Erectile dysfunction (ED) is a condition in which a man is unable to get or sustain an erection firm enough for satisfactory sexual intercourse all the way through to orgasm. Many men are too embarrassed to talk about this problem, but the truth is that erectile dysfunction treatments have come a long way. Both primary healthcare professionals and urologists are trained to treat ED.
Erectile dysfunction used to be called impotence, but that term has fallen out of favor. ED is, in fact, one of the most common sex problems that men report to their doctor. It affects as many as 30 million men.
The list below summarizes the most common options for erectile dysfunction treatments.
Oral medications |
phosphodiesterase 5 (PDE5) inhibitors work by relaxing the blood vessels connected to the penis. This allows more blood to flow into the chambers and helps sustain an erection. All PDE5 drugs only work when you are sexually aroused. It is necessary to take the pill between 30 minutes and one hour but not more than 3-4 hours before starting sexual arousal.
All PDE5 drugs share common side effects such as facial flushing, headaches, stomach upset/diarrhea/nausea, and flu-like symptoms. |
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| Cialis (tadalafil) | Available as a tablet in 4 different doses. Known as the weekend pill because it can sustain the erection for up to 36 hours, so more than one dose each day is not needed.
Pros: Works longer than all other PDE5 drugs, which means multiple dosing is not needed. The wider dosing range makes it easier to get the right dose after trials. Cons: Unusual side effects are abnormal ejaculation and prolonged painful erections (priapism lasting more than 6 hours.)
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| Viagra (sildenafil) | Available as a tablet in 3 strengths (25 mg, 50 mg, 100 mg).
Pros: Works quickly, to promote erection within one hour Cons: Erections only last 1-4 hours.
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| Vardenafil (vardenafil) | Available in only one dosage – 20mg.
Pros: Works slightly longer than Viagra, and is not affected by food. Cons: Smaller dose (20mg) than Viagra makes getting the right timing more difficult.
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Testosterone replacement |
Low testosterone can contribute to issues with forming and maintaining an erection. As you age, your testosterone levels fall off by about ten percent each decade after the age of forty. | ||||||||||||||||||||||||||||||||||||||||
| Creams | |||||||||||||||||||||||||||||||||||||||||
| AndroForte | AndroForte testosterone cream is a bioidentical, pharmaceutical-grade hormone cream designed to target low testosterone levels in men. We supply it in 5% strength. | ||||||||||||||||||||||||||||||||||||||||
| Androgel | Easy application. Used for hormone replacement therapy in men with low T. | ||||||||||||||||||||||||||||||||||||||||
Injectable medications |
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| Caverject (alprostadil urogenital) | Can be injected into the penis or as a urethral suppository pellet inserted into the urinary opening of the penis
Pros: Fast acting, gives an erection within 20-30 minutes Cons: For injections – minor pain or bleeding at the injection site. Prolonged erection (priapism) after sex. Danger of the formation of scar tissue within the deeper tissues of the penis, mainly for long-term users. Cons: For insertables – pain when inserting. Damage to the urethra. Prolonged erection (priapism) after sex. |
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Physical devices |
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| Vacuum Erection Devices | Also called a penile pump, it works by manually pulling blood into the penis using suction.
Pros: Useful mainly when all other remedies have fails, or where there are allergies to oral meds. Cons: Side effects of using a penile pump include mild bruising, restricted ejaculation. |
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| Penile Prosthesis implant | A penile prosthesis is a water chamber inserted into the erection chambers of the penis. This involves a 30- to 45-minute surgical procedure.
Pros: It enables reliable control exactly when and how long an erection lasts Cons: Expensive ($15,000 – $20,000). Risks of surgical accidents, and the device can rupture or break. |
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Lifestyle changes |
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Note: US prices have been calculated on a per-tablet basis without coupon or membership discounts, based on listed prices on June 20, 2023, on the public websites of Amazon Pharmacy and GoodRx.
