Urological Health Penis Health Erectile Dysfunction Erectile Dysfunction Guide Erectile Dysfunction Guide Symptoms Causes Diagnosis Treatment How Erectile Dysfunction Is Treated By Jerry Kennard Jerry Kennard, PhD, is a psychologist and associate fellow of the British Psychological Society. Learn about our editorial process Jerry Kennard Medically reviewed by Medically reviewed by Jamin Brahmbhatt, MD on August 28, 2020 facebook linkedin Jamin Brahmbhatt, MD, is a board-certified urologist and Chief of Surgery at Orlando Health South Lake Hospital. Learn about our Medical Review Board Jamin Brahmbhatt, MD on August 28, 2020 Print Table of Contents View All Table of Contents Lifestyle Changes Prescription Medications Pumps and Implants Shock Wave Therapy Counseling Natural Remedies Next in Erectile Dysfunction Guide Erectile Dysfunction: Signs, Symptoms, and Complications Erectile dysfunction (ED) is a common sexual disorder for which there are several treatment options. These range from taking medication or using a device, to counseling, lifestyle changes, and natural remedies. After a careful assessment of the pluses and minuses of each therapy (and often, a trial and error process), you and your doctor can choose the treatment or combination of treatments that is uniquely right for you. It's important to keep in mind that when ED is a complication of an underlying chronic condition, such as high blood pressure or diabetes, the most effective initial treatment approach will likely involve focusing on the underlying health problem itself. 1:32 Watch Now: 6 Lifestyle Changes to Treat Erectile Dysfunction Lifestyle Changes A variety of personal habits and lifestyle choices have been linked to ED. In some ways, this is a good thing, since habits can be altered and choices reconsidered. What's more, many of the lifestyle factors that contribute to sexual problems are ones that affect overall health and well-being, both physical and mental. Addressing these factors, therefore, can have benefits beyond improving erectile dysfunction. Verywell / Joshua Seong Get More Exercise Regular physical activity improves blood circulation and decreases the risk of heart disease, diabetes, and obesity, all of which can have an impact on sexual function. In fact, research shows that men who exercise more in midlife have a 70% lower risk of erectile dysfunction than sedentary men. In addition to preventing ED, physical activity has been found to improve ED. Shed Extra Weight Excess body fat may play a role in erectile dysfunction by promoting inflammation and converting testosterone to estrogen. According to one study, a third of obese men with erectile dysfunction regained sexual function after participating in a two-year weight loss program. Stopping Smoking Smoking affects circulation in ways that can inhibit blood flow to the penis and affect the ability to achieve or sustain an erection. This is why male smokers are at an increased risk of developing ED, regardless of their age or underlying medical conditions. That said, it remains unclear whether stopping smoking once a person has started will necessarily improve ED. Research suggests this may be only true in younger men who have a limited smoking history. Regardless, smoking cessation has many other health benefits, such as reducing heart disease and diabetes—two major causes of ED. Eat Well People who eat diets rich in whole-grain foods, vegetables, and fruits and low in red meat, full-fat dairy products, and sugary foods and drinks have a reduced risk of ED. Similar to smoking, adopting healthy eating habits has other health benefits too, especially with regards to improving your heart health. Take Care of Your Teeth Perhaps a less obvious lifestyle strategy is to see your dentist for regular teeth care. This is because, according to a review article of five studies involving more than 200,000 men, chronic gum disease (periodontitis) might be associated with a more than twofold increase in the risk of erectile dysfunction. Prescription Medications The oral medications for erectile dysfunction—phosphodiesterase-5 (PDE5) inhibitors—work by enhancing the effects of nitric oxide, a naturally-occurring substance that relaxes blood vessels to allow blood to flow into the penis. With this effect in place, it's possible to get an erection in response to sexual stimulation and to sustain it. Viagra (sildenafil): May be effective within 30 to 60 minutes can last up to 12 hours Cialis (tadalafil): May be effective within 60 to 120 minutes and may last up to 36 hours Levitra or Staxyn (vardenafil): May be effective within 30 to 60 minutes and can last up to 10 hours Stendra (avanafil): May be effective within 15 to 30 minutes and can last up to 12 hours Keep in mind—for Viagra, Levitra, and Stendra—eating a high-fat meal may delay the absorption of the drug, which can prolong the time it takes to get an erection and diminish the drug's overall effectiveness. Be sure to talk about PDE5 inhibitors with your doctor, making sure that they know your entire medical history and all other medications and supplements that you take. If a PDE5 inhibitor is ineffective or contraindicated, your physician may suggest you try penile injections. This is where a liquid medication such as Caverject (alprostadil for injection) or TriMix (papaverine, phentolamine and alprostadil [PGE]) is injected into your penis with a fine needle. Another treatment option includes penile suppositories like Muse (alprostadil urogenital) that are inserted into the urethra. Both of these methods will bring on an erection within five to 15 minutes without a need for major sexual stimulation. Erectile Dysfunction Doctor Discussion Guide Get our printable guide for your next doctor's appointment to help you ask the right questions. Download PDF Email the Guide Send to yourself or a loved one. Sign Up This Doctor Discussion Guide has been sent to {{form.email}}. There was an error. Please try again. Testosterone Replacement Therapy A doctor may prescribe testosterone replacement therapy if a man