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Understanding your ED treatment options

Erectile dysfunction (ED) can limit your intimacy, affect your self-esteem, and impact your relationship with your partner.1 But there’s good news — today, there is treatment for ED for every man. 

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Available treatments for ED

Make sure you understand the options available to you and be open and upfront about how the options fit your lifestyle.

Oral medications for ED

Most men with ED start with pills, such as Viagra™, Levitra™, Cialis™ and Stendra™. These may improve blood flow to the penis, and with sexual stimulation, can help you achieve an erection.2–5 If men don’t respond to oral medications, they may try other options. 

Pros: 
Pills can help you achieve an erection quickly and may have an effect on sexual intimacy. 

Cons: 
Some men cannot achieve a satisfactory erection with pills and other men will switch the type of pills to achieve a satisfactory outcome.2–6

 

Vacuum erection devices

A mechanical ED pump used to pull blood into the penis can cause an erection. The system includes a plastic cylinder, an external penile pump, and a tension band to place at the base of the penis. When the penis is erect, the ring is placed at the base to maintain an erection long enough to have sex (up to 30 minutes).7 

Pros:
An economical option that does not require prescription medications. 

Cons:
Men using VEDs reported discomfort and bruising when pumping and some men experience numbness or a cooled penis;7–8 using it right before intercourse may spoil the mood.

Penile injections

These medications (alprostadil, papaverine, etc.) may be combined and injected directly into the base or side of the penis. The recommended frequency of injection is no more than three times weekly, and should produce an erection in 5–20 minutes.9 

Pros:
An option for physical or psychological causes of erectile dysfunction using a fine gauge needle that may feel like pin prick.9 

Cons:
Beyond a possible fear of needles, men may experience pain, fibrosis, and risk of a persistent erection.9–10

Intraurethral suppositories

These medications (alprostadil, etc.) are inserted into the urethra at the end of the penis using an applicator (also called MUSE™). Medications applied 16 minutes before intimacy can dissolve inside the penis to relax the muscle, encourage blood flow, and cause an erection.11 

Pros:
For use multiple times a week, it may also be an option for physical or psychological causes of ED. 

Cons:
In addition to general discomfort, common side effects include penile pain and urethral pain or burning.10–11

Penile implants

A penile implant allows direct control of both the timing and duration of an erection. The 3-piece system includes a reservoir placed in the abdomen and two fluid filled cylinders completely concealed within the penis. Squeezing the pump in the scrotum can achieve an erection. 

Pros:
A natural looking appearance when flaccid or erect, the implant offers concealed support for an erection whenever and wherever desired. Penis surgery is minimally invasive. 

Cons:
Requires manual skill to use; some risks include but are not limited to device malfunction and postoperative pain.12–13

ED and medical conditions

Diabetes

Men with diabetes are more likely to move to advanced treatments than those without diabetes.14 A healthy lifestyle can help you control your diabetes and improve ED symptoms. Treatment options are available, however, men with diabetes are less responsive to oral ED medications.15

Understanding diabetes and ED

Heart disease

What’s good for the heart is good for your ED symptoms. If ED occurs, most treatment options are available. However, oral ED medication and heart medications don’t mix well and the medication in some injections should not be used if you have blood clotting problems.9

Understanding heart disease and ED

Prostate cancer

While ED may be a side effect of prostate cancer treatment, erectile function does not return in all cases. Penile rehabilitation and counseling may help both partners in recovery. Despite wide usage, 30–50% of patients who turn to sexual aids after surgery discontinue use within a year.6

Understanding prostate cancer and ED

Always talk to your doctor about your ED symptoms and concerns.

Out-of-pocket cost for a penile implant

30* pills16 = 1 implant17

Icon of pills.

Pill satisfaction
50% approximately of men with ED typically give up or the pills stop working6

*Based on current Medicare plan without additional plans applied.

Icon of a penile implant.

Implant satisfaction
97% of implant patients are typically satisfied18

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Frequently asked questions

Does insurance cover penile implants? Answers for your ED and penile implant questions.

Explore all FAQs
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Find an ED specialist

Find erectile dysfunction specialists to discover your best solution for ED.

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*Based on current Medicare plan without additional plans applied.

References

  1. DiMeo PJ. Psychosocial and relationship issues in men with erectile dysfunction. Urol Nurs. 2006 Dec;26(6):442–6.
  2. Viagra™ Prescribing information. Pfizer, Inc. Revised January 2010.
  3. Cialis™ Prescribing information. Lily USA, LLC. Revised October 2011.
  4. Levitra™ Prescribing information. Bayer HealthCare Pharmaceuticals. Revised November 2011.
  5. Stendra™ Prescribing Information. Vivus, Inc. 2014.
  6. Matthew AG, Goldman A, Trachtenberg J, et al. Sexual dysfunction after radical prostatectomy: prevalence, treatments, restricted use of treatments and distress. J Urol. 2005 Dec;174(6):2105–10.
  7. Osbon ErecAid™ Esteem™ Vacuum Therapy System User Guide. Timm Medical Technologies, Inc. 2011.
  8. Hellstrom WJ, Montague DK, Moncada I, et al. Implants, mechanical devices, and vascular surgery for erectile dysfunction. J Sex Med. 2010 Jan;7(1 Pt 2):501–23.
  9. Caverject™ Prescribing information. Pharmacia & Upjohn Company. Revised March 2014.
  10. Brant WO, Bella AJ, Lue TF. Treatment options for erectile dysfunction. Endocrinol Metab Clin North Am. 2007 Jun;36(2):465–79.
  11. MUSE™ Prescribing information. Meda Pharmaceuticals, Inc. Revised March 2011.
  12. Montorsi F, Rigatti P, Carmingnani G, et al. AMS three-piece inflatable implants for erectile dysfunction: a long-term multi-institution study in 200 consecutive patients. Eur Urol. 2000 Jan;37(1):50–5.
  13. AMS 700™ with MS Pump™ Penile Prosthesis Product Line Instructions for Use. American Medical Systems, Inc. 2016.
  14. Walsh TJ, Hotaling JM, Smith A, et al. Men with diabetes may require more aggressive treatment for erectile dysfunction. Int J Impot Res. 2014 May–Jun;26(3):112–5.
  15. Phé V, Rouprêt M. Erectile dysfunction and diabetes: A review of the current evidence-based medicine and a synthesis of the main available therapies. Diabetes Metab. 2012 Feb;38(1):1–13.
  16. GoodRx. Sample Savings with GoodRx. http://www.goodrx.com/. Accessed May 2015.
  17. Based on the Medicare 2015 deductible cap of $1260 for patients having an outpatient procedure. The estimated average out-of-pocket maximum for a patient with commercial insurance is $3,664 ($750–10,000). Medicare Advantage plans and private insurance plans vary in deductibles and coinsurance.
  18. Bernal RM, Henry GD. Contemporary patient satisfaction rates for three-piece inflatable penile prostheses. Adv Urol. 2012;2012:707321.