Erectile Dysfunction Treatment
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Many men experience erection problems, and this is completely normal. If you find you’re having problems getting an erection, then erectile dysfunction treatment can help.
Millions of men have benefitted from erectile dysfunction pills like Viagra, Cialis, tadalafil and Spedra, and they’re very effective and safe. On this page, you can find more information about erectile dysfunction treatments, how they work, and how they can benefit you.
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About erectile dysfunction treatment
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Erectile dysfunction is a medical term used to describe erection problems. You may have erectile dysfunction if you are unable to get an erection. You may also find that you are unable to keep an erection long enough to have sex, this is called ‘impotence’.
Erectile dysfunction is a very common experience – over half (52%) of men aged 40 to 70 report erectile problems, and it affects over a quarter of younger men in the UK.
Several factors can cause erectile dysfunction. Sometimes, there’s a physical cause, such as:
- blood vessel issues
- alcohol consumption
- neurological conditions
- drug use
- injury
Other times, there’s a psychological cause, such as stress or anxiety. For many men, they may be experiencing erectile dysfunction due to a combination of these factors.
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 erectile dysfunction tablets available to help you get and maintain an erection, regain confidence, and help you have better sex.
”If you’ve been unable to get or keep erections, you’re not the only one. Millions of people worldwide have used erectile dysfunction treatments and seen the benefits. There is no reason to hold back from requesting erectile dysfunction treatments when they may be able to help you to have a more satisfying sex life. For some people, it can help to order online, as there’s no need for a face-to-face appointment, though your GP can help too.” – Dr Brenda Ikeji, Medical Editor.
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Most medical treatments for ED work by improving blood flow to the penis, making it easier to get and maintain an erection when aroused. Treatments like oral tablets, creams, and injections support the natural process of an erection by helping the muscles in the penis relax, allowing more blood to flow in and stay trapped inside.
Other forms of treatment work differently. For example, vacuum pumps work by physically drawing blood into the penis to create an erection. If your ED is linked to psychological causes, therapies such as counselling or cognitive behavioural therapy (CBT) can also help.
Can erectile dysfunction come back after treatment?
Yes, erectile dysfunction can come back after treatment as this only helps you get an erection after you take it. This is why it is 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. Treatment for erectile dysfunction can help in the short term, but it may be worth seeking psychological support to resolve the root cause. In many cases, erectile dysfunction can be temporary.
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There are lots of erectile dysfunction treatments available, including well-known branded pills like Viagra and generic versions like sildenafil. There are also a range of other options available, like creams, injections, penis pumps, and rings.
Erectile dysfunction pills
There are several medications available to treat erectile dysfunction that come in the form of a tablet or pill. They belong to a medication group called phosphodiesterase type-5 (PDE-5) inhibitors and work by blocking the enzyme PDE-5 (in the spongy part of the penis) where the blood vessels are located. This allows the muscles to relax and increases blood flow to the penis, so you can get an erection when aroused.
PDE-5 inhibitors are usually the first-line choice for erectile dysfunction. Clinical trials have shown that PDE-5 inhibitors like sildenafil, tadalafil, avanafil, and vardenafil are effective for 60 to 70% of the population.
PDE-5 inhibitors are usually taken by mouth, with or without food, 30 to 60 minutes before you intend to have sex. There’s also daily ED pills that you take every day, so you’re always ready. 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.
Erectile dysfunction treatment cream
There are creams available that are applied directly into the penis. The active ingredient, alprostadil, is a type of vasodilator which works to widen the blood vessels in the penis, increasing blood flow, and making it easier to get an erection.
Vitaros cream is one example and usually works within 5 to 30 minutes. It’s applied into the head of the penis using the provided applicator. Clinical trials have shown that alprostadil cream significantly improves erectile function in up to 83% of men.
Erectile dysfunction injections
Caverject or alprostadil injections 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 first time you use these injections, you’ll be shown how to do it by a nurse at a clinic. Once you’ve learned how, it’s easy to do it yourself at home.
The injection is inserted into the base 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.
Vacuum pump for erectile dysfunction
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.
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Type Effectiveness and how long it takes to get an erection Erectile dysfunction pills, such as Viagra (sildenafil), Cialis (tadalafil), Spedra (avanafil), and Levitra (vardenafil)
Effective for 60 to 70% of users.
Takes 30 to 60 minutes to work.
Erectile dysfunction cream, such as alprostadil
Up to 83% effective.
Takes 5 to 30 minutes to work.
Erectile dysfunction injections, such as Caverject (alprostadil)
80% effective (according to the NHS).
Works within 10 minutes.
Vacuum pumps, such as Vaxaid V7 Deluxe Penis Pump
More than 90% effective.
Takes around 7 minutes to work.
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The best erectile dysfunction treatment for you will depend on your circumstances. For example, you may prefer one treatment over the other, or there may be medical reasons why you cannot use certain options. For example, sometimes, one treatment won’t work for you, but another will.
