Erectile dysfunction (ED) is the chronic inability to get or keep an erection long enough to have sex. It’s not an uncommon problem, and it tends to increase with age.

Currently available treatments are effective for many, but they don’t work for everyone. Side effects and underlying conditions keep some people from using them. That’s why researchers are exploring new avenues of treatment for ED.

Let’s take a look at the latest ED treatments and some innovative therapies that may be available in the coming years.

Researchers are studying several new types of treatment for ED, including:

Stem cell therapy

Stem cell therapy for ED involves the injection of your stem cells into your penis. Both animal studies and phase I studies in humans have had promising results. Research in humans suggests that it could eventually be a safe, effective treatment for ED.

However, many questions about long-term effectiveness and safety remain. Much more research needs to take place before it can be called anything more than an investigational therapy.

Promising as stem cell therapy may be, it isn’t approved for the treatment of ED. Be aware that claims to the contrary might be scams.

Platelet-rich plasma

Platelets are cell fragments in your blood that can help heal wounds and grow new blood vessels. There have been several preclinical and clinical trials of platelet-rich plasma (PRP) treatment for ED, with few adverse reactions.

In a 2020 review, researchers wrote that PRP therapy has the potential for treating male sexual dysfunction. They warn, however, that studies have been limited by size, short follow-up periods, and lack of control groups.

Although this treatment is currently available, it’s considered experimental and should be approached with caution.

Vascular stent

Just as coronary stents can help treat heart disease, there’s some reason to hope that vascular stents might be able to help treat ED. A few small trials have had good results, but larger trials are needed to determine the long-term safety and effectiveness of stents for ED.

Penile transplant

Though there have been a few successful penis transplants, the first total penis and scrotum transplant was performed at Johns Hopkins in 2018. The patient, a severely injured soldier, was expected to regain near-normal urinary and sexual functions.

With each transplant, doctors are learning more about long-term safety and efficacy.

Shockwave therapy

In recent years, penile shockwave therapy, or low-intensity extracorporeal shockwave therapy, has garnered much attention. Researchers have been looking at it as a possible treatment for ED caused by vascular disease.

Shockwave therapy involves passing low-intensity sound waves through erectile tissue. The goal is to improve blood function and encourage new blood vessels to grow.

While research has been called encouraging, shockwave therapy isn’t an approved therapy for ED. More clinical trials and longer follow-ups are needed to assess safety and effectiveness.

While research into new ED treatments is ongoing, there are lots of approved treatments that are currently used to effectively treat ED.

Lifestyle

When ED is caused by a condition such as diabetes, one of the most important things you can do is work with your doctor to manage your overall health. Lifestyle modifications can also make a significant difference. These include:

Oral medications

Phosphodiesterase type 5 inhibitors (PDE5) are a first-line therapy for ED. These include:

Newer, second-generation medications currently available include:

  • avanafil (Stendra)
  • lodenafil (Helleva), not FDA approved
  • mirodenafil (Mvix), not FDA approved
  • udenafil (Zydena), not FDA approved

In the United Kingdom, you can get sildenafil over the counter following consultation with a pharmacist. In the United States, ED drugs are available only by prescription.

These medications are effective and fairly well tolerated. They don’t automatically cause an erection. You’ll still need some form of sexual stimulation.

Side effects can include:

  • backache
  • flushing
  • headache
  • lightheadedness
  • nasal congestion
  • upset stomach
  • visual changes

ED medications may not be a safe choice if you:

  • take nitrates to treat chest pain
  • have heart disease
  • have low blood pressure

Injections

For many men, self-injected drug therapy is as effective as oral medications. It’s a bit more invasive, but it may have fewer side effects. These may include:

Injection therapy drugs include:

  • aviptadil, not FDA approved
  • papaverine, not FDA approved for penile injections
  • phentolamine, not FDA approved

Alprostadil suppositories or cream

Alprostadil urethral suppositories are inserted into the urethra with a special applicator. Side effects can include pain and minor bleeding. Alprostadil can also be applied as a topical cream, but it isn’t available everywhere.

Testosterone replacement

Testosterone replacement therapy can be prescribed if you have low testosterone. It won’t help if your testosterone level is normal, though.

Penis pump

In some cases, your doctor may prescribe a penis pump, which involves placing a hollow tube over the penis, then using a hand- or battery-operated pump. This creates a vacuum to get the blood flowing to the penis. A tension ring around the base of the penis helps hold the erection after you remove the device.

Surgery

If other methods aren’t effective or not a good fit, there are a few surgical options:

  • A surgeon can repair arteries to create better blood flow.
  • You can have an inflatable implant placed in your penis. The implant can be inflated with a pump, making your penis longer and wider.
  • You can have malleable implants inserted. You’ll be able to manually adjust the position of your penis as desired.

Psychological counseling

ED is sometimes due to psychological issues, such as:

On the other hand, ED itself can lead to or exacerbate these problems. Therapy and medication may sometimes be necessary.

External penile prosthesis

Some men with ED can benefit from over-the-counter sex aids, such as:

  • penile sleeves
  • extenders
  • support devices
  • external prosthetic phallus

The devices are:

  • more affordable than other methods
  • noninvasive
  • easy to get without a prescription

However, they may not be helpful in all cases. Research on the use of external penile prostheses is lacking. Satisfaction depends a lot on personal and partner preferences.

ED can be caused by underlying conditions that should be diagnosed and treated. You can start with your primary care doctor, but keep in mind that they may refer you to a urologist. These specialists are trained to treat the urinary tract and the male reproductive system.

It’s important to communicate openly. Tell your doctor if you have other health issues or take medications. Explain how long you’ve had symptoms of ED and how it’s affecting your quality of life.

There’s a lot of information about ED online and no shortage of claims for quick fixes. Talk to your doctor before trying anything on your own. Those claims might be scams that won’t help your ED and may have the potential to harm your health.

Still, feel free to discuss any treatment options you’re curious about with your doctor. They can help you figure out what’s safe and effective, and what’s not.

There have been many advances in treatment for ED over the past several decades. Researchers continue to improve current therapies and seek out better and safer alternatives. Ask your doctor about the latest treatments, what’s in the pipeline, and ongoing clinical trials.