Your sexual health is a vital and complex part of your overall health and well-being. We often don’t pay much mind to it when things are running smoothly, but age, stress and other medical conditions can drastically and suddenly impact sexual drive and performance.  In turn, a man’s self confidence and relationship can suffer. If you’re experiencing issues during intercourse, know that you are not alone. Erectile dysfunction (ED), issues with ejaculation and poor sex drive affect men of all ages, from all walks of life. More than 30 million men–and up to 50% of all men ages 40-70–in the United States experience ED.

I want all men / couples to know they have options.  Sexual health is about maintaining closeness and intimacy in your life.”

Erectile dysfunction can be an indication of other medical issues, both physical or psychological. If you’re experiencing ED, it’s important to consult with a medical professional to discover and treat the underlying cause. Dr. Kuan offers a number of treatment options for personalized, patient-centered care, for men experiencing all types of sexual dysfunction. If you’re frustrated by sexual dysfunction and looking to improve your quality of life, contact Dr. Kuan today.

Erectile dysfunction

Signs and symptoms

  • Trouble getting or keeping an erection
  • Low libido
  • Abnormal ejaculation / orgasm


  • Heart disease
  • High blood pressure or cholesterol
  • History of prostate cancer
  • Diabetes
  • Obesity
  • Penile curvature, Peyronie’s disease
  • Alcohol, tobacco, substance abuse
  • Stress, depression, anxiety, relationship problems
  • Other medical or psychological conditions


Treatment for ED is recommended on a case-by-case basis, depending on the underlying causes.  Lifestyle modification and risk factor reduction is important for all men, and while it may not reverse the sexual dysfunction, simple changes can slow progression.

For most men, a trial of medications (Viagra, Cialis or Levitra) is the first option.  When pills are not enough three main options remain:  penis injections, penis pumps or surgery (penile implants).  Some men will benefit from testosterone replacement / management, when the testosterone level is found to be very low, though rarely is it the only solution.

Dr. Kuan can perform an in-office penile doppler ultrasound if needed as part of your evaluation.

Low testosterone

Signs and symptoms

  • Low libido
  • Sexual dysfunction, including ED and infertility
  • Weight gain
  • Emotional changes
  • Low energy / fatigue / poor concentration


  • Hormonal disorders
  • Testicular cancer
  • Obesity
  • Diabetes
  • Injury
  • Liver or kidney disease


Low testosterone can be diagnosed with a simple blood test, which should be conducted at 8AM for the most accurate results. Testosterone lowers naturally as you age. If evidence of unusually low levels exists, the doctor will consult your medical records and conduct examinations to uncover any underlying causes. Low T can be treated with injections (in-office or at-home), testosterone pellet implants (TestoPel) and hormone gels and patches. Lifestyle modification (sleep, sleep apnea, weight loss, activity, stress management) are key to receiving good results when undergoing T replacement.  Where appropriate, alternatives to testosterone replacement are available, since not all men can safely receive testosterone.

Schedule an appointment with Dr. Kuan

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