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Male Sexual Dysfunction

Erectile Dysfunction, Peyronie's Disease, Ejaculation Disorders

Few men want to talk about their sexual problems, and many don’t seek treatment despite the relief it can bring.

Often, sexual problems that affect men can be effectively treated with medication, psychological counseling, mechanical aids, and surgery. If you have erectile dysfunction (ED), Peyronie's Disease, or premature ejaculation we can help. Our men’s health specialists ensure you understand the cause of your sexual problem and how to manage it when it occurs. Our goal is to help you have a healthy sex life, improve your sense of well-being, and your peace of mind.

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About Male Sexual Dysfunction

Erectile Dysfunction (ED)
Erectile dysfunction is defined as being unable to get or keep an erection that is firm enough to have sex. If you think you have ED and haven’t tried any medications, make an appointment with your primary care doctor first. For most men, a prescription from your primary care doctor is enough to treat ED. Duke urologists can help if medications have failed.

Peyronie’s Disease
Peyronie’s Disease is a form of erectile dysfunction and refers to a build-up of collagen, plaque or scar tissue that causes the penis to bend, curve or form an hourglass deformity, which makes erection painful.

Ejaculation Disorders

Premature ejaculation refers to ejaculation that occurs before or soon after penetration.
Inhibited or delayed ejaculation means ejaculation is slow to occur.
Retrograde ejaculation refers to semen being forced back into the bladder at orgasm, instead of leaving the body through the urethra and out the penis.

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Duke Health offers locations throughout the Triangle. Find one near you.

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Ejaculation Disorders Treatments

Behavioral Techniques

Your doctor may instruct you in several behavioral changes that can help you learn to delay ejaculation during sex.

Psychological Counseling

May be recommended to help reduce performance anxiety and help you find better ways to cope with stress.

Topical Anesthetics

May be recommended to reduce sensation and help delay ejaculation during sex.

Medication

Medications that keep the bladder neck muscle closed during ejaculation may be prescribed if retrograde ejaculation results in male infertility. Other medications may be prescribed to delay ejaculation.

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Erectile Dysfunction and Peyronie's Disease

Lifestyle Changes

If you do not have an underlying health problem or physical abnormality, your doctor may suggest an exercise regimen, dietary changes and relaxation techniques that can increase your interest or sexual desire. Smoking cessation is encouraged and current medications are evaluated to look for pharmacological causes of ED.

Psychological Counseling

May be recommended as the first line of treatment for people with depression or anxiety.

Penis Pump

The vacuum erection device is a hollow tube with a hand- or battery-powered pump that promotes erection by increasing blood flow to the penis. It may be recommended if medication is not effective.

Penile Implant

A safe, reliable and effective treatment for erectile dysfunction (ED) and Peyronie’s Disease. An inflatable prosthetic device inserted directly into the penis to provide an erection suitable for intercourse. This minimally invasive procedure is performed through small incisions which minimizes blood loss and recovery time. We use a minimally invasive technique through a small incision which allows quicker return to normal activity.

Injections and Traction Therapy

A medication is injected into the Peyronie’s scar to straighten the penis without invasive surgery. Traction devices apply upward tension on the penis to stretch it. Over time, this reduces the curvature caused by Peyronie’s Disease.

Penile Plication

Straightens a penis bent by Peyronie’s Disease. Stitches gather tissue along the longer side of the penis so that it matches the short side.

Penile Grafting

Lengthens the shorter side of the penis by removing the scar tissue and adding healthy tissue (graft). Occasionally, grafting may be combined with a penile implant.

Best Hospital for Urology in North Carolina

Where you receive your care matters. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our urology program is nationally ranked, and the highest-ranked program in North Carolina, according to U.S. News & World Report for 2025–2026.

Why Choose Duke

Personalized Treatment
We develop personalized treatment plans that take into account your age and lifestyle. Together we choose the best option for you.

Access to a Large Network of Specialists
If your sexual problem is related to a medical condition, we arrange timely referrals to our network of specialists in cardiology, sleep medicine, neurology, and endocrinology. We have extensive surgical expertise in penile implants for Peyronie’s disease.

Guidance and Counseling Regarding Sex after Cancer
We work closely with cancer specialists at Duke because male sexual disorders are a common side effect of cancer treatment. Our cancer survivorship program encourages a proactive approach to managing the sexual side effects of cancer treatment. We offer counsel and guidance on the available treatment options before your treatment begins.

This page was medically reviewed on 04/23/2024 by

Karen Baker, MD | Urologist