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Men’s Health - How is Erectile Dysfunction treated?

Most doctors suggest that treatments proceed from least to most invasive. For some men, making a few healthy lifestyle changes may solve the problem. Quitting smoking, losing excess weight and increasing physical activity may help some men regain sexual function.

Cutting back on any drugs with harmful side effects is considered next. For example, drugs for high blood pressure work in different ways. If you think a particular drug is causing problems with erection, tell your doctor and ask whether you can try a different class of blood pressure medicine.

Psychotherapy and behavior modifications in some patients might be next, followed by oral or locally injected drugs, vacuum devices and surgically implanted devices. In rare cases, surgery involving veins or arteries may be considered.

Psychotherapy

Experts often treat psychologically based erectile dysfunction using techniques that decrease the anxiety associated with intercourse. The patient's partner can help with the techniques, which include gradual development of intimacy and stimulation. Such techniques also can help relieve anxiety when erectile dysfunction from physical causes is being treated.

Drug Therapy

Drugs for treating erectile dysfunction can be taken orally, injected directly into the penis or inserted into the urethra at the tip of the penis. Drugs that we have found to work include Sildenafil (Viagra), Vardenafil Hydrochloride (Levitra) and Tadalafil (Cialis).
Men who take nitrate-based drugs such as nitroglycerin for heart problems should not use any of these because the combination can cause a sudden and severe drop in blood pressure. Also, tell your doctor if you take any drugs called alpha-blockers, which are used to treat prostate enlargement or high blood pressure. Testosterone supplementation is available for patients shown to have reduced levels of this hormone. Some patients have claimed that other oral drugs, including yohimbine hydrochloride, dopamine and serotonin agonists and trazodone are effective in the treatment of erectile dysfunction but the results of scientific studies to substantiate these claims have been inconsistent.

Intra-cavernosal Therapy

Many men achieve stronger erections by injecting drugs into the penis, causing it to become engorged with blood. Alprostadil (marketed as Caverject or Viridal) is the main drug in this category. By using ultra-fine needles these injections are painless and patients easily learn how to self inject.

Nitroglycerin, a muscle relaxant, can sometimes enhance erection when rubbed on the penis.

Research on drugs for treating erectile dysfunction is expanding rapidly. Two new preparations which involve nasal spray administration are expected to be on the market within the next year. Trials have shown that these new preparations appear to be at least as effective as if not more effective than any of the medications currently available. Patients should ask their doctor about the latest advances.