1. Lifestyle Modifications (The Foundation)
Before turning to medical intervention, addressing the root cause can sometimes reverse mild ED.
• Cardiovascular Health: ED is often a “canary in the coal mine” for heart health. 30–45 minutes of aerobic exercise three times a week can improve blood flow significantly.
• Dietary Changes: A Mediterranean-style diet (high in fruits, vegetables, and healthy fats) supports vascular health.
• Quitting Smoking & Reducing Alcohol: Smoking damages blood vessels directly, while alcohol is a central nervous system depressant that can interfere with the signals needed for an erection.
2. First-Line: Oral Medications (PDE5 Inhibitors)
These are the most common treatments and are often the first thing a doctor will prescribe.
• The Big Four: Viagra (Sildenafil), Cialis (Tadalafil), Levitra (Vardenafil), and Stendra (Avanafil).
• How they work: They enhance the effects of nitric oxide, a natural chemical your body produces that relaxes muscles in the penis to increase blood flow.
• Note: They require sexual stimulation to work; they aren’t “instant” erections.
3. Second-Line: Non-Pill Medical Options
If pills don’t work or cause too many side effects (like headaches or flushing), these localized treatments are the next step.
• Vacuum Erection Devices (VED): A plastic tube placed over the penis that uses a pump to create a vacuum, drawing blood into the shaft. A tension ring is then placed at the base to keep the blood there.
• Urethral Suppositories (MUSE): A tiny medicated pellet is inserted into the opening of the penis (the urethra). The medication is absorbed into the surrounding tissue to trigger an erection.
• Penile Self-Injections (ICI): Using a very fine needle, you inject medication (like TriMix or Alprostadil) into the side of the penis. This is often highly effective even for men who didn’t respond to Viagra.
4. Regenerative & Emerging Therapies
For men looking for “cures” rather than “fixes,” these newer options aim to repair the underlying tissue.
• Shockwave Therapy (Li-ESWT): Uses low-intensity sound waves to trigger “neovascularization”—the growth of new blood vessels. It is non-invasive and painless.
• PRP (P-Shot): Platelet-Rich Plasma involves taking your own blood, concentrating the growth factors, and injecting them back into the penis to stimulate tissue repair.
