Treatment for erectile dysfunction (ED) depends on its cause. If ED is caused by an underlying medical problem, treatment may be the first step towards eliminating ED.
Treatment can also tackle ED directly. ED treatments may be used alone or in combination with treatment for underlying conditions.
ED is often associated with lifestyle factors. A healthier lifestyle can sometimes improve your ED. Some lifestyle changes that might be able to improve your ED include:
- weight loss
- more exercise
- quitting cigarettes, alcohol, or ilicit drugs
These changes may help with ED directly. They can also improve the outlook of many underlying conditions that can cause ED.
When ED has psychological origins, therapy can help. Counseling can help you deal with stress, anxiety, and other causes of ED. In addition, sex therapy may be useful for many men with ED.
Sex therapy is a type of talk therapy that focuses on improving sexual and relationship skills. It does not involve any sexual contact with the therapist.
Sex therapy usually involves homework assignments to help you overcome your erection difficulties. You may need to complete these alone or with your sexual partner. Sex therapy may also include sex education.
Sex therapy should be provided by a trained psychologist or other mental health professional. Several professional organizations train and certify sex therapists. However, only the state of Florida licenses sex therapists.
Medications for ED can be extremely effective. They can be taken alone or in combination with other treatments. Several oral medications for ED are currently available. These drugs increase blood flow by heightening the effect of nitric oxide (NO) in the body. NO causes the muscles of the penis to relax. This allows the increase in blood that leads to an erection.
Drugs that increase NO are called phosophodiesterase (PDE) inhibitors. Several different formulations are available. Some are taken on a daily basis. Others are taken right before sex. Which drug is right for you is dependent on a variety of factors. It is important to discuss your options with your doctor. Currently, there are three approved drugs in this class:
- Viagra (sildenafil)
- Cialis (tadalafil)
- Levitra (vardenafil)
PDE inhibitors only work in 30 to 40 percent of people with ED. However, sometimes they do not work because men do not use them correctly. Simply taking one of these drugs will not give you an erection. You also need to have sexual thoughts or stimulate your penis. These drugs aid in sexual arousal. They are not a substitute for interest.
In addition, these drugs are not safe for all men. You should not take them if you:
- take nitrate drugs, such as those prescribed for angina
- use blood thinners, such as warfarin
- take alpha blockers, for an enlarged prostate
- have been prescribed high blood pressure medication
- have a history of stroke
- have a history of heart disease or heart failure
- have low blood pressure or uncontrolled high blood pressure
- have uncontrolled diabetes
Other medications for ED have a more direct effect on penile blood flow. These drugs are injected directly into the base of the penis. They are highly effective ways to achieve an erection.
Drugs used in this way include:
Alprostadil can also be inserted into the urethra as a suppository. The urethra is the channel through which urine and semen are expelled from the penis.
ED can be caused by low levels of testosterone. Testosterone replacement therapy may help some men.
Several types of surgery can be used to treat erectile dysfunction.
ED surgery is most commonly used to install a penile implant. It can also be used to fix damaged blood vessels.
There are two types of penile implants. One type is an inflatable rod. The other is a semi-rigid rod. Both types of implants are inserted into the corpus cavernosa of the penis. These are the regions that usually fill with blood during an erection.
Once penile implants are inserted, there is no going back. These implants must be used to obtain an erection. Implants are not usually considered until other ED treatment options have failed.
Blood Vessel Surgery
Blood vessel surgery for ED is not common. However, this type of surgery can be used to replace or repair damaged blood vessels in the penis. One use of this surgery is to increase blood flow. Another use is to block off veins that are allowing blood to drain too quickly from the penis.
Handheld vacuum pumps can be used to draw blood into the penis. Once an erection is achieved, the blood is trapped inside the penis by the use of an elastic band. This band is later removed to allow the erection to subside.
In general, penis pumps are highly effective and safe. However, erections obtained by using a penis pump may not feel the same as natural erections. The penis may feel cold or look blue. Ejaculation may be difficult or painful.
It is important to only use medically approved vacuum pumps to treat ED. You should also follow the instructions carefully. Incorrect use of the pump can be dangerous. Even correctly used penis pumps can cause pain and bruising in the penis.