Erectile Dysfunction Treatments

Can you recommend a support group for people who have erectile dysfunction?

Don’t Eat a Fatty Meal

Oral medications start to work within an hour. Penile low-intensity focused shockwave therapy (LiSWT). This noninvasive treatment improves blood flow by using sound waves. It can take two months to see improvement. Medications you inject directly into your penis to create an erection, including alprostadil (Caverject®), papaverine (Papacon®), phentolamine (Regitine®) or a combination of multiple medications.

ED injection medicines

Injectable medications start to work within 10 minutes. Penis pumps start to work almost immediately. Testosterone replacement therapy, which is available as a gel, injection, patches and pellets. Testosterone replacement therapy starts to work within four weeks. A penile implant is a procedure in which a surgeon places a device into your penis to make it hard.

ED overview

The device doesn’t affect sensation, peeing or orgasm. ED will not likely go away on its own without changes to your lifestyle or some kind of treatment. The outlook for ED is good and it’s a very treatable condition. Though there aren’t cures for some causes of ED, many treatment options can help you get and maintain an erection hard enough for sexual intercourse. Certain lifestyle changes can help lower your risk of developing erectile dysfunction, including: Being more physically active, especially doing cardiovascular exercises like running, jogging or bicycling. Am I a candidate for a penile implant procedure? Erectile dysfunction can cause you to feel many different emotions. You may feel embarrassed, frustrated, guilty, ashamed, angry or “less than.” This can lead to more serious long-term emotions, like anxiety and depression. But you sex erection tablet don’t have to live with these feelings. ED is common, and it doesn’t reflect your worth as a person. Erectile dysfunction is a sensitive topic for many people. The following tips can help you support your partner if they have erectile dysfunction: Tell your partner you care about their feelings and well-being. Find appropriate times to talk to your partner that won’t make them feel vulnerable. Remind your partner that they’re not alone. ED is common, and treatment is available. Therapists and support groups can help your partner process their feelings.

Product	Dosage	Quantity + Bonus	Price
Kamagra	100mg	12 Pills	55.64€ 52.99€	Buy
Cialis Generic	60mg	90 + 6 Pills	196.67€ 187.30€	Buy
Levitra Original	20mg	92 + 4 Pills	406.22€ 386.88€	Buy
Levitra Generic	20mg	60 + 6 Pills	131.11€ 124.87€	Buy
Kamagra Polo	100 mg	272 + 12 Pills	622.94€ 593.28€	Buy
Viagra Original	100mg	14 + 2 Pills	89.03€ 84.79€	Buy
Cialis Generic	60mg	20 Pills	65.61€ 62.49€	Buy
Viagra Super Active	100mg	120 + 16 Pills	198.37€ 188.92€	Buy
Viagra Generic	200mg	180 + 10 Pills	277.56€ 264.34€	Buy
Levitra Soft Tabs	20mg	270 + 10 Pills	521.78€ 496.93€	Buy
Apcalis SX Oral Jelly	20mg	70 + 7 Sachets	184.98€ 176.17€	Buy
Viagra Generic	100mg	60 + 4 Pills	96.36€ 91.77€	Buy
Super Kamagra	160 mg	8 Pills	69.23€ 65.93€	Buy
Levitra Professional	20mg	60 + 2 Pills	223.11€ 212.49€	Buy

Focus on the benefits of regular exercise, healthy foods and cutting back on substances that may cause ED. Your partner will feel supported if you have accurate, up-to-date information on erectile dysfunction and its treatment options. Offer to go with your partner to their appointments. You can help your partner ask questions, take notes and relay information to a healthcare provider that can help them in making a diagnosis. Respect their privacy if they prefer to see a provider alone. Sexual intercourse isn’t the only way to increase intimacy between partners.

• Starting Dose: Typically the lowest available dose is prescribed first.
• Titration: Dose may be increased based on effectiveness and side effects.
• Max Dose: Each medication has a maximum recommended single dose.
• Frequency: Limits on how often a dose can be taken within 24/48 hours.
• 24-Hour Limit: Generally, do not take Sildenafil, Vardenafil, Avanafil more than once daily.
• 48-Hour Limit: Do not take Tadalafil (on-demand) more than once every 48 hours.
• Daily Tadalafil: A specific low-dose (2.5mg or 5mg) formulation for continuous use.

