The first thing your doctor will do is to make sure
you're getting the right treatment for any health conditions that could
be causing or worsening your erectile dysfunction.
Depending on the cause and severity of your erectile dysfunction and
any underlying health conditions, you might have various treatment
options. Your doctor can explain the risks and benefits of each
treatment and will consider your preferences. Your partner's preferences
also might play a role in your treatment choices.
Oral medications are a successful erectile dysfunction treatment for many men. They include:
- Sildenafil (Viagra)
- Tadalafil (Adcirca, Cialis)
- Vardenafil (Levitra, Staxyn)
- Avanafil (Stendra)
All four medications enhance the effects of nitric oxide — a natural
chemical your body produces that relaxes muscles in the penis. This
increases blood flow and allows you to get an erection in response to
Taking one of these tablets will not automatically produce an
erection. Sexual stimulation is needed first to cause the release of
nitric oxide from your penile nerves. These medications amplify that
signal, allowing some men to function normally. Oral erectile
dysfunction medications are not aphrodisiacs, will not cause excitement
and are not needed in men who get normal erections.
The medications vary in dosage, how long they work and side effects.
Possible side effects include flushing, nasal congestion, headache,
visual changes, backache and stomach upset.
Your doctor will consider your particular situation to determine
which medication might work best. These medications might not treat your
erectile dysfunction immediately. You might need to work with your
doctor to find the right medication and dosage for you.
Before taking any medication for erectile dysfunction, including
over-the-counter supplements and herbal remedies, get your doctor's OK.
Medications for erectile dysfunction do not work in all men and might be
less effective in certain conditions, such as after prostate surgery or
if you have diabetes. Some medications might also be dangerous if you:
- Take nitrate drugs — commonly prescribed for chest pain (angina) —
such as nitroglycerin (Minitran, Nitro-Dur, Nitrostat, others),
isosorbide mononitrate (Monoket) and isosorbide dinitrate (Dilatrate-SR,
- Have heart disease or heart failure
- Have very low blood pressure (hypotension)
Other medications for erectile dysfunction include:
Alprostadil self-injection. With this method,
you use a fine needle to inject alprostadil (Caverject Impulse, Edex)
into the base or side of your penis. In some cases, medications
generally used for other conditions are used for penile injections on
their own or in combination. Examples include papaverine, alprostadil
and phentolamine. Often these combination medications are known as bimix
(if two medications are included) or trimix (if three are included).
Each injection is dosed to create an erection lasting no longer than
an hour. Because the needle used is very fine, pain from the injection
site is usually minor.
Side effects can include mild bleeding from the injection, prolonged
erection (priapism) and, rarely, formation of fibrous tissue at the
Alprostadil urethral suppository. Alprostadil
intraurethral (Muse) therapy involves placing a tiny alprostadil
suppository inside your penis in the penile urethra. You use a special
applicator to insert the suppository into your penile urethra.
The erection usually starts within 10 minutes and, when effective,
lasts between 30 and 60 minutes. Side effects can include pain, minor
bleeding in the urethra and formation of fibrous tissue inside your
- Testosterone replacement. Some men have erectile
dysfunction that might be complicated by low levels of the hormone
testosterone. In this case, testosterone replacement therapy might be
recommended as the first step or given in combination with other
Penis pumps, surgery and implants
If medications aren't effective or appropriate in your case, your
doctor might recommend a different treatment. Other treatments include:
Penis pumps. A penis pump (vacuum erection
device) is a hollow tube with a hand-powered or battery-powered pump.
The tube is placed over your penis, and then the pump is used to suck
out the air inside the tube. This creates a vacuum that pulls blood into
Once you get an erection, you slip a tension ring around the base of
your penis to hold in the blood and keep it firm. You then remove the
The erection typically lasts long enough for a couple to have sex.
You remove the tension ring after intercourse. Bruising of the penis is a
possible side effect, and ejaculation will be restricted by the band.
Your penis might feel cold to the touch.
If a penis pump is a good treatment choice for you, your doctor might
recommend or prescribe a specific model. That way, you can be sure it
suits your needs and that it's made by a reputable manufacturer.
Penile implants. This treatment involves
surgically placing devices into both sides of the penis. These implants
consist of either inflatable or malleable (bendable) rods. Inflatable
devices allow you to control when and how long you have an erection. The
malleable rods keep your penis firm but bendable.
Penile implants are usually not recommended until other methods have
been tried first. Implants have a high degree of satisfaction among men
who have tried and failed more-conservative therapies. As with any
surgery, there's a risk of complications, such as infection.
Recent studies have found that exercise,
especially moderate to vigorous aerobic activity, can improve erectile
dysfunction. However, benefits might be less in some men, including
those with established heart disease or other significant medical
Even less strenuous, regular exercise might reduce the risk of
erectile dysfunction. Increasing your level of activity might also
further reduce your risk.
Discuss an exercise plan with your doctor.
If your erectile
dysfunction is caused by stress, anxiety or depression — or the
condition is creating stress and relationship tension — your doctor
might suggest that you, or you and your partner, visit a psychologist or
Before using any supplement,
check with your doctor to make sure it's safe for you — especially if
you have chronic health conditions. Some alternative products that claim
to work for erectile dysfunction can be dangerous.
The Food and Drug Administration (FDA) has issued warnings about
several types of "herbal viagra" because they contain potentially
harmful drugs not listed on the label. The dosages might also be
unknown, or they might have been contaminated during formulation.
Some of these drugs can interact with prescription drugs and cause
dangerously low blood pressure. These products are especially dangerous
for men who take nitrates.