Erectile Dysfunction Treatment

What is Erectile Dysfunction (ED)?

Erectile dysfunction, also known as impotence and often referred to as ED, is a sexual health condition where a man can’t get and/or maintain an erection, be it due to physical, emotional or environmental factors (Allen et al, 2023).

Despite its prevalence, many men still find it an embarrassing condition and one that they perhaps don’t want to talk about or delay getting treatment for (Al-Shaiji, T.; 2022; Leslie & Sooriyamoorthy; 2024). This can cause sexual and emotional frustration (Medical News Today, 2022), especially since the cause is not always obvious.

Video: Erectile Dysfunction Explained

Mayo Clinic have put together a video to explain erectile dysfunction (ED) providing an overview of what it is, who can experience ED, erectile dysfunction symptoms, how ED is diagnosed, the various treatment options and coping methods. You can watch it below:

What causes Erectile Dysfunction (ED)?

There are many factors that can cause impotence, the most common one being physical. This could possibly be down to an injury (to the penis or the spinal cord), or diseases such as Parkinson’s (Parkinson's UK, 2024), Multiple Sclerosis (MS) (MS Society UK, 2024), or kidney disease. It can also be caused by physical factors that are affected by lifestyle (Maiorino et al, 2015). These risk factors include high blood pressure, high cholesterol, obesity and diabetes.

Erectile dysfunction can also be brought on by other medical treatments (NHS, 2023), such as that of cancer of the prostate and any number of other prescription drugs. If you do notice impotence after recently starting a new drug, then it’s possible that this is the cause and you should consult your doctor.

Not all physical causes are out of your control though, with smoking, drinking alcohol and using drugs all being linked to experiencing ED. As well as physical causes, your hormones can also play a part in erectile dysfunction (Society for Endocrinology, 2021). If you have a hormone disorder or testosterone deficiency / low testosterone levels, you could also notice symptoms of impotence.

Although it may surprise some people, there are also plenty of mental health and emotional factors that could be contributing towards your erectile dysfunction. This ranges from serious issues like suffering with depression (Liu et al, 2018), stress (Kalaitzidou et al, 2013) or anxiety (Velurajah et al, 2021), to the more mundane like having relationship problems or struggling with low self-esteem. Feeling guilty or having difficulty with communication can play big roles in causing impotence so it’s worth trying to work through any emotional issues if you notice symptoms or problems.

Can erectile dysfunction be cured?

Eight out of ten men have a good chance of PDE5 erectile dysfunction medication working effectively for them (Tidy & Vakharia, 2023), helping to increase the blood flow to their penis and allowing them to achieve a strong erection after arousal. In many cases erectile dysfunction can be reversed.

How can I treat erectile dysfunction (ED)?

Erectile Dysfunction Treatments

When it comes to treatment, there are plenty of options that you can try.

Lifestyle Changes

The first port of call would be to make some lifestyle changes (NHS, 2023):

• Exercising regularly 
• Maintaining a healthy diet
• Limiting alcohol intake (Arackal & Benegal, 2007)
• Quitting smoking
• Losing weight if you're overweight
• Reducing stress levels

If these make no difference then you should consider ED medication; your doctor will be able to advise the most appropriate course of treatment.

However, herbal products, food, or over-the-counter supplements are not recommended. Many sites suggest or sell these options, but they aren't proven to work and may waste your time and money. If you decide to try these, consult your doctor to ensure that they are safe for you to take prior to starting the treatment.

Erectile Dysfunction Exercises

Exercises like kegels can strengthen the muscles around your penis, improving blood flow and erections.

Erectile Dysfunction Medication

There are plenty of medications available for erectile dysfunction, with all of them boasting their own set of benefits. The most widely-known one is Viagra (the branded form of the generic ED medication, Sildenafil), which gets to work in just 30 minutes and lasts for 4-5 hours. There is also Cialis (or the generic Tadalafil) which has earned its nickname of ‘the weekend drug’ thanks to its 36 hour window of effectiveness. These drugs are different forms of the drug class, PDE5 inhibitor and work by increasing the blood flow to the penis, helping you to achieve and maintain an erection (Dhaliwal & Gupta, 2023). With a wide range available on UK Meds, you have plenty to choose from. And the doctor’s service at UK Meds can help you work out which one to go for, based on what best suits your individual needs.

Summary of Erectile Dysfunction Treatments

What alternative erectile dysfunction treatment options are available?

Aside from typical erectile dysfunction tablet treatments such as Viagra & Cialis, there are alternative forms of treatment that could help in treating ED and improving erectile function.

