Treatment Overview

Treatment for an erection problem (erectile dysfunction) depends on the cause of the problem, which may be psychological, physical, or a combination of both. Erection problems that have one or more major physical causes also often have psychological factors that make the problem worse and make treatment more complicated.

Many doctors take a stepwise approach to treating erection problems, using the least invasive treatments first. These steps are:

1. Discovering and then eliminating medicines that may be causing your condition. In some cases, a different medicine can be tried.
2. Trying testosterone or another treatment to fix a hormone problem if tests show you have one.
3. Trying an oral medicine. Medicines used for erection problems include phosphodiesterase-5 inhibitors such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra). One of these medicines may be tried unless an easily treated cause—such as a medicine side effect or testosterone deficiency—has been identified.
4. Getting counseling if a psychological cause is suspected.
5. Trying medicines that are injected or inserted into the penis.
6. Trying a vacuum device.
7. Trying penile implant surgery.

Counseling (also called psychotherapy) or behavioral therapy may be appropriate even if your erection problem has a physical cause. It may be offered if your health professional suspects psychological issues play a role in your erection problems.

For more information on treatment options, see:

Erection Problems: Should I Take Medicine?

Erection Problems: Should I Try Injection Treatments?

What to Think About

It is important to involve your partner in your decision regardless of the treatment you choose.

Oral medicines have revolutionized the treatment of erection problems. And they are commonly tried first before other medicine or surgery.

Although phosphodiesterase-5 inhibitors have relatively few side effects, they can be dangerous in certain men. If you are taking nitrate-containing medicines, such as nitroglycerin, you cannot use sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra). You also should not take certain alpha-blockers—used to lower blood pressure and to treat an enlarged prostate gland—with these medicines because of the risk of a dangerous drop in blood pressure. Check with your doctor to see whether you can take sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra) with your alpha-blocker.

Many men overestimate how important being able to have erections is to their relationships. Some men find that when they are able to have erections again, the hassle of using the treatment is not worth the effort. Other men may find that being able to have erections doesn't change their relationship as much as they or their partners had expected.