Treating erectile dysfunction

What are the treatment options?

Erectile dysfunction isn’t something that you have to live with. The sooner you talk to your treatment team, the better the chances of improving your sex life. Your doctor can suggest several interventions.

PDE-5 inhibitors: These drugs dilate the blood vessels and allow more blood to flow into your erectile tissue. They are taken in tablet form and last for several hours. They are effective if nerve bundles are preserved and sexual arousal is present when they are used. However, they can have undesirable side effects on the heart and circulation and must not be taken with some heart medications.

Penile injection therapy or MUSE: Penile injection therapy or erectile tissue auto-injection therapy and MUSE (medicinal urethral system for erection) are two therapies based on the body’s own messenger substance prostaglandin E1. With penile injection therapy, you have to inject the medication directly into the erectile tissue or into the urethra with MUSE using a rod. Overdoses can lead to painful permanent erections. Erectile tissue auto-injection therapy and MUSE are also effective for severed nerves.

Mechanical aids: If you don’t want to or are not allowed to take medication, vacuum erection aids are an alternative. You insert your member into a plastic cylinder and create a vacuum with a pump. The vacuum helps to fill the erectile tissue with blood. A penis ring is then placed at the root of the stiff member to stop the blood from flowing back. This keeps the penis stiff. There are hardly any side effects to worry about with mechanical aids. However, a penis ring should be removed after 30 minutes at the latest so that the blood flow in the erectile tissue is normal again and no damage occurs.

Pelvic floor training: The muscles in the pelvic floor support the flow of blood into the penis. They can also help you maintain an erection for longer. Regular pelvic floor exercises support these muscles and can relieve erection problems, especially in combination with other therapies.

Author: Dr. Volker Henn| Reviewer: Dr. Christian Keinki

Sources:

• How Cancer Can Affect Erections | Adult Males with Cancer. (2020). American Cancer Society. https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/fertility-and-sexual-side-effects/sexuality-for-men-with-cancer/erections-and-treatment.html
• Difficulty getting an erection | Prostate cancer | Cancer Research UK. (2019). Cancer Research UK. https://www.cancerresearchuk.org/about-cancer/prostate-cancer/practical-emotional-support/sex-relationships/difficulty-getting-erection
• Yetman, D. (2020, November 20). What Are the Most Common PDE5 Inhibitors? Healthline. https://www.healthline.com/health/pde5-inhibitors
• Roland, J. (2020, March 5). Erectile Dysfunction Injections: How to Inject, What to Expect, and More. Healthline. https://www.healthline.com/health/erectile-dysfunction-injections
• Alprostadil (Urethral Route) Proper Use – Mayo Clinic. (2022). MayoClinic. https://www.mayoclinic.org/drugs-supplements/alprostadil-urethral-route/proper-use/drg-20138507?p=1
• Erectile Dysfunction (ED): Causes, Diagnosis & Treatment. (2019). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/10035-erectile-dysfunction#:%7E:text=Mechanical%20aids,penis%20and%20causes%20an%20erection.
• Case-Lo, C. (2018, September 17). Exercises to Eliminate Erectile Dysfunction. Healthline. https://www.healthline.com/health/erectile-dysfunction/exercises