Erectile dysfunction treatment

There are many different ED treatment options to suit your needs, with the most popular and well-known being tablets like Viagra and sildenafil. These contain a type of active ingredient that all belong to the same medication group: phosphodiesterase type-5 (PDE-5) inhibitors. If you cannot take tablets, or would prefer a different option, you can also get a mouth spray containing sildenafil, the same active ingredient in Viagra and sildenafil tablets, called Hezkue.

For people with nerve damage or who cannot take PDE-5 inhibitors, we can also prescribe Vitaros cream, which contains a different type of medication but works in a very similar way to PDE-5 inhibitors.

There is currently only 1 ED cream available called Vitaros. It’s usually offered if you do not want to take tablets or cannot, or if you have nerve damage to your penis. Although not a PDE-5 inhibitor, it works in a very similar way.

Vitaros cream

Vitaros cream is applied directly onto the penis using a special applicator. It contains a synthetic (artificial) version of prostaglandin E1 (PGE-1) called alprostadil. This is absorbed into the blood vessels of the penis, making them wider to improve blood flow and the ability to get and maintain an erection. It works within 5 to 30 minutes and lasts around 1 to 2 hours.

ED spray is a newer type of treatment that may be preferable for people who do not want to take tablets. Hezkue spray is the only type of ED spray currently available, and it’s also a PDE-5 inhibitor.

Hezkue spray

Hezkue spray contains sildenafil, the same active ingredient in Viagra, Viagra Connect, and sildenafil tablets. It’s flavoured with mint to make the taste more appealing. It works in the same way as it’s a PDE-5 inhibitor, but because you spray it into your mouth, it works faster. Hezkue works in around 12 to 37 minutes, but new studies show it may work in as little as 5 minutes, and lasts around 4 to 6 hours.

Are there over-the-counter ED tablets?

Yes. Viagra Connect is an over-the-counter ED tablet containing sildenafil. They are a 50mg version of Viagra, the recommended dose for most people. If you need a higher dose, you will need a prescription from a doctor. A pharmacist will need to have a short consultation with you to prescribe Viagra Connect, as they need to make sure it’s safe for you and does not interact with any current medications or conditions you have. You can also get it online.

Another over-the-counter ED tablet is Cialis Together, which contains tadalafil in a lower dose of 10mg. Cialis Together works to increase blood flow to the penis by relaxing blood vessels. Known as the ‘weekend pill’, it can be taken 30 minutes before sex and stays in your system, allowing you to be ready for sex for 36 hours, though you must be sexually aroused for it to work. Cialis Together is not available at Asda Online Doctor, but the higher dose alternative, Cialis, is available to request.

In normal circumstances erectile dysfunction treatments are perfectly safe. As with any medication though, there can be some side effects.

Common side effects

Some common side effects of PDE5 inhibitors include:

• headaches
• tummy problems
• dizziness
• aches and pains
• changes in vision
• hot flushes
• a runny nose

Rare and uncommon side effects

Severe but rare side effects of PDE5 inhibitors include:

• priapism (where your erection lasts longer than 4 hours and is painful)
• changes in your hearing
• loss of vision

Common side effects around the penis area when using PGE1 treatment (like Vitaros cream) are:

• pain, itching or tenderness
• swelling
• throbbing or tingling
• inflammation or irritation around the head of the penis

Your partner may also have mild burning or itching symptoms in their genitals during or after sex.

There are lots of other options if you need help getting and keeping an erection. Some are medical treatments and others are non medical treatments that you may want to try first before anything else.

Vacuum erection devices

When you put one of these on, it creates a vacuum around your penis. You then use a small hand pump to draw air from the vacuum, which draws blood into the penis and makes it erect. A band then fits around the base of the penis to maintain the erection for no more than 30 minutes for safety.

Testosterone therapy

If low testosterone (male hormone) is detected in your blood, you may use injections, patches, or gels to replace it. This may improve your mood and sex drive, but it is not proven to improve erectile dysfunction.

Penile injections

These can be used if your erectile dysfunction is not improving with usual erectile dysfunction treatments, like Viagra or Cialis. A synthetic hormone is injected into the penis to increase blood flow. It is perfectly safe and you can be trained to do it yourself.

Implants

There are two types of penile implant, semi rigid and inflatable. Semirigid implants are always hard but can be turned away from the body for sex, or towards the body to cover it. Inflatable implants mean you can inflate or deflate the implant and get an erection as and when needed.

Lifestyle changes

There are some lifestyle changes you can make yourself that may improve your erectile dysfunction symptoms over time.

Changes you can make yourself include:

• quitting smoking
• exercising regularly
• avoiding too much alcohol
• avoiding taking drugs
• lowering your stress levels

Counselling

Sometimes ED is caused by something that affects you mentally, like depression, anxiety, trauma, or nervousness around sex and sexual activities. If you and your doctor have ruled out physical conditions, counselling can support you to manage your mental health or sexual anxieties, reducing or curing your ED. If you only have ED with your partner, not masturbating on your own, couples counselling could also be beneficial. Speak to your GP for advice on finding the right type of counselling for you, or you can find a private therapist.

Erectile dysfunction is a sexual condition that happens when you cannot get or keep an erection hard enough and for long enough for sex. It can happen for many reasons, and your doctor can help you find the underlying cause if you’re not sure. It can be short-term or long-term, depending on what is causing it, and treatment can help you take control of your sex life.

