About erectile dysfunction treatment

What is erectile dysfunction?

Erectile dysfunction, also called ‘impotence’, is the inability to get or maintain an erection. It is a common experience, over half (52%) of men aged 40 to 70 report erectile problems. Several things can cause erectile dysfunction, such as blood vessel issues, stress, neurological conditions, alcohol or drug use and injury.

Having problems getting an erection from time to time isn’t usually a cause for concern. If it continues, it can be stressful, affect your confidence, and contribute to relationship issues. Sometimes, identifying and treating the underlying cause is enough to help you get better erections. There are also medications available to help you get and maintain an erection, regain confidence and help you have better sex.

How does erectile dysfunction treatment work?

There are various types of erectile dysfunction treatments available, including tablets, creams, injections and vacuum pumps. All the medical treatments available work in a similar way – to relax the smooth muscles and increase blood flow to the penis making getting erections easier when aroused.

About ED pills

• Phosphodiesterase-5 inhibitors (PDE5Is) are effective for 60 to 70% of the population.
• Usually effective within 30 to 60 minutes.
• Examples include, Viagra (sildenafil), Cialis (tadalafil), Spedra (avanafil), and Levitra (vardenafil).

About ED creams

• Up to 83% effective.
• Usually effective within 5 to 30 minutes.
• Examples include Alprostadil.

About ED injections

• 80% effective (according to the NHS).
• Usually effective within 10 minutes.
• Examples include Caverject (alprostadil).

About vacuum pumps

• >90% effective.
• Usually effective within around 7 minutes.
• Examples include the Vaxaid V7 Deluxe Penis Pump.

Can erectile dysfunction come back after treatment?

Yes, erectile dysfunction can come back after treatment. It’s important to identify or rule out any underlying physical causes, like diabetes or heart disease. In some cases, there are emotional causes of erectile dysfunction, such as anxiety or depression. In many cases, erectile dysfunction can be temporary.

What erectile dysfunction treatments are there?

There are lots of erectile dysfunction treatments available, including well-known branded pills like Viagra and generic versions such as sildenafil. There are also a range of other options available, like creams, injections, penis pumps and rings. Treatments like counselling are available alongside these options if you are having problems with your mental wellbeing associated with your erectile dysfunction symptoms.

Pills

There are oral medications available to treat erectile dysfunction. They are called phosphodiesterase type-5 (PDE5) inhibitors. They work by blocking the enzyme PDE5 in the spongy part of the penis where the blood vessels are located. This allows the muscles to relax and increase blood flow to the penis, enabling you to get an erection when aroused.

PDE5 inhibitors are usually the first-line choice for erectile dysfunction. Clinical trials have shown that PDE5 inhibitors like sildenafil, tadalafil, avanafil, and vardenafil, are effective for 60 to 70% of the population.

Oral PDE5 inhibitors are usually taken by mouth, with or without food, 30 to 60 minutes before you intend to have sex. For them to work effectively, you will need to be aroused as they do not work on their own. They are also more effective when you drink minimal alcohol and, if you are going to take them with food, a light meal is recommended.

Creams

There are creams available that are applied directly to the penis. The active ingredient is alprostadil, a type of vasodilator which works to widen the blood vessels in the penis, increasing blood flow, and making erections easier.

Vitaros cream is one example and usually works within 5 to 30 minutes. It is applied directly to the head of the penis using the provided applicator. Clinical trials have shown that alprostadil cream significantly improves erectile function but only in 31 to 40% of men.

Injections

Caverject or alprostadil injections are usually given at an outpatient clinic under the supervision of a urologist or specialist nurse. They contain the same active ingredient as erectile dysfunction creams (alprostadil) and work by opening up the blood vessels in the penis, helping you to get an erection.

The injection is inserted into the side of the penis and you should be able to get an erection within 10 minutes. When injections are used, an erection should last around 45 minutes.

For more information, we provide a breakdown on Caverject and one on alprostadil too.

Vacuum pumps

Vacuum pumps are medical devices that can improve erection quality. There are different types of pumps available, some use air to create a vacuum causing blood to rush to the penis while others use water. Some pumps use a combination of air and water like the Vaxaid V7 Deluxe.

Penis pumps can also be used in combination with other treatments, such as Viagra or sildenafil. They are also a good medication-free alternative for men who don’t want to take medication or do not respond to other erectile dysfunction treatments.

Penile implants

Penile implants are devices that are surgically inserted into the penis to help men get an erection. They are usually used when other treatments have failed or other conditions have affected your ability to get an erection, such as Peyronie’s disease or priapism (painful erections).

Treatments offered by ZAVA are:

Pills

• Viagra
• Viagra Connect
• Sildenafil
• Cialis
• Cialis Daily
• Tadalafil
• Spedra
• Levitra

Vacuum pump

• Vaxaid V7 Deluxe Penis Pump

What’s the best treatment for erectile dysfunction?

The best treatment available for erectile dysfunction will depend on your circumstances. For example, you may prefer one treatment over the other, or there may be medical reasons why you can’t use certain options.

Generally, the most effective treatments are oral medications that increase blood flow to the penis, such as sildenafil (Viagra), tadalafil (Cialis), and Levitra (vardenafil). These are often the first-line erectile dysfunction treatment for most men, but your doctor can discuss which treatment is right for you.

How to get erectile dysfunction treatment?

There are a few ways to request erectile dysfunction treatment. You can request treatment:

• online from an online doctor service like ZAVA
• through your regular GP surgery
• from a local pharmacy

Getting erectile dysfunction treatment online

Certain qualified services like ZAVA allow you to request treatments for erectile dysfunction online. You can do this by:

1. Filling out a short online questionnaire about your health
2. You can then request treatment by logging in or signing up and making payment
3. One of our doctors will check your questionnaire answers to make sure treatment is right for you
4. If your request is approved, your order can be sent to your door or to a local Post Office for collection
5. If treatment is not right for you, our doctors will be in touch with alternative options

Getting erectile dysfunction treatment on the NHS

You can request treatment by making an appointment with your GP. They can assess if treatment is right for you and then offer a prescription.

