What is Erectile Dysfunction?
Erectile dysfunction (ED) is a type of penile disorder. It affects the ability to achieve and maintain an erection strong enough for sexual intercourse.
Emotions play an important role in achieving and maintaining an erection. Feeling relaxed, confident, and aroused is essential. However, it is normal to have erection problems occasionally. Erection problems can occur if you feel nervous, anxious, frustrated, or tired. Alcohol or drug use can also have an effect. It can also be a consequence of other conditions or a side effect of certain medications or cancer treatments.
Best erectile dysfunction treatment options
The first step in treating erectile dysfunction is to identify the underlying cause. A doctor will help you determine the best treatment for you. Treatment options may include:
Cardiovascular exercise. Performing vigorous cardiovascular exercise for at least 45 minutes three times a week can help reverse some cases of mild ED. Cardiovascular exercises can include brisk walking, jogging, swimming, cycling, and skipping.
Quit smoking. For men with mild erectile dysfunction, quitting smoking may produce improvement after several months.
Consult a sex therapist.
Oral medications that help increase blood flow to the penis, such as sildenafil (Viagra®), vardenafil (Levitra®), tadalafil (Cialis®), or avanafil (Stendra®). Oral medications begin to take effect within an hour. Low-intensity focused shock wave therapy (LiSWT) for the penis. This noninvasive treatment improves blood flow using sound waves. Improvement may take two months.
Medications injected directly into the penis to achieve an erection, such as alprostadil (Caverject®), papaverine (Papacon®), phentolamine (Regitine®), or a combination of several medications. Injectable medications begin to take effect in 10 minutes.
Vacuum constriction device (penis pump). Penis pumps begin to take effect almost immediately.
Testosterone replacement therapy, available in gel, injection, patch, and tablet form. Testosterone replacement therapy begins to take effect in four weeks.
Penile implant procedure. A penile implant is a procedure in which a surgeon inserts a device into the penis to achieve an erection. The device does not affect sensation, urination, or orgasm.
Treatment
Treatment for erectile dysfunction depends on the cause, its severity, and the presence of preexisting conditions. There are several treatment options.
Your doctor can explain the advantages and disadvantages of each treatment. Your preferences are important. Your partner's wishes may also influence your treatment decisions.
Oral Medications
Oral medications are effective for many people with erectile dysfunction. These include:
- Sildenafil (Revatio, Viagra).
- Tadalafil (Adcirca, Cialis, among others).
- Vardenafil.
- Avanafil (Stendra).
Other Medications
Other medications for erectile dysfunction include:
Self-injectable therapy. A fine needle is used to inject alprostadil (Caverject, Edex) into the base or sides of the penis. The dose of each injection is sufficient to achieve an erection that lasts no more than an hour.
These injections may also contain one or two additional medications (BiMix, Tri-Mix). Side effects may include minor bleeding at the injection site and an erection that lasts too long, called priapism.
Intraurethral medications. These medications are inserted into the penis, into the tube that carries urine from the body, called the urethra.
Testosterone replacement therapy. For those with low testosterone levels, testosterone replacement therapy can help combat erectile dysfunction.
Penis Pumps, Surgeries, and Implants
Penis pumps. A penis pump, also called a vacuum erection device, is a plastic tube that is placed over the penis. A manual or battery-powered pump is connected to the tube. The pump draws air from the tube, creating a vacuum that draws blood into the penis.
Once an erection is achieved, a rubber ring is placed at the base of the penis. This retains blood and helps maintain the erection. The vacuum device is then removed.
Penile prosthesis. This treatment involves surgery to insert an implant into the penis. Some of these devices can be inflated, allowing you to control when and how long you have an erection. A semi-rigid shaft keeps the penis rigid. However, it can be bent outward for sexual intercourse and inward when you don't want it to be visible.
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