ED can also happen very occasionally for some people due to other reasons, such as if you’ve had alcohol, taken drugs, or are stressed. This is normal, and you usually do not need treatment for this. ED is not the same as premature ejaculation (PE), which happens when you ejaculate quickly with little control. However, ED and PE can be linked, so sometimes getting treatment for ED may help with PE too.

What are the symptoms of ED?

The symptoms of ED include:

• not being able to get an erection despite sexual arousal
• not being able to keep an erection long enough for sex
• low sex drive (libido) – this does not happen to everyone

ED can happen on your own, or may only happen when you are with someone else. Depending on what’s causing it, you may also still get spontaneous erections, such as when you wake up in the morning.

Erectile dysfunction affects around 332 million men worldwide, and there are lots of different things that can cause it. The most common causes of ED are either psychological (the mind) or physical (the body).

Psychological causes of erectile dysfunction can include:

• anxiety
• stress
• depression
• relationship troubles

Physical causes of erectile dysfunction can include:

• issues with your blood circulation
• high blood pressure
• high cholesterol
• diabetes
• an injury
• changes in hormone levels

Common risk factors include:

• being over 50 years old
• smoking, alcohol, or drugs
• being overweight
• poor diet
• lack of exercise
• high blood pressure or sugar levels (diabetes)
• cardiovascular disease
• high cholesterol

ED can be diagnosed by a doctor. To make the diagnosis and prescribe treatment, they will check things like:

• your medical history – incase there is an underlying cause
• what medications you are taking – as some treatments can cause ED
• your symptoms – ED can usually be diagnosed through symptoms alone

In some cases, if ED is caused by another condition, you may need to be referred to a specialist. You can request treatment from us even if you have not been formally diagnosed by your GP, as our consultation will check your symptoms to see whether ED treatment is suitable. We still recommend speaking to your GP to get help with finding the cause of your symptoms, as this can improve them.

Is erectile dysfunction common?

Yes, erectile dysfunction is common and can happen to you at any age, although most of the time it is temporary. Erectile dysfunction is seen in around 55% of men between the ages of 40 and 70 years old, and becomes more common as you get older.

While erectile dysfunction is common, you should discuss it with your doctor if it keeps happening, as it could be a sign of a different health problem.

Is erectile dysfunction permanent?

No, erectile dysfunction is not permanent, and even if it’s long-term, you can use treatments to manage it. Most of the time it will go away on its own if it’s linked to stress or anxiety.

While there are treatments available to help reverse erectile dysfunction, completely curing it depends on the underlying condition. Treatments help by increasing blood flow to the penis. You should speak with your doctor to find out which erectile dysfunction medication is best for you.

Can stress cause erectile dysfunction?

Yes, stress can cause erectile dysfunction. If you find stress is affecting your sexual performance in general, this may need to be treated separately. Your doctor may refer you to a therapist or offer medication to improve your mental health, and see if erectile dysfunction happens less often as a result.

Does erectile dysfunction affect fertility?

No, erectile dysfunction does not affect fertility, as your sperm are not affected by it. However, if you are having a problem getting an erection, you may have trouble getting your partner pregnant since you need to be hard and ejaculate so your sperm can enter their womb.

The health of your sperm is what can affect your fertility, so if you are having problems conceiving, speak to your doctor about your options.

What should I do if ED tablets don’t work for me?

If ED tablets do not work for you at first, it’s recommended to try them on 8 different days before speaking to your doctor about an alternative. Sometimes it can take time for them to work for you, and things like anxiety around sex or the tablets working can make it harder to get an erection at first. If you’ve already tried this and you’re taking your treatment correctly, speak to your doctor.

Remember that some things can affect how well ED tablets work, such as taking them with a large, heavy meal, taking them too early (most take at least 30 minutes to work), or drinking alcohol.

Does alcohol consumption affect how well erectile dysfunction medication works?

Yes. Although alcohol does not directly stop erectile dysfunction medications from working, alcohol in general can reduce or stop the effects of medication because it can cause erectile dysfunction, especially at higher volumes. Alcohol could also increase the chance of side effects from erectile dysfunction medication, like headaches and dizziness. It’s best to use your treatment without alcohol or limiting your alcohol consumption to get the best effect.

Does smoking or vaping have a direct impact on the effectiveness of treatments?

Yes. Smoking or vaping can cause erectile dysfunction or make your symptoms worse, so even if it does not directly impact how the medication works, it can make it less effective when you try it. If you smoke or vape, your doctor may recommend quitting to help with your ED symptoms. It may also help to avoid or limit smoking or vaping before, during, and after using your erectile dysfunction medication.

Do I need a prescription for ED tablets?

Most of the time. A lot of ED tablets are prescription-only, although you can get Viagra Connect or Cialis Together over the counter.

Will erectile dysfunction medication increase my sex drive or libido?

No. erectile dysfunction medication increases blood flow to improve your erection hardness and how long it lasts, but it does not increase your sex drive. However, if treatment helps with your ED, you may find that your sex drive increases again, as you may feel less stress or pressure to get an erection. If you have a low sex drive and treating your ED does not help, it may be caused by something else. We recommend speaking to your doctor if this is the case for you.