Erectile Dysfunction Treatments and Medications

They all work slightly differently, but each prescription improves blood flow to the penis, which can boost sexual performance. Other ED treatments include: injections, testosterone replacement, vacuum pumps, and penile implants.

Lifestyle factors like smoking, excessive alcohol consumption, or extreme stress can also contribute to ED. Or, certain medications like antidepressants, antihistamines, or opiates. ThIt’s not just a normal part of getting older that you have to live with. No matter your age, ED can be diagnosed and treated at any stage of life.

Conversations about your sexual health can be awkward. But it’s important to be open and transparent when speaking to your doctor. It’ll make it much easier to diagnose and treat your condition, so you can get back to having healthy erectile function.

If you have preexisting health conditions, certain treatment options may not be safe. Be sure to disclose all medical issues and any supplements or prescription drugs you take. Depending on your specific medical condition and history, your primary care doctor may refer you to a specialist in urology or endocrinology.

The majority of erectile dysfunction cases are curable, as long as the underlying cause is established. For example, if a medication you’re taking is causing impotence, your doctor may suggest an alternative drug or timing of the drug. Or perhaps smoking is the culprit of your symptoms, in which case kicking the habit may be all you need. One study shows an improvement in erectile quality in 25 percent of men who quit the habit, compared to zero improvement in men who continued smoking.

For the cases where it’s not curable, such as when a chronic disease like diabetes is the primary cause, many treatment options are available so you can get back to enjoying a healthy sex life.

MED2005 is a glyceryl trinitrate topical gel, designed to be used on demand. It’s an exciting new option that has signs of potential, but a recent study calls for additional research to determine its effectiveness, including clinical trials that monitor high doses.

PDE5i work by inhibiting the breakdown of cyclic guanosine monophosphate (cGMP) by the phosphodiesterase type 5 enzyme (PDE5) in the smooth muscle of the corpora cavernosa. These smooth muscles of the penis contain most of the blood during an erection, so when relaxed using PDE5i, the result is increased erection hardness and duration.

It’s important to note these erectile dysfunction medications are not aphrodisiacs, will not cause sexual desire and are not needed in men who get normal erections. In other words, even with these medications, sexual stimulation is still needed to achieve an erection. However, the assurance of an erection may relieve performance anxiety—which as a result could increase desire.

According to the 2018 American Urological Association Erectile Dysfunction Guideline, PDE5i medications, particularly sildenafil, tadalafil, and vardenafil, appear to have similar effectiveness in the general erectile dysfunction population. The comparison to avanafil, another popular PDE5i, is less clear as published research is limited. PDE5i medications vary in dosage, how long they work, and side effects.

In addition to PDE5i drugs, there are other medications that treat erectile dysfunction, like alprostadil.

A common misconception is that sildenafil will increase your sex drive, however it does not. As the production of cGMP requires the release of nitric oxide in response to sexual arousal. Meaning, sildenafil will only work if you are sexually excited.

The recommended dose of Viagra is 25 to 100 mg taken 30 minutes to four hours before sexual activity. Generally it takes 30 to 60 minutes to be absorbed into your system and take effect, lasting four to five hours.

Before taking sildenafil, be sure to tell your healthcare provider of any other medications and supplements you use as it may interact with other drugs, including those that treat high blood pressure, antibiotics, and antidepressants.

However, tadalafil is more slowly absorbed than sildenafil. It takes about two hours to reach maximum concentration compared to one hour. It can still be effective up to 36 hours after a dose, and is mainly eliminated by metabolism.

Dosage varies depending if you take it as needed or on a daily basis. As needed doses vary from 5 to 20 mg, taken orally prior to sexual activity. Daily dosage often starts with an initial 2.5 mg taken once a day at the same time. Then, moves to a maintenance dose of 2.5 to 5 mg once a day depending on the individual.

Doctors generally advise patients take vardenafil 25 to 60 minutes before attempting intercourse. The normal starting dose of vardenafil is 10 mg, however it’s available as an oral medication in 2.5 mg, 5 mg, 10 mg, and 20 mg doses.

Vardenafil has a similar half-life to sildenafil—approximately four hours. As with other PDE5i, it has the potential to interact with other drugs, and should not be prescribed for patients taking potent CYP3A4 inhibitors such as ketoconazole and ritonavir, and patients with severe cardiovascular disease and disorders, especially if you’re taking nitrates.

Rapidly absorbed, avanafil can reach maximum concentrations after only 30 to 45 minutes. Some men are able to achieve an erection just 20 minutes after a 200 mg dose, however absorption can be delayed by food. Avanafil can last for six to 12 hours.

Avanafil should not be used by people with severe liver disease. Like other PDE5i, it could interact with many other drugs, including nitrates.

One downside to this injectable treatment is that is can be very painful, and in some cases cause scarring to the penis.

If you’re not into needles, Alprostadil you can place the suppository the urethra using a special applicator. The erection usually starts within 10 minutes, however it’s not as effective as its injectable form. When effective, erections can last between 30 and 60 minutes.

Testosterone is a male sex hormone, essential for a normal erection. If testosterone levels are too low, you may suffer from erectile dysfunction, however research shows that high levels of the hormone have no major impact on ED.

Aging doesn’t cause ED, but after age 50, men’s levels of testosterone slowly decrease, affecting sexual function and increasing the likelihood of erectile dysfunction.

Testosterone treatments are generally more expensive than other treatments, and can be administered with an injection, a gel, or a patch placed on the skin. You must keep taking testosterone indefinitely to maintain the benefits of the treatment.

The main adverse effects of avanafil include headache, flushing and nasal congestion, as well as loss of hearing or vision.

Side effects of alprostadil injections can include mild bleeding from the injection site, prolonged erection (priapism) and, rarely, formation of fibrous tissue at the injection site.

Side effects of an alprostadil urethral suppository (Muse) can include pain and discomfort, minor bleeding in the urethra, and formation of fibrous tissue inside your penis.

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You can also try the following medical interventions.

Once you achieve an erection, you place a tension ring around the base of the penis to hold in the blood and keep it hard. The tension ring is removed after intercourse.

Erections achieved through this method tend to last long enough to enjoy intercourse, however side effects include possible bruising of the penis and restricted ejaculation due to the ring.

Penile implants are not usually recommended until you’ve exhausted all other options without success. As with any surgery, there are risks and potential complications involved, including infection.

If you have erectile dysfunction, there are many treatment options available to improve your sex life. Whether it be suggesting lifestyle changes, like doing more exercise or reducing your alcohol consumption, or recommending one of the many effective men’s health medications available, your doctor will be able to guide you through the best and most appropriate treatment.