Erectile dysfunction, also known as ED, is a common sexual issue that impacts people’s ability to get or maintain an erection (1). According to some estimates, 1 in 5 men will experience ED in their lifetime (2). People of all ages can experience ED, but it is more common in men over 40 (3), and research indicates that more than 50% of men over the age of 70 will experience ED (4). Because many men feel pressure to get hard and stay hard during sex, it’s common for ED to be a source of worry and embarrassment. But ED is nothing to be ashamed of. Having good sex is about so much more than a hard penis: communication, chemistry, and creativity can go a long way towards helping you have a pleasurable and satisfying sex life, whether or not you get hard. That said, if having an erection is important to you or your partner, there are many treatment options.
The type of ED treatment that’s right for you depends on a number of factors, including the causes of your symptoms, your lifestyle, and your goals for treatment. Because ED can be an early symptom of a medical condition like diabetes or heart disease, it’s always a good idea to check in with a healthcare provider if you’re experiencing ED. Working with a caring healthcare professional can help you identify the best treatment for your needs.
Here are 7 types of ED treatments to consider:
1. Lifestyle Changes
The American Urological Association recommends that people experiencing ED consider lifestyle changes like quitting smoking, exercising regularly, and eating a healthier diet as the first step in treating ED. (5) Dr. Judson Brandeis, a urologist, surgeon, and researcher tells O.school: “The development of ED [is often] an early warning sign that the cardiovascular system is beginning to deteriorate. Take this seriously. Start exercising, eating better, and get a checkup. Your penis may actually save your life.”
- Exercise. Exercise can have big benefits for general wellbeing, including improvements in heart health, stamina, mental health, and longevity. (6) Research also shows that exercise, particularly vigorous aerobic exercise, can improve symptoms of ED. (7)
- Dietary changes. Eating a balanced diet is key in maintaining overall health. Research suggests that eating a diet rich in vegetables, fruits, nuts, legumes, and whole grains and low in saturated fat and animal products can help to reduce the risk of ED. (8)
- Quit smoking. In addition to increasing your risk for cancer and heart disease, research has shown that smoking nearly doubles the risk of ED. (9) The good news is that former smokers have about the same rates of ED as people who have never smoked. (9) Quitting smoking is one of the best steps you can take if you want to improve ED symptoms and overall health.
- Pelvic floor exercises. Pelvic floor exercises like Kegels strengthen the muscles that support the penis and may help to improve erectile function. (10)
- Check your meds. Some medications, like certain antidepressants and medications used to treat high blood pressure, can contribute to ED. (3) If you’re taking medication and having difficulties getting or staying hard, it may be helpful to talk with a healthcare provider about changing the dosage or trying a different treatment. It’s important to work with a healthcare provider if you want to make a change to your medication; stopping or attempting to change the dosage on your own could be dangerous.
Medications are some of the most effective treatments for ED and can be even more effective when combined with therapy and lifestyle changes. (2) ED medications can have serious side effects if used in combination with other medicines or by people with certain health conditions. (2) Using medications that weren’t prescribed to you can be dangerous. Always work with a healthcare provider if you want to try medication to treat ED.
- Oral medications. There are several medications on the market that can be effective for treating ED, including Viagra, Levitra, Cialis, and Stendra. (2) These medications are known as PDE5-inhibitors and work by helping blood vessels in the penis to expand, allowing the penis to fill with blood. (2) These medications work well for most people who take them, enabling around 80% to get and stay hard long enough to have sexual intercourse. (11) These medications can have serious side effects if used in combination with other medications or by people with certain health conditions. (2) Using medications that weren’t prescribed to you can be dangerous; always work with a healthcare provider if you want to try medication to treat ED.
- Injections. For people who can’t take oral medications for ED, or who haven’t experienced an improvement in their symptoms after trying them, at-home injections of medications like Caverject or TriMix can be an effective treatment. Studies show that these treatments can be as effective as oral medications. (12) According to the American Urological Association, between 54% and 100% of people treated with injectable ED medications were able to achieve erections that allowed them to have sexual intercourse. (5)
- Suppositories. For people who can’t or take oral medications and want to avoid injections, a medication called alprostadil can be inserted directly into the urethra. Often sold under the brand name MUSE (short for Medicated Urethral System for Erection), this treatment involves inserting a small amount of medication into the urethra using a plastic applicator. This treatment has been shown to be about 64% effective in helping people to get an erection hard enough to allow intercourse. (13)
- Testosterone. For some people who experience ED due to low sexual desire, or whose testosterone levels are lower than average, treatment with testosterone therapy may be helpful, especially when combined with oral medications. (5) For people whose testosterone levels are considered typical, however, there is little evidence that supplementing with testosterone improves ED symptoms. (14)
Medications are among the most effective treatments for ED and can be even more effective when combined with therapy and lifestyle changes. (2) Here’s a chart outlining the various medication types, how they work, who they are best for, and effectiveness.
