Specific treatment for erectile dysfunction will be determined by your doctor based on:
- Your age, overall health, and medical history
- Extent of the disease
- Your tolerance for specific medications, procedures, or therapies
- Expectations for the course of the disease
- Your opinion or preference
Below are some of the treatments available for ED.
These are the common medications used to treat ED:
- Sildenafil citrate (Viagra). A prescription medication taken orally for the treatment of ED. Viagra does not directly cause penile erection, but affects the response to sexual stimulation.
- Vardenafil citrate (Levitra). In clinical studies, Levitra has been shown to work quickly and improve sexual function in men the first time they take the medication. It has been shown to work well in men of all ages, in men with diabetes, and in men who have had the surgical procedure called radical prostatectomy.
- Tadalafil citrate (Cialis). Studies have indicated that Cialis stays in the body longer than other medications in its class. Most men who take this medication find that an erection occurs within 30 minutes and the effects of the medication may last up to 36 hours.
The FDA recommends that men follow general precautions before taking a medication for ED. Men who are taking medications that contain nitrates, such as nitroglycerin, should NOT use Viagra, Levitra, or Cialis. Taking nitrates with one of these medications can lower blood pressure too much. In addition, men who take Levitra or Cialis should not use alpha blockers, as they could result in hypotension (abnormally low blood pressure). Experts recommend that men have a complete medical history and physical examination to determine the cause of ED. Men should tell their doctor about all the medications they are taking--including over-the-counter medications.
In addition, men should not take these medications if they have a history of heart attack or stroke, or if they have a bleeding disorder or stomach ulcers.
Men with medical conditions that may cause a sustained erection, such as sickle cell anemia, leukemia, or multiple myeloma, or a man who has an abnormally-shaped penis, may not be able to benefit from these medications. Also, men with liver diseases or a disease of the retina, such as macular degeneration or retinitis pigmentosa, may not be able to take these medications, or may need to take the lowest dosage.
These medical treatments should NOT be used by women or children. Older men are especially sensitive to the effects of these medical treatments, which may increase their chance of having side effects.
Hormone replacement therapy
Testosterone replacement therapy may improve energy, mood, and bone density, increase muscle mass and weight, and heighten sexual interest in older men who may have deficient levels of testosterone. Testosterone supplementation is not recommended for men who have normal testosterone levels for their age group due to the risk of prostate enlargement and other side effects. Testosterone replacement therapy is available in an oral form and as a skin patch.
Three types of implants are used to treat ED:
- Hydraulic pump. A pump and two cylinders are placed within the erection chambers of the penis which causes an erection by releasing a saline solution; it can also remove the solution to deflate the penis.
- Prosthesis. Two semi-rigid but bendable rods are placed within the erection chambers of the penis which allows manipulation into an erect or nonerect position.
- Interlocking soft plastic blocks. These are placed within the erection chambers of the penis and can be inflated or deflated using a cable that passes through them.
Infection is the most common cause of penile implant failure and is treatable with antibiotics. In some cases, the infected implant must be replaced by a new implant. Implants are usually not considered until other methods of treatment have been tried.