Erectile dysfunction (ED) is a common medical condition that affects men around the world. It can be caused by a number of factors such as stress, anxiety, relationship issues, substance abuse, vascular problems, neurological impairments, or underlying medical conditions such as diabetes. Fortunately, there are several treatment options for ED. The following is a list of the most common treatment options:

Addressing the underlying cause

Often, ED has an underlying cause such as poorly controlled diabetes, certain medications such as selective serotonin reuptake inhibitors (SSRIs), low testosterone (hypogonadism), smoking, excessive alcohol consumption, and/or obesity. Therefore, it is important to treat the underlying cause of ED before moving on to other treatment options. This could involve stabilizing one’s diabetes, changing medications, using testosterone replacement therapy, or making lifestyle changes such as quitting smoking or losing weight.

Psychosexual therapy

ED can be psychogenic in nature, meaning that it is caused by psychological factors like one’s thoughts, feelings, or relationship dynamics. When this is the case, psychosexual therapy will likely be the most effective treatment approach. Even when ED is not psychogenic, sex therapy or counseling may still be helpful for men struggling with ED as it often impacts one’s mental health.

PDE5 inhibitors

Oral ED medications like sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra), and avanafil (Stendra) belong to a group of medications known as PDE5 inhibitors. These medications are generally effective for treating ED and may have mild side effects such as headache, nausea, and flushing. There is also a slight risk of priapism (an erection that lasts over 4 hours) with PDE5 inhibitors.

Vacuum erection device

A vacuum erection device is a cylindrical device that is placed over the penis and pulls all of the air out of the cylinder, drawing blood into the penis to create an erection. This erection may then be sustained using a ring or band at the base of penis to keep the blood in the organ. While effective, some men find the device to be cumbersome.

Intracavernosal injections

Some men may opt to use intracavernosal injections to treat ED. For this option, men are taught how to inject ED medication directly into the penis with a small needle and syringe to create an erection.

Penile implant surgery

For chronic ED that does not respond to conservative therapy options, penile implant surgery is an option. During this surgery, a penile prosthesis or implant is inserted into a man’s penis so that he gains the ability to get erections on demand. There are two different types of penile implants: the inflatable implant and the semi-rigid rods implant. As the name suggests, an inflatable implant is inflated with fluid that is pumped from a connected reservoir in order to create an erection. The semi-rigid rods, on the other hand, are simply positioned away from the body to attain an erection.

References:

• Hellstrom, W.J., Montague, D.K., Moncada, I., Carson, C., Minhas, S., Faria, G., & Krishnamurti, S. (2010). Implants, mechanical devices, and vascular surgery for erectile dysfunction. The Journal of Sexual Medicine, 7(1), 501-523. DOI: https://doi.org/10.1111/j.1743-6109.2009.01626.x
  
  
• Rezaee, M.E., Ward, C.E., Brandes, E.R., Munarriz, R.M., & Gross, M.S. (2020). A review of economic evaluations of erectile dysfunction therapies. Sexual Medicine Reviews, 8(3), 497-503. DOI: https://doi.org/10.1016/j.sxmr.2019.06.001