The current first-line treatment for erectile dysfunction is a class of drugs called PDE-5 inhibitors. These oral medications, which include Viagra, Cialis, Levitra, Stendra, and generic equivalents, allow most men to achieve erections. But these drugs simply treat the symptoms of ED; they don’t improve the underlying condition.
Given a choice, most men would prefer a solution that actually fixed the problem permanently, and didn’t require ongoing medications.
Surprisingly, there are options that may help!
But first, it’s important to understand that there are many underlying causes for erectile dysfunction. The potential for curing ED depends on the specific cause, and the severity of the condition. For example, ED due to nerve damage will probably not respond to the treatments outlined below.
Cardiovascular Health and Erectile Dysfunction
The most common cause for erectile dysfunction is a cardiovascular or circulatory problem, so a good place to start is by paying attention to your cardiovascular health. This may require some big lifestyle changes, but there is another great reason for making a commitment: it can (literally) save your life. Heart disease is the number one cause of death in the United States, and the same changes that will help with ED will also minimize the risks to your heart and circulatory system.
Studies have shown that eating a heart-healthy Mediterranean diet, reducing your sodium intake, and getting regular aerobic exercise can lessen the symptoms of erectile dysfunction.
For specific recommendations, see our article, “Can Diet and Exercise Cure ED?“
Bloodflow to the Penis
Men with erectile dysfunction may no longer get nocturnal erections. Scientists believe that these erections are important to providing bloodflow and oxygen to the penis. Lack of bloodflow can further damage the tissue of the penis. There are two treatment options that can improve blood flow.
- Low-Intensity Extracorporeal Shockwave Therapy (LI-ESWT), commonly called shockwave therapy, can improve bloodflow by breaking up the plaque that can block blood vessels. The shockwaves also cause microtrauma to the tissues of the penis; as the body heals itself, it also creates new blood vessels through a process called angiogenesis. Clinical studies have show that shockwave therapy can be a safe and effective treatment for vascular ED.
The therapy is usually administered in a clinic; a treatment program consists of 6-12 sessions. Clinical treatments are expensive; a complete series will cost several thousand dollars. There are also shockwave therapy devices available for home use.
- Regular use of a vacuum erection device, or penis pump can also improve blood flow. Studies have shown that therapeutic use of a pump can improve penile health.
Studies show that there is a correlation between obesity and erectile dysfunction. Other studies show improvements in erectile function after weight loss. The message is clear: if you are your weight is contributing to your ED, losing weight is an important part of your recovery plan.
Several studies have shown that sleep disorders, lack of sleep, and irregular sleep patterns are tied to higher rates of erectile dysfunction.
Not getting enough sleep can lower your testosterone levels, which may contribute to ED.
It’s important to establish regular sleep patterns and get enough sleep each night. In addition to improving your overall health, this may help to improve your erectile dysfunction.
Pelvic Floor Muscles
There is also evidence that strengthening the pelvic floor muscles can improve erectile dysfunction, premature ejaculation, and urinary incontinence.
The best way to strengthen these muscles is with Kegel exercises. Some men have trouble sticking with Kegel exercises, or. may not be sure they are doing them correctly. Physical therapists use electrical stimulation to exercise the pelvic floor and give a better workout than Kegel exercises alone; there are also electrical stimulation devices available for home use.
Psychological Erectile Dysfunction
Sometimes erectile dysfunction can have a psychological cause, including stress, anxiety disorders, depression, PTSD, or relationship issues. Even if there is an underlying physical cause, repeated “failures” can create stress, which then becomes a contributing factor.
Treating stress and anxiety can be difficult, and may require some changes in your lifestyle. Some of the steps described above – such as eating a healthy diet, getting regular aerobic exercise, and getting enough sleep – will improve your overall fitness, and reduce stress.
If you have problems moving past psychological issues, a few sessions with a sex coach or counselor who deals with sexual dysfunction can often help. There are many counselors with online practices if yu can’t find someone in your area who treats ED-related issues.
Getting Help with Lifestyle Changes
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Lifestyle changes – including diet, exercise, and stress-reduction – have been proven to help with erectile dysfunction as well as overall health. But for most men, making significant changes in their habits is very difficult.
We recommend Regimen, an app-based wellness program that can make permanent changes to your habits – and your erectile dysfunction – in just 12 weeks.
What to Avoid: Supplements for ED
There is an entire industry devoted to promoting and selling herbal products for erectile dysfunction. There are three important things to consider before taking supplements:
- They simply don’t work. Clinical studies show little if any benefit.
- They can have dangerous side-effects, especially if you have preexisting medical conditions or you are taking other medications. Despite what the promoters tell you, natural does not mean safe.
- They are very poorly regulated. When you buy herbal supplements, you don’t know what you are getting. Various investigations have shown that 40% to 80% of the products sold don’t contain the ingredients they claim! Hundreds have been found to contain contaminants, including insecticides.
There are treatments for erectile dysfunction that don’t require medications, and may permanently improve or even reverse ED.
They may not be effective for all types of ED, and they require a major commitment. In fact, to see significant improvements, you’ll probably need to work on several of these techniques over a period of months. The good news is that most of these changes will improve your overall health, whether or not you see immediate improvements in your erectile dysfunction!