Treatments for Erectile Dysfunction

Erectile dysfunction occurs when you can't attain or keep an erection sufficient for sexual intercourse. During sexual stimulation, nerves release a chemical that causes the penis arteries to dilate, allowing the spongy erectile tissue in the penis shaft to fill with blood, resulting in an erection that should last until orgasm and ejaculation. Erectile dysfunction can result from circulatory impairment (such as high blood pressure, atherosclerosis and diabetes), nerve impairment from neurological disease or injury, decreased testosterone level, stress or substance abuse.

Lifestyle Changes

• Erectile dysfunction can be helped by reducing stress and fatigue, and reducing or stopping the use of alcohol, tobacco and illicit drugs. Alcohol depresses the central nervous system and can impair nerve function. Smoking constricts arteries and can increase circulatory impairment. Illicit drugs, such as heroin, cocaine and marijuana, may cause erectile dysfunction and impotence through impairment of nerves and/or circulation.

  If you are taking medications that cause erectile dysfunction, such as some heart and blood pressure medications and antidepressants, you should discuss with your doctor the possibility of changing to other medications.

Medications

• You may need to receive testosterone to increase your hormone level in order to achieve an erection. Oral medications, such as Viagra, Levitra and Cialis, cause relaxation of the smooth muscles, allowing the arteries in the penis to dilate enough for an erection. Viagra or Levitra is usually taken about an hour before sexual intercourse, but Cialis can be taken up to 36 hour before intercourse or with a daily maintenance dose. These medications don't resolve erectile dysfunction for all men and may cause facial flushing.

Penile Medications

• According to Mayo Clinic, prostaglandin E (alprostadil), alone or combined with papavarine or phentolamine, is administered to the penis to increase blood flow. You can inject the medication directly into the erectile tissue, using a syringe and a very small needle. An erection should occur within 20 minutes and last about 60 minutes. Another option is to insert a small suppository (pellet of medicine) directly into the urethra, using a special applicator. Both procedures are uncomfortable.

Vacuum Device

• The cylindrical vacuum constriction device fits over the penis and a hand pump draws blood into the penis. You then slide a rubber ring down to the base of the penis to maintain the erection and remove the cylinder. According to Urology Channel, you must pump one to three minutes to achieve an erection, and you can leave the ring in place for about a half hour. Only the part of the penis beyond the O-ring stays erect, and the O-ring may interfere with ejaculation. Leaving it in place for longer periods could cause circulatory damage.

Surgery

• A surgeon can implant semi-rigid malleable rods into the penis. The rods maintain a permanent erection, but the rods can bend the penis close to the body. Another option is an inflatable implant with cylinders in the penis shaft, a pump and release valve in the scrotum, and a permanent reservoir for saline (salt water) in the lower abdomen. You can feel the pump and press it to bring saline into the cylinders to achieve an erection and later press the release valve to move the saline back to the reservoir.

  If you have blockage of an artery, you may be a candidate for bypass surgery in which a vein from another part of your body is grafted into place to carry blood around the blocked area to the penis.