You can show your partner you care through physical contact such as holding hands or back rubs, spending time with them, kissing, writing notes, being patient and being a good listener. Erectile dysfunction (ED) is common, especially as you get older. It can cause embarrassment, low self-esteem and other more serious psychological conditions. But you shouldn’t feel ashamed or embarrassed to have ED.

Comparison Chart: Oral vs. Injectable ED Therapies

What sexual positions do you regularly engage in? The provider may also ask to talk with your sexual partner. Your partner may be able to offer additional insight on potential causes. The provider may order tests to confirm their diagnosis and determine the cause of your ED. It depends on what your healthcare provider suspects is causing erectile dysfunction.

Medication May Not Be the Solution

Tests that measure if the nerves in your penis respond to vibrations (penile biothesiometry). Drugs that temporarily make your penis erect (vasoactive injection). Before testing, your provider will explain what’s involved with a test and answer any questions you have. If you don’t feel comfortable, you can decide not to do the test at any time. The first step in treating erectile dysfunction is identifying the underlying cause.

How much do ED medications cost? Are they covered by insurance?

A healthcare provider will help determine the best treatment for you. Vigorous cardiovascular exercise for at least 45 minutes three times per week may help reverse some cases of mild ED. Cardiovascular exercises may include brisk walking, jogging, swimming, bicycling and jumping rope. For men with mild ED, quitting smoking can lead to improvement after several months. Oral medications that help increase blood flow to your penis, including sildenafil (Viagra®), vardenafil (Levitra®), tadalafil (Cialis®) or avanafil (Stendra®). It may be your body’s way of telling you that something isn’t right. It’s important to have an open conversation with a healthcare provider about your symptoms and how they affect your quality of life.

• Daily low-dose tadalafil can provide spontaneity.
• Side effects may include back pain or muscle aches (especially with tadalafil).
• Men should be aware of interactions with other prescriptions.
• ED can have physical and psychological causes.
• Men with certain eye conditions should avoid specific ED meds.
• Ed medications do not protect against sexually transmitted infections.
• Regular exercise can improve overall vascular health.
• Combining medication with therapy can be more effective.
• Some men experience no response to initial ED treatments.
• Always follow healthcare provider instructions for safe use.

They can diagnose ED, determine its cause and recommend the most appropriate treatment for you. Sign up for our Health Essentials emails for expert guidance on nutrition, fitness, sleep, skin care and more. Learn more about the Health Library and our editorial process. Cleveland Clinic’s health articles are based on evidence-backed information and review by medical professionals to ensure accuracy, reliability and up-to-date clinical standards. What Is Erectile Dysfunction ( Updated 6/2018. Erectile Dysfunction (Impotence) ( Updated 8/26/2020.

Myth 4: Natural supplements are a safer alternative to ED medications.

This may be a sign of priapism, which can cause permanent damage to your penis without treatment. Is it normal to have erectile dysfunction? How do you know I have erectile dysfunction? What ED treatment option do you recommend? Can erectile dysfunction cause other conditions that affect my sexual health? National Institute of Diabetes and Digestive and Kidney Diseases (U.S.) Definition & Facts for Erectile Dysfunction ( Updated 7/2017. At Cleveland Clinic, we offer specialty care that’s focused on you. When seeing a urologist for erectile dysfunction (ED), many men ask about oral medications (pills that can be taken by mouth). These drugs have been a major force in erectile dysfunction treatment for over two decades.

What should I know before taking ED medications?

Conditions that affect your body’s ability to deliver blood to your penis are the most common cause of ED. You may have a greater risk of getting ED if you: Have a body mass index (BMI) over 25. A healthcare provider can diagnose ED and determine its cause. They’ll review your medical history and perform a physical exam. They’ll also ask you questions about your personal and sexual history.

4. Penile injections

These questions may make you feel embarrassed or awkward. But it’s important to be honest with the provider in order to quickly determine the cause. Are you currently taking any medications, including prescription drugs, over-the-counter drugs, herbal supplements, dietary supplements and nonmedical drugs? Has a healthcare provider ever diagnosed you with depression or anxiety? How often are you able to get erections?

Follow a healthy eating plan

How long are you able to maintain an erection? Do you lose your erection because you ejaculate sooner than you would like? When did you first notice symptoms of erectile dysfunction? What exactly happened when you first had erectile dysfunction symptoms? Do or did you experience erections at night or during the morning? Sildenafil (brand name Viagra®) was the first to be approved by the U.S. Food and Drug Administration (FDA) in 1998. Tadalafil (Cialis®) and vardenafil (Levitra®) followed; both drugs were approved in 2003.

