ED treatment options: practical guide

Erectile dysfunction (ED) affects many men at different ages, and treatments cover drugs, devices, injections, surgery, and counseling. Pick an option based on how quickly you need results, health conditions, side effects, and personal preference.

Start with pills: PDE5 inhibitors are first-line. Sildenafil (Viagra) works in 30–60 minutes and lasts about 4–5 hours. Tadalafil (Cialis) can start in 30 minutes and lasts up to 36 hours — good for spontaneity. Vardenafil and avanafil are similar; avanafil may act faster, often within 15–30 minutes. Common side effects are headache, flushing, nasal congestion, and sometimes vision changes. Never take PDE5 inhibitors with nitrates; that combo can cause dangerous blood pressure drops. Talk to your doctor about heart meds and alpha-blockers.

Injectable therapies and urethral suppositories are next if pills fail. Alprostadil injection works in 5–20 minutes and has a high success rate, but it can cause penile pain or bruising. A vacuum erection device is non-drug, works right away, and can be a reliable option for many men. Penile implants (inflatable or malleable) are a surgical choice when other treatments don’t help; satisfaction rates are high but consider recovery time and cost.

Low testosterone can cause low libido and poor erections. If tests show low T, a doctor may suggest replacement, but that’s only helpful when hormones are actually low. For anxiety, relationship issues, or sudden ED, sexual counseling or CBT often works well, either alone or with medical treatments.

Lifestyle changes can improve erections. Lose weight if you’re overweight, exercise regularly, stop smoking, cut back on heavy drinking, and control blood sugar and blood pressure. These steps help long-term and may reduce medicine doses. If ED started after a new drug, talk to the prescriber about alternatives.

Many men use telehealth or online pharmacies for convenience. That can work, but always use reputable services that require a prescription and check reviews. Beware of sites selling cheap pills without a doctor review. See a doctor if ED is sudden, painful, linked to heart symptoms, or if treatments don’t help after a few tries.

Quick side-effect checklist

Pills: headache, flushing, nasal congestion, upset stomach, dizziness, and occasional vision changes. If you feel faint, sweating, or chest pain after taking a pill, seek emergency care. Injections: pain, minor bleeding, fibrosis if used often. Vacuum device: numbness or bruising, and using it correctly avoids injury. Implants: risks from surgery include infection and device problems. Always report new or severe symptoms to your provider.

Choosing the right option

Start with a short talk with your doctor about health history, current meds, and goals. If you have heart disease or take nitrates, pills may not be safe. Try a pill first if you want a noninvasive route. If pills fail, consider injections or a vacuum device before surgery. Remember, treating underlying causes like diabetes or stress often improves results. Ask about costs, follow-up, and realistic expectations.

If you want personalized advice, book an appointment, bring a med list, and be honest about lifestyle and mental health today.