Treatment options for erectile dysfunction 

Treating underlying condition

For example, hormone therapy for hypogonadism (an abnormally low level of testosterone)

  • Can resolve erectile dysfunction
  • May require referral to specialists and further tests
Lifestyle changes

Losing weight if overweight, quitting smoking, drinking less alcohol, exercising more and reducing stress

  • Can also improve general health
  • Can reduce risk of cardiovascular disease
  • None
Medicine: phosphodiesterase-5 (PDE-5) inhibitors

Medication that increases blood flow to the penis. Sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra) and avanafil (Spedra) are all PDE-5 inhibitors

  • Available on NHS for people with certain conditions, such as diabetes, or for those receiving certain treatments, such as dialysis 
  • Can improve erections in around two-thirds of men
  • Can be used ‘on demand’ or taken long-term according to preference
  • Not suitable for people taking organic nitrates (medicine for cardiovascular disease) or amyl nitrate (poppers)
  • Not suitable for people with certain cardiovascular conditions (your GP can advise you)
  • Can cause headaches, nausea, vomiting, dizziness, muscle aches, back pain, vision problems and a blocked nose
  • May need to pay full cost of prescription
Vacuum pump

Plastic tube that covers the penis. A pump sucks the air out, creating a vacuum that causes blood to rush to the penis and cause an erection. A ring is placed around the base of the penis to trap the blood

  • Successful in nine out of 10 men
  • Can be used if medication is unsuitable
  • Can be used regardless of the cause of erectile dysfunction
  • May not be available on the NHS
  • Can cause pain or bruising
  • May be unacceptable to younger men
  • Cannot maintain erection for more than 30 minutes
Medicine: alprostadil

A synthetic hormone that stimulates blood flow to the penis. Can either be injected into the penis or inserted into the urethra (tube carrying urine out of the body)

  • Can be used if PDE-5 inhibitors have not worked
  • Effective in 85 out of 100 people when injected into the penis
  • Available on NHS for people with certain conditions, such as diabetes, or those receiving certain treatments, such as dialysis 
  • May need training in correctly inserting or injecting medication
  • Can cause penis pain, injection site reactions, headache, dizziness and changes in blood pressure
  • May need to pay full cost of prescription
Penis implant

Surgery to insert either semi-rigid or inflatable implants into the penis

  • Around three quarters of men are satisfied with the results
  • Permanent solution to erectile dysfunction
  • Unlikely to be available on the NHS and may be very expensive
  • Can cause infection or mechanical problems

Talking about any issues that are contributing to impotence; involves psychosexual therapy or cognitive behavioural therapy

  • Useful if impotence has a primarily psychological cause, such as anxiety or depression
  • Can be used alongside medication
  • Can take a long time to work
  • Not effective if impotence has a physical cause
Sex therapy

A programme to help you and your partner work through your sexual problems, such as sensate focus

  • Useful if erectile dysfunction has a primarily psychological cause
  • Takes pressure off as sex is usually banned for the first few weeks or months
  • You and your partner can learn to explore each other’s bodies in new ways
  • May take time
  • Not effective if erectile dysfunction has a physical cause 
Pelvic floor muscle exercises

Training and strengthening the muscles that control urination and the anus (back passage) could help to reduce the symptoms of erectile dysfunction.

  • Simple and easy to do
  • Some people experience an improvement in their condition
  • Not effective if there is a psychological cause