Addressing Underlying Health Conditions

Vardenafil for the treatment of erectile dysfunction: an overview of the clinical evidence. Clinical Interventions in Aging, 4, 463-472. Avanafil for treatment of erectile dysfunction: review of its potential.

• Initial consultation typically involves a detailed medical and sexual history.
• Follow-up appointments assess medication effectiveness and adjust treatment plans.
• Combination therapy (e.g., oral pill + injection) may be used for difficult cases.
• Treatment goals are individualized: restoration of satisfactory sexual intercourse.
• Partner involvement in consultations is often encouraged for better outcomes.
• Monitoring for side effects and drug interactions is an ongoing process.
• Treatment may evolve as health conditions change or new therapies become available.
• A good doctor-patient relationship is key to successful long-term management.

Vascular Health and Risk Management, 8, 517-523. Cross-Study Review of the Clinical Efficacy of Apomorphine SL 2 and 3 mg: Pooled Data from Three Placebo-Controlled, Fixed-Dose Crossover Studies. European Urology Supplements, 1(3), 12-20. Apomorphine: an update of clinical trial results.

Preparing for your appointment

Notably, men who take medications for cardiovascular problems may not be suitable candidates for ED supplements. Most of the supplements you can use to combat ED are more expensive than generic drugs. You also have to take them every day for them to be effective, unlike certain ED meds that you can take as needed. Ultimately, the choice between a prescription ED treatment and a supplement comes down to budget and lifestyle, and the choice is yours to make. Innerbody uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles.

What you can do

Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Physical Activity to Improve Erectile Function: A Systematic Review of Intervention Studies. One Patient Out of Four with Newly Diagnosed Erectile Dysfunction Is a Young Man—Worrisome Picture from best ed treatments the Everyday Clinical Practice. Direct comparison of tadalafil with sildenafil for the treatment of erectile dysfunction: a systematic review and meta-analysis. International Urology and Nephrology, 49(10), 1731-1740. International Journal of Impotence Research, 12 Suppl 4, S67–S73. A single-centre result of two courses of low-intensity shockwave therapy (Li-SWT) in erectile dysfunction.

Effect of oral administration of high-dose nitric oxide donor L-arginine in men with organic erectile dysfunction: results of a double-blind, randomized, placebo-controlled study. Treatment of erectile dysfunction with pycnogenol and L-arginine. Journal of Sex & Marital Therapy, 29(3), 207–213. Red ginseng for treating erectile dysfunction: a systematic review.

Should I Get Surgery for Erectile Dysfunction?

Coward, R. M., & Carson, C. C. (2008). Tadalafil in the treatment of erectile dysfunction.

What to expect from your doctor

Therapeutics and Clinical Risk Management, 4(6), 1315-1330. Kloner, R.A., Goggin, P., Goldstein, I., Hackett, G., Kirby, M.G., Osterloh, I., Parker, J.D., Sadovsky, R. (2018, May 18). A New Perspective on the Nitrate–Phosphodiesterase Type 5 Inhibitor Interaction. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. British Journal of Clinical Pharmacology, 66(4), 444-450.

Can Supplements Help Erectile Dysfunction?

DHEA (dehydroepiandrosterone) is a precursor to the sex hormones testosterone and estrogen that our body’s adrenal glands typically produce. Production of DHEA naturally drops as we age. Several studies on diabetics have uncovered an inverse relationship between serum DHEA levels and the incidence of ED.22 Those results suggest that possibly a third of men with diabetes-related ED could treat their ED using DHEA. The World Anti-Doping Agency and many collegiate and international competitive organizations have banned DHEA as a performance-enhancing drug. The quantities you’ll encounter in male enhancement supplements aren’t likely to help you break any home run records, but they could still show up on mandatory drug tests.

Erectile dysfunction care at Mayo Clinic

You might also find that DHEA raises your cholesterol levels, so if you have high cholesterol levels already, DHEA might not be the right choice. CBD is also a popular ingredient for erectile performance, especially if anxiety and psychogenic ED are at issue, and some of our favorite CBD companies have introduced sex-focused products that include some of these ingredients. Among these gummies, Neurogan’s Pure Intimacy is an easy top pick, as it combines an effective dose of CBD with both maca root and horny goat weed. Side effects with all of the supplements mentioned here tend to be mild, if any occur. Most men don’t experience any, but it’s always wise to share your supplement plans with your healthcare provider before adding anything new to your regimen. The World Journal of Men's Health, 36(3), 183-191. Efficacy and safety of long-term tadalafil 5 mg once daily combined with sildenafil 50 mg as needed at the early stage of treatment for patients with erectile dysfunction. Phosphodiesterase-5 (PDE5) Inhibitors In the Management of Erectile Dysfunction. The Efficacy and Safety of Avanafil During a Treatment of Male Erectile Dysfunction: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Therapeutics and Clinical Risk Management, 19, 629-644.

The efficacy of fluoxetine in the treatment of premature ejaculation: a double-blind placebo controlled study.