Shockwave Therapy

There is a recent form of medical education for ED treatments, called shockwave therapy, which could be a potential treatment for erectile dysfunction in patients who have undergone prostate cancer surgery (Guy's and St Thomas' NHS Foundation Trust, 2022). This therapy works on a damaged penile blood vessel by regenerating new blood vessels and nerves.

ED Cream

ED treatments such as alprostadil (branded as Vitaros) come as an ED cream and are typically only prescribed as a treatment of erectile dysfunction if ED tablets (typically PDE 5 inhibitor treatments), such as sildenafil and tadalafil haven't been able to cure erectile dysfunction in a patient (NHS Lancashire and South Cumbria Medicines Management Group, 2015).

Vacuum Penis Pump

According to Cambridge University Hospitals (2022), vacuum pumps (vacuum erection assistance devices) and vacuum therapy are a non invasive way for a man to obtain and sustain an erection if they are suffering from erectile dysfunction (impotence). The vacuum device works by removing air from the cylinder (either via a hand operated pump or a small electric motor), encouraging blood flow into the penis and facilitating an erection, after which a constriction ring is added onto the base of the penis to hold blood in an maintain the erection.

Penile Implant

Whilst it is typically a last line ED treatment, if other medical ED treatments such as tablets, vacuum devices, pellets and injections have failed and may not be suitable for every patient, a penile implant is a treatment that involves the insertion of an artificial implant into the penis (penile prostheses), which allows men to achieve erections for successful sexual intercourse (Newcastle upon Tyne Hospitals NHS Foundation Trust, 2021).

Speak to your healthcare provider to ensure that you are receiving the most suitable and safest ED treatments for your individual needs.

What potential side effects can erectile dysfunction drugs have?

Potential side effects can vary from person to person for each ED medication.

Erectile Dysfunction FAQs

What erectile dysfunction tablets are there?

There are several types of erectile dysfunction (ED) tablets, all belonging to a group of drugs called PDE5 inhibitors. These work by relaxing blood vessels, increasing blood flow to the penis, and helping achieve an erection. Each pill has a different active ingredient, so you might need to try a few to find the best one for you.

Here are the 4 main types of ED tablets:

• Sildenafil (found in Viagra, Viagra Connect, and generic Sildenafil)
  • NHS’s first choice and most popular.
  • Starts working in about 30 mins and lasts for 4-6 hours.
• Tadalafil (found in Cialis, Cialis Daily, Cialis Together and generic Tadalafil)
  • Known as the 'weekend pill'.
  • Begins working in about 30 mins and lasts up to 36 hours.
• Vardenafil (found in Levitra and generic Vardenafil)
  • Similar to Viagra, but slightly better for men with eye problems.
  • Takes effect in about 30 mins and lasts 4-6 hours.
• Avanafil (found in Spedra)
  • The fastest-acting ED pill.
  • Starts working in as little as 15 mins.

All these treatments:

• Are effective for most men.
• Are safe if approved by a doctor or pharmacist (for Viagra Connect).
• Can be prescribed and bought online without a previous diagnosis or prescription.

What’s the strongest/most effective tablet?

No single ED medication is stronger or more effective than another. They all work similarly, but individual responses can vary. Generally:

• Higher dosages might increase effectiveness but also raise the risk of side effects.
• Start with the standard dose and only increase if needed and side effects are minimal.
• Never take more than one ED tablet within 24 hours.
• Consult a doctor before changing medications or doses.

Which tablet has the least side effects?

All ED pills, except Spedra, cause side effects in fewer than 2% of men. Lower dosages tend to have fewer side effects:

• Try the standard dose first and consult a doctor before changing dosages.

Which tablet works fastest?

• Spedra: Starts working in as little as 15 mins.
• Cialis Daily: Always effective since it's taken daily, no need to plan ahead.

Which tablet lasts longest?

• Cialis: Lasts up to 36 hours, earning the nickname 'weekend pill'.
• Cialis Daily: Continuously effective as long as you take it daily.

Can you get erectile dysfunction treatments on an NHS prescription?

Certain erectile dysfunction treatments are available on an NHS prescription. For example, the ED medicine, sildenafil, is available on NHS prescriptions if you have erectile dysfunction or pulmonary hypertension, although it's branded form, Viagra, is not available on the NHS, except in special situations; you can also get sildenafil (generic Viagra) on a private prescription from your doctor, where you will pay the full cost of the erectile dysfunction drug (NHS, 2022). The same is the case for the ED drug, tadalafil, the generic form of Cialis.

ED Pills

What Is Viagra?

Viagra

One of the most popular erectile dysfunction medications to improve sexual function is Viagra. The active ingredient in Viagra is Sildenafil (EMA, 2024). You can buy Viagra and it's generic version Sildenafil tablet medication here at UK Meds. Viagra tablets should be taken from between one and four hours before you are intending to have sex (Drugs.com, 2023).

