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Treatments

Treatment is a result of the underlying cause. Overall, exercise, particularly of the aerobic form, is effective in preventing ED during midlife. 18–19 Counseling can be used where the root cause is psychological, including how to alleviate the sex-related stress or anxiety. Mouth and vacuum erection systems are first-line interventions, 20, 24 followed by injections of medications into the penis, as well as penile implants. Reconstructive vascular surgery is useful in certain communities. Treatments, rather than surgery, do not fix the underlying physiological issue but are used prior to sex as needed.

Medications

The sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis) antagonists of PDE5 are prescription medications that are taken by mouth. Sildenafil is available without a prescription in the UK as from 2018. In addition, a cream that combines alprostadil with the DDAIP permeation enhancer has been approved as a first line treatment for ED in Canada. At the other hand, penile injections may include one of the following medicinal products: papaverine, phentolamine, and prostaglandin E1, also known as alprostadil. Including injections, there is a suppository of alprostadil which can be injected into the urethra. An erection will begin within 10 minutes after insertion and last up to an hour. Medicinal products used to treat ED can cause a side effect called priapism.

Testosterone

Men with low testosterone levels may get ED. Taking testosterone will help keep an erection going. People with type 2 diabetes are twice as likely to have lower testosterone levels, and are three times more likely than non-diabetic people to experience ED.

Pumps

Through applying negative pressure a vacuum erection system helps draw blood into the penis. Sometimes this type of device is called a penis pump and can be used just before sexual intercourse. Various types of vacuum therapy devices approved by the FDA are available upon prescription. A purpose-designed external vacuum pump can be used to achieve erection when pharmacological methods fail, with a separate compression ring attached to the base of the penis to preserve it. These pumps should be distinguished from other penis pumps (supplied without compression rings) which are claimed to increase penis length if used frequently, rather than being used for temporary impotence treatment, or to vibrate as a masturbation aid. More dramatically, penile implants that are inflatable or rigid can be surgically mounted.

Surgery 

Sometimes, the most common technique is prosthetic implants, which involves inserting artificial rods into the penis as a last resort after other procedures have failed. Some studies say that reconstructive vascular surgery is a feasible alternative for some people.

Alternative medicine

Alternative treatments for the treatment of sexual dysfunction are not approved by the Food and Drug Administration (FDA).

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