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If you’re one of the 30 million people living with erectile dysfunction (ED), then you know how frustrating it can be to get or keep an erection firm enough for sex.

The good news is there are many treatment options available for ED. Combined with taking care of your health overall, these treatments may help you manage ED effectively.

In this article, we’ll cover effective treatments, including products and services, from oral medications, penis pumps, and prescription creams to sex aids and other support at your fingertips.

Oral medications are often a first choice for treating ED. The most common oral medications for ED are phosphodiesterase type 5 (PDE5) inhibitors, including sildenafil, tadalafil, and vardenafil.

Your doctor can prescribe these drugs with personalized treatment, or you can turn to a telemedicine company that provides ED treatment. Here are three to consider.

Roman

Roman is a telemedicine company that provides diagnosis, treatment, and medication for ED, hair loss, premature ejaculation, cold sores, and genital herpes. The healthcare professionals for the company can analyze laboratory tests related to ED as well as conduct a digital consultation.

If appropriate, they will write you a prescription for ED medication. Providers from Roman prescribe sildenafil and tadalafil.

Pricing is dose-dependent and based on generic versus brand-name ED drugs. For example, a 50-milligram (mg) dose of sildenafil (generic Viagra) costs $34, and a 50-mg dose of Viagra costs $70.

Hims

Hims is a telemedicine company that provides services for hair loss, ED, skincare, primary care, and mental health.

After completing an online profile, you will speak with a healthcare professional licensed in your state to start your diagnosis and discuss potential treatments. They provide both generic and brand-name medications for ED.

If appropriate, a doctor will write you a prescription for an ED medication you can buy on the website. You then receive a month’s worth of medication at a time.

Hims offers five medications approved by the Food and Drug Administration (FDA), including Viagra, sildenafil, Cialis, tadalafil, and avanafil. Subscriptions range from $20 per month up to $116 per month.

BlueChew

BlueChew is a telemedicine subscription-based service that offers chewable tablets of sildenafil or tadalafil.

The company offers monthly subscription plans that start at $20 for six tablets of sildenafil (30 mg) or four tablets of tadalafil (6 mg) up to $120 for 34 sildenafil tablets (45 mg) or 28 tadalafil tablets (9 mg).

The chewable tablets are not FDA approved, but the ingredients are. To get BlueChew tablets, an affiliated provider will write you a prescription after you complete a medical profile and digital consultation, and it is deemed medically appropriate.

Penis pumps work by drawing blood into the penis via air suction to produce an erection. You can also find pumps that use water pressure.

When used in the treatment of ED, it can improve your ability to have sexual intercourse.

Oral medications and prescription creams or suppositories are often the “go-to” for ED, but some people find sex aids and external penile prostheses are also helpful (and fun) in the bedroom.

Penile sleeves

Penis sleeves cover the penile shaft and allow you to have insertive sex. Some of the sleeves are hollow with a space inside for the penis, so that you can slip it over the penis.

You can get a complete sheathe that covers the glans of the penis, also called the head or tip, or a partial sheathe that leaves the glans exposed.

Other penis sleeves are more like a penile prosthesis. You can also get an extender that covers the penis and adds more material to extend it.

Support devices

A wearable support device is an aid you can use in penetrative sex. It braces the shaft while pulling the glans away from the base of the penis.

External prosthetic phallus

You may know an external prosthetic phallus as a strap-on dildo.

An external penile prosthesis doesn’t involve using your penis. You will wear it above your penis for penetrative sex.

ED rings

A penis ring is a band that fits around the base of your penis. When it’s in place, it improves your ability to maintain an erection. They’re often made from plastic, silicone, or rubber.

Erections come from good blood flow, which is affected by your cardiovascular health.

Lifestyle modifications such as stopping smoking and increasing physical activity may help reduce ED symptoms.

Finding healthy strategies and tools for stress management and other aspects of your life like relationships, finances, and physical activity can all make a difference.

If you smoke, talk with a doctor about a smoking cessation program.

At home, you can try taking these steps to improve ED symptoms:

  • reduce or eliminate alcohol
  • increase physical activity
  • eat a variety of foods
  • reduce stress

Also consider speaking with a therapist to reduce stress, improve relationships, or get help sticking with ED treatment.

Treating other medical conditions you may have is also important for treating ED.

Conditions such as high blood pressure and cholesterol levels, heart disease, and type 1 or type 2 diabetes are closely linked with ED. Managing these conditions can go a long way to improve sexual function.

Anxiety, stress, or other mental and emotional issues are common when you’re experiencing ED or sex and relationship issues. You may want to consider counseling.

According to the American Urological Association (AUA), counseling can help reduce anxiety about sexual situations. You can also use this time to improve communication with your sexual partner.

You can participate in counseling sessions in-person or online. Telehealth or teletherapy providers are becoming a popular option for people looking for convenience and therapists that may not be located nearby.

Prescription creams and suppositories may help in the treatment of ED. Some prescription topical creams contain the drug alprostadil, which may be effective in treating ED. It’s also well-tolerated by most people, according to a 2016 review.

The FDA has twice turned down approving the product Vitaros, a topical alprostadil formulation. It’s approved in Europe and Canada.

Nitroglycerin gel is another topical product for ED, but it’s not approved by the FDA to treat ED. Speak with your doctor to learn more about this treatment.

L-arginine is an amino acid that plays a role in vasodilation. Because of this, it’s sometimes used as a natural, over-the-counter cream. By itself, it has not been found to restore healthy erectile function.

In addition to all of the treatments options we’ve covered, your doctor may talk with you about injections, testosterone replacement, and surgery.

Surgery

Penile implant surgery involves placing inflatable or semirigid rods into the penis.

The inflatable rods allow the penis to inflate, which creates an erection. You control when it inflates and deflates through a pump that is inside the scrotum. This is the preferred penile implant.

Semirigid penile implants, on the other hand, are always firm. You can bend it toward the body when not having sex.

Testosterone replacement therapy

Testosterone therapy could play a role in ED if you have hypogonadism or low testosterone levels, according to a 2017 review.

If you are unresponsive to phosphodiesterase-5 inhibitors and you have mild ED, testosterone replacement may help. Speak with your doctor about testing to check if your testosterone levels are low.

How can you know? You would want to get your testosterone levels tested a number of times to see if they are in fact low.

Injections

Penile injections can improve blood flow to the penis, allowing you to get a firmer erection.

The main types of medication used in injections include papaverine, phentolamine, and prostaglandin E1, or alprostadil. These are meant as self-injections you can do at home.

For example, for injections with alprostadil (Caverject), you would inject the medication directly in the shaft of the penis.

Suppositories

Alprostadil suppositories, also known by the brand name MUSE, come in a plastic applicator that you use to insert the medication in your urethra.

Suppositories and penile shots are different ways of applying the same active medication. Speak to a urologist about these and other ED treatment options to answer any questions.

Treatments for ED have changed over the last several years. Along with conventional treatments, you can manage ED symptoms with a combination of oral medications, sexual aids, lifestyle modifications, and counseling.

It may take some trial and error to find the best therapy or treatment for you. That’s why it’s important to work closely with your doctor or a healthcare professional. They can accurately diagnose your condition and recommend the best treatment plan for you.