ED treatment: what works and what to watch for

Struggling with erectile dysfunction (ED) is more common than you think. The good news: there are reliable options that work for most people. This page lays out the main treatments, quick safety checks, and how to pick the right path so you can talk to your doctor with confidence.

Common ED treatments and how they differ

PDE5 inhibitors are the first-line choice for most men. These include sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra) and avanafil. Sildenafil and vardenafil usually work within 30–60 minutes and last a few hours. Tadalafil can work for up to 36 hours, which some people prefer for spontaneity. Side effects include headache, flushing, nasal congestion, and sometimes visual changes. Crucial safety note: never take PDE5 inhibitors with nitrates (often given for chest pain) — that combo can dangerously lower blood pressure.

If pills don’t help or aren’t safe for you, there are other options: vacuum erection devices (a non-drug pump that helps blood flow into the penis), intraurethral suppositories, and penile injections like alprostadil. These work well for many men but need some training and carry risks like pain or local bruising. Penile implants are a surgical option reserved for stubborn cases; they have high satisfaction rates but require counseling and a skilled urologist.

Treat the body and mind — both matter

ED often has mixed causes: blood flow issues, hormone imbalances (low testosterone), nerve problems, medications, or stress and anxiety. Lifestyle changes can make a big difference: lose excess weight, quit smoking, cut heavy alcohol use, get regular exercise, and control blood pressure and blood sugar. If anxiety or relationship stress plays a role, sex therapy or couples therapy can improve outcomes when combined with medical treatment.

Before starting treatment, your doctor should check your heart health, review current meds, and test testosterone if symptoms suggest low levels. Be upfront about all prescription and herbal supplements — some interact with ED drugs or affect heart risk.

Buying medication online? Use licensed pharmacies only. Look for clear contact information, require a prescription, and check for pharmacy accreditation in your country. If a site sells prescription ED drugs without asking for a prescription, that’s a red flag. Telemedicine visits with a licensed provider can be a safe, convenient way to get a legitimate prescription and follow-up care.

Finally, try to keep expectations realistic. ED drugs improve the ability to get an erection but don’t create spontaneous desire. If something doesn’t work, talk to your clinician — switching drugs, adjusting dose, or combining treatments often helps. Getting the right care is usually a step-by-step process, not a single quick fix.