Viagra OTC

Whilst Viagra (sildenafil) is a prescription medication, you can get an over the counter version of the ED pill, Viagra, that doesn't require a prescription, this is called ‘Viagra Connect’ (GOV.UK, 2017).

What is Cialis?

Cialis

Cialis is a popular ED medication because it's an oral ED tablet that can give a man the freedom to have sex within a 36 hour timeframe (Medical News Today, 2024). You can buy Cialis and Cialis Daily (tadalafil daily treatment) from UK Meds, along with other popular ED medicines. The generic version of the Cialis tablet is known as Tadalafil.

Cialis OTC

Whilst Cialis (tadalafil) is a prescription medication, you can get an over the counter version of Cialis called ‘Cialis Together’ that doesn't require a prescription (GOV.UK, 2023)

What is Levitra?

Levitra

Levitra is a branded form of the ED treatment, Vardenafil. It works in a similar way to Cialis and Viagra as an oral medication, increasing blood flow to the penis which helps a man to get and keep an erection (WebMD, 2024). It typically lasts for 4 hours after being taken, following sexual stimulation and should usually be taken 60 minutes before sexual intercourse (Drugs.com, 2023). You can buy Levitra, it's generic version, Vardenafil, and other erectile dysfunction drugs online at UK Meds.

Can high blood pressure cause erectile dysfunction?

If you experience erectile dysfunction regularly, it may be caused by an underlying condition such as high blood pressure (hypertension) (NHS, 2023). In fact, according to the European Society of Cardiology (2020), men with high blood pressure (hypertension) are twice as likely to have erectile dysfunction and impaired penile blood flow in comparison to men with a normal and healthy blood pressure level.

Can erectile dysfunction affect mental health?

Yes, men suffering from erectile dysfunction / an erection problem during sexual activity can also experience mental health issues as a result, with ED patients showing a greater deterioration in psychological, social and physical well being, in comparison to a healthy male who doesn't experience ED (Elterman et al, 2021).

Can erectile dysfunction be an early sign of heart disease?

Erectile dysfunction (a form of male sexual dysfunction) could be a potential early indicator of cardiovascular disease / heart disease and future heart problems (Harvard Medical School, 2020). If you have heart disease as an underlying cause, selecting the right ED treatment option could help to treat the erectile dysfunction that you are experiencing; your doctor or healthcare provider will be able to advise you on the most appropriate course of ED medication to suit your individual requirements and ED symptoms that you are experiencing.

Are premature ejaculation (PE) and erectile dysfunction (ED) the same?

No. Whilst premature ejaculation (PE) and erectile dysfunction (ED) are both forms of male sexual dysfunction affecting mens health and could occur together, ED is both a short term and long term condition where a man cannot get or maintain an erection firm enough to have sex; whereas premature ejaculation describes when a man ejaculates sooner than they would like to during sexual activity.

More Information:

• NHS - Erection Problems (Erectile Dysfunction)
• Mayo Clinic - Erectile Dysfunction
• National Institute of Diabetes and Digestive and Kidney Diseases - Erectile Dysfunction
• NHS Inform Scotland - Erectile Dysfunction (Impotence)
• Medical News Today - Erectile Dysfunction
• Clinical Knowledge Summaries - Erectile Dysfunction
• WebMD - Understanding Erectile Dysfunction Basics
• British Association of Urological Surgeons - Erectile Dysfunction (Impotence)
• Patient - Erectile Dysfunction (Impotence)
• British Heart Foundation - Erectile Dysfunction
• ScienceDirect - Erectile Dysfunction
• The Urology Foundation - Erectile Dysfunction

Support Resources

Interested in finding out more about erectile dysfunction? The UK Meds Health Hub has a range of helpful content related to erectile dysfunction for you:

• What Causes Erectile Dysfunction
• UK Meds Hard Talk Erectile Dysfunction Campaign
• How Does Cialis Work
• Is Viagra, Cialis, or Levitra the Best
• Guide to Vitaros for Erectile Dysfunction: Exploring Alprostadil
• Cock Rings for Erectile Dysfunction: Everything You Should Know About Penis Rings
• Horny Goat Weed vs Viagra
• Can Losing Weight Treat Erectile Dysfunction
• How to Make Erectile Dysfunction Medication Work Better
• When Should I Take Viagra for the Best Results
• Foods Like Viagra That Give Erection
• What Does Cialis Do
• How Long Will Cialis Work
• What Is Alprostadil
• Taking Erectile Dysfunction Medication with Alcohol
• Does Masturbation Cause Erectile Dysfunction