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 people, but your doctor can discuss which treatment is most suitable for you.
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There are a few ways to request erectile dysfunction treatment. You can request treatment:
- online from a safe and regulated online doctor service like ZAVA
- through your regular GP surgery
- from a local pharmacy
Some kinds of erectile dysfunction treatment require a prescription from your GP, while others can be purchased from a pharmacy without a prescription, though you’ll still need to answer some questions to make sure it's safe for you to take. You might also find it convenient to buy erectile dysfunction treatment online, rather than visiting a pharmacy or GP surgery in person. At ZAVA, we offer various erectile dysfunction treatments in the UK.
Start your treatment for erectile dysfunction with ZAVA:
Can I buy erectile dysfunction pills over the counter?
You can buy some kinds of erectile dysfunction pills over the counter in the UK without a prescription. For example, Viagra Connect and Cialis Together are available over the counter without a prescription but any others you’ll need a prescription for. Viagra Connect comes in 50mg tablets only, which is the standard dose for Viagra. If you think you need a different dose, you should speak to a doctor.
Getting erectile dysfunction treatment online
Qualified and regulated services like ZAVA allow you to request treatments for erectile dysfunction online. You can do this by:
- Filling out a short online questionnaire about your health.
- Request treatment by logging in or signing up and making payment.
- One of our doctors will check your questionnaire answers to make sure treatment is right for you.
- If your request is approved, your order can be sent to your door or to a local Post Office for collection.
- 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 erectile dysfunction 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 do not 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 have a consultation with 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 by a pharmacist for these treatments before you can buy them. The difference is that a pharmacist can run through the assessment with you, instead of your doctor.
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The 3 most common side effects of oral erectile dysfunction treatments are headache, flushing and indigestion.
Other common side effects include:
- feeling sick (nausea)
- blurred vision
- stuffy or running nose
- dizziness
Uncommon side effects include:
- being sick (vomiting)
- skin rashes
- bloodshot eyes
- pounding or rapid heartbeat
- muscle pain
- sleepiness
- vertigo
- dry mouth
- abdominal pain
- nosebleeds
Rare side effects include:
- 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. You may also want to read our articles about specific erectile dysfunction treatment side effects for:
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 erectile dysfunction treatments, you should stop taking them and call 999:
- an allergic reaction, including difficulty breathing, wheeziness, swollen face, lips, throat, or eyelids
- chest pains
- sudden loss of or reduced vision
- serious skin reactions (this can also happen with creams)
- priapism (a prolonged, painful erection that lasts longer than 4 hours)
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Erectile dysfunction treatment is very effective for the majority of people. However, it 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
Who cannot take oral erectile dysfunction medicine (pills)?
Oral ED treatments may not be suitable if you:
- take certain angina treatments
- have had heart failure
- are allergic to the ingredients
- take nitric oxide donors (amyl nitrate, also known as ‘poppers’)
- take high blood pressure medications like riociguat
- have low blood pressure
- have rare inherited eye diseases
- have liver issues
You should avoid drinking alcohol at the same time as taking erectile dysfunction pills because it can increase potential side effects and also affect your ability to get an erection.
Who cannot use erectile dysfunction treatment cream?
ED creams may be unsuitable if you:
- have had a heart attack
- have frequent dizziness
- have sickle cell anaemia
- have thrombocythemia
- have polycythemia
- have multiple myeloma or leukaemia
- have inflammation or penis infection
- get blood clots
- have a partner who is pregnant, breastfeeding or looking to get pregnant (unless you use a condom
Who cannot use erectile dysfunction injections?
ED injections may be unsuitable if you have:
- 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
- a previous or current MRSA infection
- a high risk of variant CJD (Creutzfeldt–Jakob disease)
You must not use erectile dysfunction injections if you take:
- blood-thinning medications
- medications for heart or lung disease
- medications that widen blood vessels
- other erectile dysfunction medications like Viagra
Who cannot use a vacuum pump?
Vacuum pumps may be unsuitable if you have:
- priapism
- Peyronie’s disease
- urethral strictures
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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
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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 (a buildup of fats, cholesterol, and other substances in and on the artery walls). 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.

Brenda studied medicine at St Georges University of London and has most recently worked in John Radcliffe Oxford University Hospitals, covering acute and general medicine.
Meet our doctorsLast reviewed: 06 May 2025
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Viagra Connect 50 mg film-coated tablets, emc [accessed April 2025]
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Vitaros 3 mg/g cream, emc [accessed April 2025]
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Penile injections for erectile dysfunction (impotence), NHS [accessed April 2025]
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Insertion of penile prosthesis for erectile dysfunction, NHS [accessed April 2025]
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Erectile dysfunction: How common is it?, NICE [accessed April 2025]
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