Erectile Dysfunction (ED): Symptoms, signs, diagnosis & more

Erectile dysfunction

Treatment

The first thing the doctor will do is to ensure that you get the right treatment for any problems of health that might exacerbate or worsen erectile dysfunction.

You may have different treatment options depending on the cause and severity of your erectile dysfunction, and any underlying health conditions. Your doctor should clarify the risks and benefits of each procedure, and consider your needs. The interests of your partner might also play a part in your care choices.

Medications

Flaccid or erect penis

For many men, oral medicines are successful in
treating erectile dysfunction. They include:

Sildenafil (Viagra)
Tadalafil (Adcirca, Cialis)
Vardenafil (Levitra, Staxyn)
Avanafil (Stendra)
These four drugs improve the effects of nitric oxide — a natural chemical created by your body that relaxes the muscles in your penis. In response to sexual stimulation, this increases blood flow and helps you to get an erection.

Taking one of those tablets won't produce an erection immediately. Firstly, sexual stimulation is needed to cause nitric oxide to be released from your penile nerves. These medicines amplify that signal, enabling certain men to function normally. Oral erectile dysfunction medications aren't aphrodisiacs, aren't going to cause excitement and aren't needed in men getting regular erections.

The dosage of the drugs varies, how long they operate and the side effects. Possible side effects include flushing, nasal swelling, diarrhea, visual changes, back pain and stomach upset.

Your doctor will consider your particular situation to decide which drug may work best. Such drugs may not instantly cure erectile dysfunction. You might need to consult with your doctor to find the right dosage and prescription.

Get your doctor's permission before you take some erectile dysfunction medication, including over-the-counter supplements and herbal remedies. Erectile dysfunction medications do not work in all men and maybe less effective under certain conditions, for example after prostate surgery or if you have diabetes. Some medications might also be dangerous if you:

Take nitrate — commonly prescribed for chest pain (angina) — like nitroglycerin (Minitran, Nitro-Dur, Nitrostat, others), isosorbid mononitrate (Monoket), and isosorbid dinitrate (Dilatrate-SR, Isordil);

Have heart disease or heart failure
Have very low blood pressure (hypotension)

Suffer from ED

Other medications

Other medications for erectile dysfunction include:

Alprostadil self-injection. With this process, you can inject alprostadil (Caverject Impulse, Edex) into the base or side of your penis using a fine needle. In some situations, the drugs commonly used for other conditions are used either alone or in combination with penile injections. Examples include papaverine, alprostadil, and phentolamine. Such combination drugs are often called bimix (when two medicines are included) or trimix (when three are included).

Each injection is dosed to produce an erection that doesn't last more than an hour. Since the needle used is very strong, discomfort from the site of the injection is usually minor.
Side effects may include minor bleeding from the injection, prolonged erection (priapism) and, rarely, injection site formation of fibrous tissue.

Alprostadil urethral suppository. Alprostadil intraurethral (Muse) therapy involves placing a tiny suppository of alprostadil into the penile urethra inside your penis. The suppository is inserted into your penile urethra using a special applicator.

Normally the erection starts within 10 minutes and takes between 30 and 60 minutes if successful. Side effects can include pain, minor urethral bleeding and fibrous tissue forming inside your penis.

Testosterone replacement. Many people have erectile dysfunction, which could be caused by low hormone testosterone levels. In this scenario, replacement therapy with testosterone may be prescribed as the first step, or given in conjunction with other therapies.

Ed treatment

Penis pumps, surgery, and implants

A battery-powered penis pump
Battery-powered penis pump for erectile dysfunction
Possible side effects include flushing, nasal swelling, diarrhea, visual changes, back pain and stomach upset. Other treatments include:

• Penis pumps. A penis pump (vacuum erection device) is a hollow tube with a pump operated by hand or with a battery. Place the tube over your cock, then use the pump to suck the air inside the tube. It creates a vacuum in your penis that draws blood.

Once you have an erection, to keep it tight in the semen, you slip a friction ring around the base of your penis.  You then remove the vacuum device.

Usually, the erection lasts long enough for a pair to have sex. You remove the tension ring after intercourse. Penis bruising is a possible side effect, and the band restricts ejaculation. Your penis might feel cold to the touch.

If a penis pump is a good treatment choice for you, your doctor may recommend a specific model, or prescribe it. That way, you can be confident that it suits your needs, and that a reputable manufacturer is making it.

• Penile implants. This treatment involves inserting instruments on both sides of the penis, surgically. These implants are either flat or malleable (bendable) rods. Inflatable devices allow you to monitor when and for how long an erection is taking place. The malleable rods keep the penis bendable but firm.

Usually, penile implants aren't recommended until other methods are first tried. Implants have a high level of satisfaction among men, who have tried and failed more restrictive therapies.  There is a risk of complications as with any surgery, such as infection


Check with your doctor to make sure it's safe for you before using any supplements — especially if you have chronic health conditions. Many alternative products that claim to work may be unsafe for erectile dysfunction.

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