Doctors today can successfully treat almost every case of erectile dysfunction (ED).
Talking with Your Doctor
The first step in getting treatment for ED is for you to discuss the situation with your physician. He or she will take a careful medical history as an important first step in the treatment of ED. This is generally followed by a physical exam which may include assessment of your vascular system, thyroid gland, nervous system, prostate and genitals.
Treatment Options
When treating ED, there are many options to choose from. Depending on the cause and nature of the problem, your physician may prescribe or refer you to other specialists for the following types of treatments:
Treatments for Psychological Causes
To treat a psychological cause a doctor may recommend treatment from a qualified psychologist, psychiatrist, sex therapist or marriage counselor. Counseling can often resolve any psychological problems causing ED. Men and their partners may wish to go through counseling together. Even if the problem is physical, there may be psychological side effects. Therefore, counseling may also be part of the recommended treatment for a physical problem.
Lifestyle and Medication Changes
Recommendations for lifestyle changes may include:
- Reducing fat and cholesterol in your diet
- Decreasing or limiting alcohol consumption
- Eliminating tobacco use and substance abuse
- Losing weight, if appropriate
- Getting regular exercise.
Your doctor may recommend a change to your medications if you currently are taking prescription drugs which may cause ED.
Drug Therapy
First-line, non-invasive treatments for ED include oral medications such as Viagra®, Cialis® and Levitra®. These medications improve blood flow to the penis by working directly on the blood vessels. They allow the arteries to expand, which could produce an erection. Pills are generally taken about an hour to several hours before planned sexual activity, and must be combined with sexual stimulation to provide an erection. While widely talked about and available today, drug treatments do not work for 20 to 30 percent of men.¹
1. Goldstein I, Lue TF, Padma-Nathan H, Rosen RC, Steers WD, Wicker PA. Oral sildenafil in the treatment of erectile dysfunction. Sildenafil Study Group. N Engl J Med May 14 1998 v. 338(20) p.1397-404.
Vacuum Pumps
Vacuum pump therapy may be prescribed as a non-invasive treatment. When an erection is desired, the vacuum constriction device is placed over the penis. By withdrawing air, a vacuum is created, mechanically enhancing the flow of blood into the penis. A rubber ring placed around the base of the erect penis traps the blood inside the penis and maintains the erection. Vacuum pumps are not prescribed for patients who have bleeding disorders, sickle cell anemia or are on anticoagulants. They also can be cumbersome to use.
Transurethral Therapy (Suppositories)
Using an applicator, the patient inserts a small pellet of medication into the urethra opening at the end of the penis. The medication is absorbed into surrounding erectile tissue, causing blood vessels to relax so the penis fills with blood and becomes erect. This is a less invasive treatment than injection therapy.
Injection Therapy
The patient or his partner uses a needle to inject medication directly into the base of the penis. The relaxation of muscle tissue allows blood to flow into the penis, creating an erection. Because this therapy can sometimes be uncomfortable, many men discontinue use within the first year¹.
1. Hanash KA. Comparative results of goal oriented therapy for erectile dysfunction.J Urol Jun 1997 Jun v. 157(6) p. 2135-8.
Surgical Treatments: Penile Implants
If drug treatments, injections and other non-surgical therapies are not successful in resolving ED, and psychological causes are not suspected, you and your physician may consider penile implant surgery. Penile implants from AMS have helped over 300,000 men return to an active sex life, and studies show high satisfaction among patients and their partners.
A penile implant (also called a penile prosthesis) is concealed entirely within the body, and requires some degree of manipulation before and after intercourse to make the penis erect or flaccid. There are different types of implants based on the manner of operation, naturalness of the erection and the number of components implanted. In a choosing a penile implant, considerations include medical condition, lifestyle, personal preference and cost.
Penile implants are surgical solutions and have the risks associated with surgery, including anesthesia reactions, infections, pain and other complications.
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