Most men with ED start with pills, such as Viagra™, Levitra™, Cialis™ and Stendra™. These may improve blood flow to the penis, and with sexual stimulation, can help you achieve an erection.17-19 40 If men don’t respond to oral medications, they may try other options.
Pros: Pills can help you achieve an erection quickly and may have an effect on sexual intimacy.
A mechanical ED pump used to pull blood into the penis can cause an erection. The system includes a plastic cylinder, an external penile pump, and a tension band to place at the base of the penis. When the penis is erect, the ring is placed at the base to maintain an erection long enough to have sex (up to 30 minutes).20
Pros: An economical option that does not require prescription medications.
Cons: Men using VEDs reported discomfort and bruising when pumping and some men experience numbness or a cooled penis;20-21 using it right before intercourse may spoil the mood.
These medications (alprostadil, papaverine, etc.) may be combined and injected directly into the base or side of the penis. The recommended frequency of injection is no more than three times weekly, and should produce an erection in 5-20 minutes.22
Cons: Beyond a possible fear of needles, men may experience pain, fibrosis, and risk of a persistent erection.22-23
These medications (alprostadil, etc.) are inserted into the urethra at the end of the penis using an applicator (also called MUSE™). Medications applied 16 minutes before intimacy can dissolve inside the penis to relax the muscle, encourage blood flow, and cause an erection.24
Pros: For use multiple times a week, it may also be an option for physical or psychological causes of ED.
Cons: In addition to general discomfort, common side effects include penile pain and urethral pain or burning.23-24
A penile implant allows direct control of both the timing and duration of an erection. The 3-piece system includes a reservoir placed in the abdomen and two fluid filled cylinders completely concealed within the penis. Squeezing the pump in the scrotum can achieve an erection.
Pros: A natural looking appearance when flaccid or erect, the implant offers concealed support for an erection whenever and wherever desired. Penis surgery is minimally invasive.
Men with diabetes are more likely to move to advanced treatments than those without diabetes.9 A healthy lifestyle can help you control your diabetes and improve ED symptoms. Treatment options are available, however, men with diabetes are less responsive to oral ED medications.4
What’s good for the heart is good for your ED symptoms. If ED occurs, most treatment options are available. However, oral ED medication and heart medications don’t mix well and the medication in some injections should not be used if you have blood clotting problems.22
While ED may be a side effect of prostate cancer treatment, erectile function does not return in all cases. Penile rehabilitation and counseling may help both partners in recovery. Despite wide usage, 30-50% of patients who turn to sexual aids after surgery discontinue use within a year.27