There are several treatments for erectile dysfunction. Your doctor can advise you on the benefits and drawbacks of each.
Lifestyle changes are one of the most effective treatments. Weight loss, increased physical activity, cutting out smoking, getting enough sleep and reducing alcohol can all have a big effect on erectile dysfunction. If you have obstructive sleep apnoea, make sure you are using your CPAP machine.
This can be useful even if there is a medical cause, as it gives you a chance to talk about how you feel about having erectile dysfunction. If there is an underlying psychological reason for the difficulty, this is a safe place to explore what this might be and what you can do about it. This is generally not available as a funded service and you would normally need to pay for this privately. If you have been sexually abused, then you may be able to access free counselling through ACC.
Sensate focus exercises
Sensate focus exercises are intimacy exercises you do with your partner. Sensate focus is about setting the stage for sensuality rather than sexuality, focusing on touch and being touched, and being mindful during the experience. The exercises are progressed in steps starting from non-genital touching. Read more about sensate focus exercises.(external link)
Tablets (taken by mouth)
Tablets for erectile dysfunction are called phosphodiesterase-5 (PDE5) inhibitors such as sildenafil (Viagra, Silvasta, Vedafil), tadalafil (Cialis) and vardenafil (Levitra). These medicines usually enable an erection by relaxing the blood vessels in your penis, but only when you are stimulated or aroused. They are all similarly effective. Read more about PDE5 inhibitors and frequently asked questions about their use.
If the tablets mentioned above don't work, then injecting a medicine called Caverject into the base of your penis is another option. It allows most men to get an erection, which may last beyond ejaculation. Some men may be put off by this method, but the injector devices are simple and convenient to use and the procedure is virtually painless. Your doctor or sexual health specialist needs to show you in person how to use it safely.
Other possible treatments
For some men, vacuum pump devices, rigid or inflatable surgical penile implants or testosterone replacement (only for men with unequivocally low levels of this hormone) may also be options. Constriction bands at the base of the penis can be a treatment option for men with non-sustained erections. Discuss these options with your doctor.
Do herbal products work?
Many herbal products such as horny goat weed, ginkgo, yohimbe and ginseng claim to improve sexual function. There is no sound evidence that these herbal products work well for erectile dysfunction. They have not been well studied or tested. Since some erectile dysfunction is related to psychological problems, herbal products may help with anxiety, which may indirectly help sexual function.
Some herbal products and supplements can cause side effects or interact with other medicines. Talk to your doctor or pharmacist before you try an alternative treatment for erectile dysfunction, especially if you're taking medications or you have a chronic health problem such as heart disease or diabetes.