How to save on Viagra, Cialis, and other ED meds

The Journal of Urology, 151(1), 54–61. Efficacy and safety of PDE5 inhibitors in the treatment of diabetes mellitus erectile dysfunction: Protocol for a systematic review. Erectile dysfunction and mental health in a general population of older men. The Journal of Sexual Medicine, 6(2), 505–512. Clinical safety of oral sildenafil citrate (VIAGRATM) in the treatment of erectile dysfunction.

Oral medicines

International Journal of Impotence Research, 10, 69–730. Tadalafil in the treatment of erectile dysfunction; an overview of the clinical evidence. Clinical Interventions in Aging, 1(4), 439-449. Comparison of clinical trials with sildenafil, vardenafil and tadalafil in erectile dysfunction. Expert Opinion on Pharmacotherapy, tadalista tablets 6(1), 75–84. The Journal of Urology, 156(5), 1631–1632. Relative Efficacy of Minoxidil and the 5-α Reductase Inhibitors in Androgenetic Alopecia Treatment of Male Patients: A Network Meta-analysis.

• Future oral drugs may target different pathways beyond PDE5 inhibition.
• Improved topical formulations aim for systemic absorption without side effects.
• Advanced shockwave devices are being refined for better precision and outcomes.
• Nanotechnology could enable targeted drug delivery to penile tissue.
• Brain-computer interfaces are far-future possibilities for stimulating arousal centers.
• Tissue engineering aims to create functional bioengineered erectile tissue.
• Personalized medicine may use genetic profiling to predict best treatments.
• Ongoing research into the role of inflammation and microvascular health in ED.

Atorvastatin efficacy in the primary and secondary prevention of cardiovascular events. Trends in Urology & Men's Health, 12(6), 19-22. Psychological Factors Related to Impotence as a Sexual Dysfunction in Young Men: A Literature Scan for Noteworthy Research Frameworks. Clinics and Practice, 12(4), 501-512. The role of cortisol in erectile function.

Translational Andrology and Urology, 12(8), 1213-1214. People who Expect to Enter Psychotherapy are Prone to Believing that They Have Forgotten Memories of Childhood Trauma and Abuse. Mental Health Medications, U.S. Department of Health and Human Services. Penile Entrapment With Thick Penile Ring: A Case Report and Literature Review. Vacuum therapy in erectile dysfunction—Science and clinical evidence. International Journal of Impotence Research, 22(4), 211-219.

What Is Erectile Dysfunction?

Testosterone boosters may help with ED if low testosterone is at the source. Some prominent testosterone boosters, like tongkat ali and ashwagandha, also have anti-anxiety effects, which might help with cases of psychogenic ED, regardless of testosterone levels.39 40 And because erectile performance often suffers with low testosterone, some brands will include erection-supporting ingredients in their testosterone boosters, even when there’s less evidence connecting them with testosterone. A great example of this is the potent maca extract in Innerbody Testosterone Support and Roman’s supplement. Volume pills often better resemble fertility supplements than ED solutions. In fact, our top-rated volume pill is a male fertility supplement by Bird & Be.

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Again, some ingredient crossover means you can find volume pills that have beneficial potential for ED. It would be understandable if you wanted to try a single supplemental ingredient as opposed to a complex formula. With the exception of a few great products out there, many such complex supplements include a few iffy ingredients or subclinical doses that call their potential safety and efficacy into question. And even with a good complex supplement, you won’t know which of its ingredients are working for you, in particular, and which may not be. Here’s a quick look at some popular single-ingredient supplements people look to for help with ED. The science of vacuum erectile device in penile rehabilitation after radical prostatectomy. Translational Andrology and Urology, 2(1), 61–66.

What Treatments Might Not Work for Erectile Dysfunction?

Not all of the items on this list are home runs, but their prevalence in the marketplace demands that we address them: Studies using high doses of maca root powder have illustrated its ability to improve erectile performance.43 But maca isn't always well-absorbed, so extracts made from the powder are superior to consuming 10g of the dried and ground root. L-Arginine is an amino acid we naturally have within our bodies. Under normal circumstances, it plays a role in nitric oxide production, which in turn plays a crucial role in allowing blood to rush into the penis to cause an erection. In one study, a third of men reported that they experienced significant improvement in sexual function while using L-arginine.19 A separate study of men ages 25-45 examined the effect of taking both L-arginine and pycnogenol (chemicals taken from French pine trees) together for ED treatment.20 Participants were given L-arginine for one month; nothing happened. Then the men were given both L-arginine and pycnogenol for a month.

Is there an ED medication that truly has no side effects?

After this second month, 80% of the men reported that their sexual function was mostly restored. Using this same combination for a third month, over 92% of the men had what they considered normal erections. While erection-specific research has only been conducted in animals, horny goat weed is among the most popular herbal remedies for ED. As with maca, we recommend extracts over powders and advise men to focus on the icariin content of the extract over raw dose numbers.45 Panax ginseng (red ginseng) is sometimes called “herbal Viagra.” There have been more than a handful of studies providing evidence that Panax ginseng can help with ED. However, the studies leave a fair bit to be desired in their methodologies and size.21 The evidence thus far points to the need for more research into the potential of red ginseng as an effective treatment. The role of vacuum pump therapy to mechanically straighten the penis in Peyronie’s disease.