ED treatments: what works, what to try first, and what to avoid

Struggling with erections is common, but the good news is there are several proven options that actually help. This page gives clear, practical info on the main ED treatments—what they do, when they make sense, common side effects, and real steps you can take next.

Medicines and pills

The most used treatments are oral drugs called PDE5 inhibitors. You’ve probably heard of sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra). They help blood flow to the penis so you can get and keep an erection when sexually stimulated. Tadalafil lasts longer (often up to 36 hours), while sildenafil and vardenafil work for a shorter window and typically start working within an hour.

Important safety tips: don’t take these if you use nitrates (for chest pain) — the combo can dangerously lower blood pressure. Also mention any heart meds, alpha-blockers, or grapefruit to your doctor. If pills don’t work or cause side effects like headache, flushing, or nasal congestion, other options exist.

Other medical options

For men who don’t respond to pills, consider:

- Vacuum erection devices: a pump creates a vacuum that draws blood into the penis; a ring holds the erection. They’re drug-free and work for many men.

- Penile injections: a small medicine (commonly alprostadil) is injected into the penis to produce an erection. They work fast but require training and sterile technique.

- Urethral suppositories: a tiny pellet placed inside the urethra can trigger an erection without a needle.

- Penile implants: surgical option when other treatments fail. Modern implants are reliable and discreet, but surgery has risks and recovery time.

Don’t forget hormone checks. Low testosterone can cause low libido and contribute to ED. If tests show low levels, your doctor may discuss replacement therapy, but that’s a separate decision with its own risks and benefits.

Psychological causes matter. Performance anxiety, stress, or relationship issues are common. A short course of counseling or sex therapy often improves results, especially when paired with medical treatments.

Lifestyle changes are powerful. Quit smoking, cut down heavy drinking, lose excess weight, get regular exercise, and control blood sugar and blood pressure. Those moves not only improve erections but overall health.

Buying meds online? Be cautious. Use pharmacies that ask for a prescription, show clear contact info, and have real reviews. Avoid sites selling cheap mystery pills with no ingredients list. We have deeper guides on safe online pharmacies and specific medicines if you want to read more.

Next steps: talk honestly with a healthcare provider about symptoms, current meds, and heart health. Ask about a basic exam and lab tests. With the right plan — pills, devices, therapy, or a combo — most men see meaningful improvement.