Erections that come and go
Reliable in some settings, but less so with a partner, after travel, after hard training or in busy weeks.
Erections may be strong in some situations and unreliable in others, such as with a partner, after travel or after heavy training. Some men notice muted sensation, numbness after long sitting or cycling, or tension in the perineum.
Erections depend on blood flow, hormones, nerve signaling and a nervous system that can relax. ED usually has more than one cause. Alongside the vascular, hormonal and psychological factors your doctors look at, the pelvic floor, hips and lower belly can stay tight. That tension can press on nerves that carry sensation and arousal signals.
I work alongside your urologist and other doctors, who manage the vascular, hormonal and medication side of ED. I treat the pelvic floor, hip and nerve contributors with dry needling, a form of acupuncture. Along the side wall of the pelvis, a tight obturator internus can squeeze the pudendal nerve, so I release that muscle. If that nerve becomes irritable, I use electroacupuncture, fine needles near the nerve with a gentle current, to help shift how it signals. Separately, electroacupuncture over the sacrum aims to influence the pelvic nerves, from S2 to S4, that help control blood flow for erections. Custom herbal formulas are another option, aimed at supporting circulation and hormone health.
Most men have had blood work, a review of medications and heart health, and often a prescription. These steps matter and should come first. Medication supports blood flow but doesn’t release a pelvic floor that stays tight or calm an irritated nerve. Routine exams and imaging don’t check pelvic floor tone or nerve sensitivity. Advice to do Kegels, exercises that squeeze the pelvic floor, may not fit when the muscles are already too tight rather than weak.
I start by asking when the problem began, when it’s better or worse, and how sitting, training, sleep, stress and medications fit in. Then the exam:
Urology, endocrinology, cardiology, primary care and mental health providers stay central to your care. If my findings suggest a conversation with any of them, I’ll let you know and send along what I saw.
No. ED can involve blood vessels, hormones, nerves, medications and stress. Alongside your medical care, I treat the muscle and nerve side and use electroacupuncture to help influence the nerves that control erections. Custom herbal formulas can support circulation. Results vary, and medication decisions stay with your doctor.
I look at the pattern. Changes with stress, sleep, training, long sitting, hip or back pain, pelvic tension or sensation point toward muscle and nerve contributors. I also review what your doctors have already checked.
Yes. I use dry needling on the pelvic floor and on the hip and low back muscles that often keep it tight. The plan is based on your exam and what you’re comfortable with.
Releasing the obturator internus eases pressure on the pudendal nerve where it runs past. If that nerve stays irritable, electroacupuncture near it works on the nerve directly. Many men have a mix of the two, so treatment usually covers both.
Many men with ED notice that link. Stress changes breathing, pelvic floor tone and the state of the nervous system. I work on the physical side of that loop, and support from a mental health professional can help too.
See a doctor promptly for ED that comes on suddenly with nerve symptoms like weakness or numbness. The same applies to chest pain or shortness of breath with exertion, signs of infection, or significant penile pain or a change in shape.
Adults with pelvic floor, nerve and orthopedic pain, along with neurological conditions. Most of my patients come to me after other care hasn't fully settled things. If you're looking for general wellness acupuncture, I'm not the right fit.
We review your history and what you've already tried. I assess the muscles and nerves involved, and you're treated the same day.
It depends on the condition. Pelvic and orthopedic plans usually run 4 to 6 weeks. Neurological plans are usually 2 visits a week for 6 weeks or 3 a week for 4. After that, visits space out so the changes hold. These are typical timelines, not promises.
Yes. I work alongside doctors, physical therapists and specialists. If something I find needs a closer look from one of them, I'll tell you.
I'm an out-of-network provider. You pay at the time of your visit, and my office submits the claim so any reimbursement comes to you. Free benefit checks are available before your first visit through the verification form, and HSA and FSA cards work. I don't take Medicare or Medicaid, though some Medicare Advantage plans reimburse out-of-network care. Full insurance details
Yes. I treat adults, teens and children, though I don't specialize in infants or toddlers.
Yes. Book a free discovery call to ask your questions and see whether we're a good fit.
Dry needling is a form of acupuncture. Fine needles go into tight bands of muscle and trigger points to lower muscle tension and change how the area is signaling.
You may feel a brief twitch or a deep ache as the needle reaches tight muscle. It passes quickly, and any soreness afterward usually fades within a day or two.
It's generally safe with a properly trained practitioner. Needles are sterile and single-use, and I check your health history first, including blood thinners. In New York, dry needling can only be performed by licensed acupuncturists, MDs and DOs. Physical therapists and chiropractors aren't permitted to perform it.
Eat something light beforehand and wear loose clothing that lets me reach the area being treated.
Usually not. Ultrasound helps in a few specific cases, but it hasn't been shown to improve results for common trigger points. A careful hands-on exam is what guides the needle. More on ultrasound-guided dry needling
Dry needling aimed at the pelvic floor and the hip and abdominal muscles around it, for pain, tension and urinary symptoms driven by those muscles and their nerves. More on pelvic floor dry needling
Sometimes, depending on the muscles involved, and you'll be draped throughout. Treatment always follows your consent and comfort. I don't do internal exams or internal treatment.
No, though it helps if you've already seen a doctor or pelvic floor physical therapist. Bring any notes or imaging you have.
Completely. I've heard it all, and there's no judgment here, just a straightforward conversation so we can treat what's going on.
Yes, I treat adults of every gender and identity. After gender-affirming surgery involving the pelvis, bring your surgical notes and we'll decide together what fits.
We also offer house calls and after-hours appointments by arrangement.
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118 W. 72nd St, Rear Lobby, New York, NY 10023
Evidence-based acupuncture and dry needling on the Upper West Side. From chronic pain and headaches to pelvic floor dysfunction, Dr. Jordan Barber pairs the highest level of training with care that actually listens.
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