is found to have a low testosterone level, along with other symptoms, such as low libido and ED. That said, testosterone deficiency is uncommonly the primary cause of ED. Before you take testosterone, your doctor will have you tested to make sure that you do indeed have a deficiency. Symptoms of Low Testosterone Reviewing Current Medications Taking a step back, besides taking a prescription, it's equally if not more important to first review your current list of medications with your doctor. It is very possible that one or more of them may be causing or contributing to your erectile dysfunction. While you may not necessarily be able to stop that medication, recognizing it as a potential culprit may at least help you and your doctor understand the "why" behind your erectile dysfunction. Medications that classically cause erectile dysfunction as a side effect are antidepressants, especially selective serotonin reuptake inhibitors (SSRIs), such as Zoloft (sertraline). Other potential medications linked to erectile dysfunction include certain blood pressure medications and pain medications. Pumps and Implants A mechanical device may be worth trying if medication and other interventions don't work. One option is a vacuum pump, a plastic tube that is placed over the penis. When air is sucked out of the tube it creates pressure that causes blood to be forced into the penis. A ring can then be temporarily placed at the base of the penis to stop the blood from draining away too quickly. A penile implant is another option, of which there are two types. One type, called a semi-rigid penis implant, keeps the penis erect all the time, though it can be bent downward when you aren't having sex. The other type, an inflatable two- or three-piece penis implant, includes a pump that's implanted in the scrotum and can be squeezed in order to make the penis erect. Low-Intensity Shock Wave Therapy While not a conventional therapy, an emerging treatment for erectile dysfunction is low-intensity shockwave therapy. This treatment is still in the research phase, but entails delivering sound waves to the penis, which is believed to ultimately increase blood flow and, thus, improve erectile dysfunction. Shock Wave Therapy for Erectile Dysfunction Counseling Research suggests that combining a psychological intervention with medication improves sexual satisfaction and symptoms of erectile dysfunction better than either therapy alone. This makes sense considering that even though ED is most often caused by a medical condition (e.g., heart disease or high blood pressure), stress and mental health problems, such as anxiety and depression, can exacerbate it. Moreover, suffering from ED often has emotional consequences, which may negatively impact relationships or a person's self-esteem. If you are considering therapy for ED, consider seeing a certified sexual therapist or joining group psychotherapy, both of which have been shown to be beneficial for the patient and their partner. Natural Remedies Research has found that, to some extent, acupuncture can improve ED. While the precise mechanism remains unclear, experts suspect that acupuncture may help regulate nerve sensitivity and improve blood flow to the penis. What Is Acupuncture? What Are the Benefits? There are lots of herbs and nutritional supplements claiming to improve sexual function in general and to treat ED in particular. However, there's very little research to prove that any of them actually work. Options like red Korean ginseng, horny goat weed, L-arginine, L-carnitine, zinc, and niacin all have potential side effects when taken in high doses. In addition, when research has shown a nutrient such as zinc or niacin to improve sexual function, it's usually in people who are deficient in it. So before you stock up on over-the-counter supplements for ED, speak with your doctor. They can test you for deficiencies and steer you toward the most effective and safest way to treat your erectile dysfunction. A Word From Verywell There are obviously a lot of treatment options available for ED, which in no small part is due to the fact that a healthy sex life is important for many people's sense of well-being. That said, try not to get overwhelmed with all the different choices. It may take a bit of time and patience on your part, but under the guidance of your doctor, you can find the treatment that works best for you. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Rew KT, Heidelbaugh JJ. Erectile Dysfunction. Am Fam Physician. 2016;94(10):820‐827. Krzastek SC, Bopp J, Smith RP, Kovac JR. Recent advances in the understanding and management of erectile dysfunction. F1000Res. 2019;8:F1000 Faculty Rev-102. Published 2019 Jan 25. doi:10.12688/f1000research.16576.1 Maiorino MI, Bellastella G, Esposito K. Lifestyle modifications and erectile dysfunction: what can be expected?. Asian J Androl. 2015;17(1):5‐10. doi:10.4103/1008-682X.137687 Duca Y, Calogero AE, Cannarella R, et al. Erectile dysfunction, physical activity and physical exercise: Recommendations for clinical practice. 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F1000Res. 2016; 5: F1000 Faculty Rev-369. doi: 10.12688/f1000research.7885.1 Schmidt HM, Munder T, Gerger H, Frühauf S, Barth J. Combination of psychological intervention and phosphodiesterase-5 inhibitors for erectile dysfunction: a narrative review and meta-analysis. Sex Med. 2014 Jun;11(6):1376-91. doi: 10.1111/jsm.12520 Wang J et al. The safety and efficacy of acupuncture for erectile dysfunction: A network meta-analysis. Medicine (Baltimore). 2019 Jan;98(2):e14089. doi: 10.1097/MD.0000000000014089 Erectile Dysfunction/Sexual Enhancement. National Center for Complementary and Integrative Medicine Additional Reading Ciocanel O, Power K, Eriksen A. Interventions to Treat Erectile Dysfunction and Premature Ejaculation: An Overview of Systematic Reviews. Sex Med. 2019 Sep;7(3):251-69. doi:10.1016/j.esxm.2019.06.001 Collins, CE, Jensen, ME, Callister, R., Plotnikoff, RC, and Morgan, PJ. 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