized plan is on target. If we don’t see the results we want, we’ll make the necessary adjustments or pivot to another solution, whatever it takes to get you where you need to be.


Sexual Dysfunction Is Generally Classified Into Four Types Or Categories:

  • Orgasm disorders (either delay or absence of orgasm)
  • Arousal disorders (inability to become physically aroused during sexual activity)
  • Pain disorders
  • Desire disorders (lack of interest in sex or of sexual desire)

In Women, Symptoms Of Sexual Dysfunction Typically Include:

  • Inability to become aroused or achieve orgasm
  • Inability to relax the vaginal muscles for intercourse, resulting in painful intercourse
  • Inadequate vaginal lubrication before and during intercourse, which can lead to dryness and irritation

Around 43% of women experience some kind of dysfunction in their sexual and/or reproductive health, including urinary dysfunction, decreased libido, vaginal dryness, and painful sex.

While Hormone Imbalances And A Decline In Estrogen Production At The Onset Of Perimenopause Or Menopause Are Often The Most Common Causes Of Sexual Dysfunction In Women, Problems Can Also Arise As A Result Of Age- Or Life-Related Issues Like:

  • Weight gain
  • Stress and fatigue
  • Mood swings
  • Reduced muscle tone and stamina
  • Chronic health conditions
  • Effects of aging, like loss of skin elasticity and tone

There Are Four Primary Sex Hormones Responsible For Sexual Arousal And Function:

Testosterone. Although a predominantly “male” hormone, both men and women produce testosterone, and it’s an important hormone in increasing libido and encouraging sexual activity.

Estrogen. Like testosterone, both men and women produce estrogen, although it is typically considered the “female” hormone. Estrogen is important in promoting vaginal lubrication and increasing sexual desire.

Progesterone. Progesterone is produced in the ovaries and has various responsibilities throughout the reproduction cycle. High levels can contribute to mood swings, bloating, and breast tenderness, while low levels are often associated with menopause-type symptoms like decreased libido, hot flashes, and abnormalities in the menstrual cycle.

Dehydroepiandrosterone (DHEA). Produced in the adrenal gland and the brain, DHEA is used by the body to create testosterone and estrogen. It typically peaks in people’s late 20s to early 30s, then begins a steady decline.

For women, imbalanced hormones can cause a decline in sexual interest or performance as a result of menopause—which causes a decrease in both female hormones (estrogen and progesterone) and testosterone, which drives libido—and/or as a result from changes in vaginal atrophy and loss of elasticity, which can lead to burning, painful intercourse, bleeding after sex, and increased vulnerability to tears and infection.

Increasing estrogen levels with HRT can have a significant impact on the frequency and intensity of menopausal symptoms like hot flashes, night sweats, mood swings, and sleep disturbances. It can also ease vaginal dryness and itching—making sex less painful—and increase libido. For many women, HRT may help reduce the risk of heart disease, prevent fractures caused by osteoporosis, and lower the chances of developing dementia.

Sexual Activity And Its Various Expressions—From Hugging To Orgasm And Everything In Between—Release Hormones Like:

  • Prolactin, which can help improve sleep
  • Human Growth Hormone (HGH), which helps fight signs of aging in the skin, muscles, and hair
  • Oxytocin and other endorphins, which are the body’s natural pain relievers, immune system supporters, and mood boosters
  • Serotonin, which can reduce the symptoms of depression

Orgasm in particular also signals the release of immunoglobulin A (IgA), an antibody that helps fight off infection.

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