Not all treatments are available for everyone on NHS prescription. The NHS has strict prescribing guidelines for erectile dysfunction treatment, so you may only be able to request certain medications.

Your doctor may agree to offer you a private prescription for certain medications even if you don’t meet their criteria for an NHS prescription, however you would then have to pay full price for your treatment.

Getting erectile dysfunction treatment from a pharmacy

Most treatments for erectile dysfunction are prescription-only, meaning you have to see a doctor first. However, there are a couple of treatments you can get over-the-counter in pharmacies:

• Viagra Connect
• Cialis Together

You still need to get assessed for these treatments before you can buy them. The difference is a pharmacist can run through the assessment with you, instead of your doctor.

What are the side effects of erectile dysfunction treatment?

The 3 most common side effects of oral erectile dysfunction treatments are:

1. Headache
2. Flushing
3. Indigestion

Other common side effects include:

• feeling sick (nausea)
• blurred vision
• stuffy or running nose
• dizziness

Uncommon side effects:

• being sick (vomiting)
• skin rashes
• bloodshot eyes
• pounding or rapid heartbeat
• muscle pain
• sleepiness
• vertigo
• dry mouth
• abdominal pain
• nosebleeds

Rare side effects:

• fainting
• stoke
• heart attack
• irregular heartbeat
• numb mouth
• double vision
• dry nose
• irritability
• loss of hearing

For a full list of side effects, you should read the patient information leaflet that is provided with your treatment.

Side effects are usually mild to moderate and should only last for a short period. If you are concerned or the side effects are difficult to manage, you should speak to your doctor.

If you experience any of the following side effects while taking oral erectile dysfunction treatments, you should stop taking them and call 999:

• an allergic reaction (difficulty breathing, wheeziness, swollen face, lips, throat, or eyelids)
• chest pains
• sudden loss of or reduced vision
• serious skin reactions

Who can take erectile dysfunction treatment?

Erectile dysfunction treatment may not be right for everyone. Certain medications or conditions may interact with some treatments making them less effective, or potentially unsafe.

As a general rule, erectile dysfunction treatments are not suitable for:

• anyone under 18
• women
• pregnant women

Speak to your doctor if you have any concerns about erectile dysfunction medication in relation to any health concerns.

Oral medication contraindications

The following may make oral ED treatments unsuitable for you:

• angina treatments
• alcohol
• heart failure
• allergic to the ingredients
• nitric oxide donors (amyl nitrate)
• a medication used to treat high blood pressure in the lungs called riociguat
• low blood pressure
• rare inherited eye diseases
• liver issues

Cream contraindications

The following may make ED creams unsuitable for you:

• history of heart attack
• dizziness
• sickle cell anaemia
• thrombocythemia
• polycythemia
• multiple myeloma or leukaemia
• inflammation or penis infection
• blood clots
• partner is pregnant, breastfeeding or looking to get pregnant unless you use a condom

Injection contraindications

The following may make injectable ED treatments unsuitable for you:

• any of the following fitted: artificial heart valve, coronary artery stent, heart pacemaker or defibrillator, artificial joint, artificial blood vessel graft, neurosurgical shunt, or any other implanted foreign body
• sickle cell anaemia
• multiple myeloma or leukaemia
• blood-thinning medications
• medications for heart or lung disease
• medications that widen blood vessels
• other erectile dysfunction medications like Viagra
• previous or current MRSA infection
• high risk of variant CJD

Vacuum pump contraindications

The following may make vacuum pumps unsuitable for you:

• priapism
• Peyronie’s disease
• urethral strictures

How do I know if I need erectile dysfunction treatment?

The main symptom of erectile dysfunction is being unable to get or maintain an erection for sex. This is not the same as premature ejaculation where orgasm or ejaculation occurs very quickly.

Other symptoms may include:

• being able to get an erection but not every time you want to have sex
• getting an erection that doesn’t last long enough for sex
• inability to get an erection at any time

If you experience any of these symptoms you must get a diagnosis from a doctor. They can help you identify any underlying causes and recommend suitable treatment options.

You can request erectile dysfunction treatment from ZAVA. Simply fill out our online medical questionnaire and one of our doctors will review your answers to see which erectile dysfunction treatment is right for you.

What other treatment options are there?

As well as medications and medical devices, making healthy lifestyle choices can sometimes help with erectile dysfunction.

Alternatives to erectile dysfunction medication include:

• losing weight if you are overweight
• eating a healthy, balanced diet
• getting daily exercise
• quitting smoking if you are a smoker
• trying to reduce or avoid stress and anxiety
• limiting your alcohol intake to less than 14 units per week
• trying to avoid cycling for a while to see if this makes a difference (if you cycle for more than 3 hours per week)

Can erectile dysfunction be cured?

In some cases, erectile dysfunction is temporary and can be reversed by making healthier lifestyle choices, treating underlying health problems or making changes to medications causing erectile dysfunction as a side effect.

Erectile dysfunction can be prevented long-term by identifying and resolving the underlying cause of the issue. For example, erections can be affected by a condition called atherosclerosis. For this, your doctor may advise changing your diet, losing weight, increasing exercise, and prescribing medication to treat it. These steps may help to improve your erectile function long-term.

Overall, erectile dysfunction treatments are effective and allow many people to have a healthy sex life. They are usually safe to use long-term, so even if it’s not possible to improve erections through methods like lifestyle changes, they can still be relied on.