• Natural Nitric Oxide Boosters: Foods like beets, leafy greens, and dark chocolate.
• L-arginine: An amino acid precursor to nitric oxide, found in supplements.
• Panax Ginseng: An herbal supplement with some evidence for improving ED.
• L-citrulline: Another amino acid that may improve blood flow.
• DHEA: A hormone precursor, but evidence for ED treatment is limited.
• Yohimbine: An alkaloid with historical use, but significant side effects.
• Warning: Supplements are not FDA-regulated and can interact with medications.

The FDA approved the fourth ED drug, avanafil (Stendra®) in 2012. All of the drugs are classified as phosphodiesterase type 5 (PDE5) inhibitors, and they work in similar ways. Many men find them effective and convenient. Still, they’re not right for every man, and there are differences among them that men should be aware of. For a man to get an erection, muscles in the penis need to relax so that blood can flow in during sexual stimulation. As the penis fills with blood, it becomes firm and erect. A chemical called nitric oxide, which is naturally produced by the body, helps this process along. The four oral ED drugs help nitric oxide do its job so that the penis muscles can relax and let the blood in. ED drugs do not create an erection automatically, however. A man still needs sexual stimulation to achieve an erection. In the United States, they are available by prescription only. ED drugs are not sold over the counter, and men need a doctor’s prescription to obtain them. It’s important for men to see a doctor when they start having trouble with erections. ED can be a sign of health conditions like diabetes and heart disease. If these conditions are found, they can be treated along with the ED. ED drugs don’t increase sexual desire. ED drugs allow blood to flow into the penis more easily to create an erection, but they do not affect sexual desire.

Vision Problems

Eating healthy foods with low saturated fats, such as fruits, vegetables and whole grains. Talk to a primary care physician or a urologist if you suspect you have erectile dysfunction. They can help diagnose ED, identify its cause and recommend the best treatment option for you. A urologist is a healthcare provider who specializes in diagnosing and treating conditions that affect your reproductive system and urinary system. Go to your nearest emergency room if you’re taking medication for erectile dysfunction and have a painful erection that lasts longer than two to four hours. Men need to have the drive for sexual activity as well as sexual stimulation for the drugs to work.

Age Group	Expected Efficacy	Safety Considerations	Notes
40-50 years	High	Generally safe, monitor comorbidities	Regular health check, dose adjustments possible
51-65 years	Moderate to high	Increased risk of cardiovascular issues	Screening recommended before therapy
Over 65 years	Variable	Higher likelihood of side effects	Careful evaluation, start with lower doses

ED drugs don’t prevent pregnancy or lower risk for sexually transmitted infections. Couples still need to use contraceptives and follow safe sex practices, like using condoms and dental dams. ED drugs have some side effects in common. The 4 ED drugs do share some mild side effects, such as headache and flushing.

Brand Name	Generic Name	Dosage Forms	Mode of Action	Typical Dosage
Viagra	Sildenafil Citrate	Tablets	Vasodilation via PDE5 inhibition	50-100 mg as needed
Cialis	Tadalafil	Tablets	Long-lasting PDE5 inhibitor	10-20 mg as needed
Levitra	Vardenafil	Tablets	PDE5 inhibition	10-20 mg as needed
Stendra	Avanafil	Tablets	Rapid onset PDE5 inhibitor	50-200 mg as needed

They also have some more serious side effects in common.

• PDE5 inhibitors have different durations and onset times.
• Combining ED meds with other vasodilators may cause hypotension.
• ED drugs may improve self-esteem and relationships.
• Use caution with recreational drugs when on ED medications.
• Proper storage is necessary to maintain medication potency.
• Men with kidney impairment may need dose adjustments.
• ED medications are sometimes used off-label for pulmonary hypertension.
• Some drugs may cause temporary vision disturbances.
• Open communication with healthcare providers ensures safe use.
• Lifestyle modifications can sometimes eliminate the need for medication.

If any of these symptoms occur, patients should seek emergency medical care: An erection lasting longer than 4 hours Swelling of the face, mouth, throat, hands, feet, or legs However, other side effects may be different for each drug: Numbness or tingling in the limbs, hands, or feet Changes in color vision, such as a blue tinge or trouble seeing the difference between blue and green Pain in the muscles, back, arms, legs, or stomach Changes in color vision, such as a blue tinge or trouble seeing the difference between blue and green Changes in color vision, such as a blue tinge or trouble seeing the difference between blue and green Patients should note that some side effects are more common with specific drugs.