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Erectile dysfunction (ED), or the inability of a man to achieve or maintain an erection, affects an estimated 30 million men in the United States. ED has many causes, most of which are treatable, but as few as 25 percent of the men it affects seek treatment.

Now, Dr. Ridwan Shabsigh, associate professor of urology at Columbia University and director of the New York Center for Human Sexuality at NewYork-Presbyterian Hospital's Columbia University Medical Center, takes an honest look at ED in his new book, Back to Great Sex: Overcome ED and Reclaim Lost Intimacy.

"Erectile dysfunction can be psychologically devastating, not just to those it affects but also to their wives or partners," Dr. Shabsigh says. "My primary objective in writing this book is to empower patients by providing them with the latest scientific knowledge and teaching them communications skills so they are better prepared to talk to their doctor and seek treatment."

Most men experience ED at some point in their lives, usually by age 40, although it is most prevalent in men between the ages of 40 and 70. While prevalence increases with age, ED is not an inevitable consequence of aging.

Dr. Shabsigh oversees the care of thousands of patients with ED and other sexual dysfunctions at the New York Center for Human Sexuality and is currently leading several research projects at the Columbia Urology Research Laboratory. Drawing on this experience, Dr. Shabsigh offers a comprehensive approach to ED in Back to Great Sex, highlighting topics such as:

• Stop making excuses. The first step in getting back to great sex is communication—with your partner and your doctor. Dr. Shabsigh addresses the many excuses he's heard over the years, including "maybe it will go away," and "it's my partner's fault."
• What happens in the doctor's office. No one needs to live with ED. Dr. Shabsigh outlines what you should look for, expect, and require of your doctor.
• How to treat ED. Medial professionals have a variety of options for treating ED, but you can't ignore it or handle it yourself. ED is a progressive condition and can only get worse. Dr. Shabsigh discusses lifestyle adjustments, reversible causes, first-line therapy treatments such as oral medications, second-line treatments such as self-injections, and third-line treatments such as penile implants.
• For women only: your role in ED. ED is not just a man's problem or a woman's problem. It is a couple's problem. Dr. Shabsigh dedicates this chapter to women. It address a woman's part in understanding ED and communicating with her partner and her physical role in treatment and restoration of function.

"Women typically make health care decisions for the whole family," Dr. Shabsigh says. "I wrote this book with that in mind, so that women can gain what knowledge they need to help take control when their male partners experience ED."

Other chapters in Back to Great Sex address the physical and psychological causes of ED, prostate cancer and ED, heart disease and ED, restoring sex to your life, and choosing a physician, facility, and treatment. Each chapter contains a list of questions asked by Dr. Shabsigh's patients. The book concludes with resources for patients, a reading list, and a detachable questionnaire for patients to fill out and take to their doctor.

"The last few years have seen an increase in public awareness of erectile dysfunction, because of spokespeople like Sen. Bob Dole and new drugs like Viagra," Dr. Shabsigh says. "I hope this book will further the progress we have made and ultimately help couples regain lost intimacy."

Back to Great Sex will be published on Aug. 1, 2002, by Kensington Books.