Devices like cock rings, penis pumps, and strap-ons can enable people who experience ED to have penetrative sex with a partner. According to an article published in the journal Translational Urology and Andrology, these types of devices can work well for people who want a simple solution that doesn’t require a trip to the doctor, have underlying health conditions that make ED medications unsafe, or who want to avoid surgery.
- Cock rings. Cock rings are devices that fit over the base of the penis and can help you to maintain an erection by keeping blood inside the tissues of the penis. They are often made of silicone and can be basic rings or include vibrators that provide extra stimulation for you and your partner. Cock rings may work for people who can get an erection but struggle to maintain it, or who experience premature ejaculation. They shouldn’t be worn for more than 30 minutes.
- Penis pumps. According to the American Urological Associate, about 77% of couples who use a penis pump are satisfied with the results. (5) These devices work by applying suction using a pump, which pulls blood into the penis while a ring placed around the base keeps the blood in place. Similar to a cock ring, this ring should not be left in place for more than 30 minutes.
- Strap-ons and penis sleeves. If penetration during sex is a priority for you or your partner, strap-on dildos and penis sleeves allow for reliable penetration without the need for a hard dick.
4. Psychological treatments
Dr. Brandeis tells O.school: “If a man is getting nighttime or morning erections, but no erections with his partner, then the cause is likely psychological. A therapist trained in sexual health is the best first step.” ED symptoms may stem from anxiety, depression, PTSD, or another mental health condition. (16) Even if a medical condition like diabetes or heart disease is the main cause of ED, sexual performance anxiety—the worry about not getting an erection or pleasing your partner—can make ED symptoms worse. (16)
- Individual therapy. For people whose ED results from, or is made worse by, mental health conditions, therapy can be an effective treatment on its own, or in combination with medications used to treat ED. (17)
- Couples counseling. Sometimes, ED can result from problems within a relationship. (5) If this is the case, couples counseling can help you to get to the root of the issue and improve communication, which can be a good first step towards treating ED symptoms. (16)
- Mindfulness practice. Research also suggests that practicing mindfulness—being aware of feelings in the moment without judgment, as well as examining your mindset and beliefs—may be an effective treatment for ED. (16)
5. Surgical procedures
- Penile implants. For people who want a more permanent solution, or who can’t use pills for medical reasons, surgical implants can provide on-demand erections. (5) Penile implants carry greater risks than most other ED treatments because of the potential for infection and injury, but they also have the highest satisfaction rate of available treatments. (18) Inflatable implants include hollow tubes that are placed in the penis, a reservoir of fluid that’s placed in the scrotum or the lower abdomen, and a pump that lets you transfer the fluid to your penis. (18) Semi-rigid implants are flexible rods placed inside the penis that can be manually adjusted. (18)
- Vascular surgery. For a small number of younger people who experience ED due to pelvic injury, surgery to restore blood flow to the arteries and veins of the penis may be helpful. (19) Information about the effectiveness of these surgeries is limited, however, and they are still considered experimental. (19)
6. Experimental treatments
- Stem cells. Stem cell therapy for ED is the injection of stem cells—special “blank slate” cells that can turn into another type of cell and may help to renew structures in the body like muscles and nerves—into the penis to regrow the tissues that make erections possible. (20) These treatments are still considered experimental and are being studied for effectiveness.
- Shock waves. Low-intensity shockwave therapy is the application of sound waves to the penis using a wand-like device to encourage the growth of new blood vessels. (15) There is some evidence that this treatment might be effective, but it has not been approved by the FDA and is still considered experimental.
7. Alternative treatments
- Supplements. There are many supplements on the market that claim to help men get erections and stay hard longer. These products have not been shown to be effective for ED treatment. (21) Talk to your healthcare provider if you’re considering using herbs or dietary supplements to treat ED.
- Platelet-rich plasma. Penile injections of platelet-rich plasma, a substance made from blood containing lots of platelets (a type of blood cell important in wound healing), has been marketed as a treatment for ED in recent years. (22) This treatment is not FDA-approved and there is little evidence that it works. (22)
- Acupuncture. Acupuncture is the insertion of thin needles into different points on the body and is a component of traditional Chinese medical practice. (National Institutes of Health) Some people try acupuncture as a treatment for ED, but there is no evidence that it works to improve ED symptoms. (23)
The bottom line
ED is a condition that can have more than one root cause. Working to improve your overall well-being by eating a healthy diet, exercising if you’re able to, avoiding tobacco and reducing alcohol use, as well as prioritizing your mental health, can help to improve erectile health. In addition to healthy habits, there are many treatments available to help relieve ED symptoms. The most effective treatment for you depends on your individual situation. The best way to determine which treatment is right for you is to consult with a trusted healthcare provider.