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Treatment Options For ED: More Than Pills

Posted on June 13, 2024 by Henry Ford Health Staff
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When you think of erectile dysfunction (ED) treatments, pills likely come to mind. Though they were the first ED treatment to be FDA-approved, oral medications are no longer your only option.

Henry Ford Health urologist Stephen Liroff, M.D., explains the different ED treatments and how to find a solution that works.

Health History and Lifestyle

Before you start treatment for ED, your provider will need to learn more about you. They may perform a physical exam and ask about your symptoms, medical history and lifestyle. 

“There’s no single ED treatment that’s right for everyone, so getting to know the patient’s needs is important,” explains Dr. Liroff. “Sometimes ED is linked to a hormonal imbalance or a condition like diabetes, heart disease or depression. Finding the cause of ED is the first step in choosing the best treatment.”

ED Treatment Options

Once any health conditions have been addressed, you can move on to treatments to help you get or keep an erection. Your options may include:

ED medications

ED medications improve blood flow to the penis, which helps people achieve an erection. These pills are safe and effective for many people, which is why they remain a first-line treatment.

Not everyone should take these medications, however. “Oral medications for ED can cause dangerous interactions if you take them with nitrates, which are medications that treat angina or chest pain,” says Dr. Liroff. “ED medicines can also interact with certain heart medications and alcohol. Finally, depending on the drug, you have to take them 15 minutes to two hours before sexual activity, which requires advanced planning.”

ED injection medicines

If oral medications aren’t right for you, injectable ED treatments are a good next step. “With ED injection medicines, you use a thin needle to place medicine directly in your penis,” says Dr. Liroff. “Up to 85% of men get good results with this treatment, but the main drawback is having to give yourself an injection before sex.”

Penis pump

A vacuum erection device, sometimes called a penis pump, creates a gentle vacuum around the penis to create an erection. “Pumps for ED help draw blood into the penis, and then you use a stretchy band to keep the blood in place,” says Dr. Liroff. “The FDA-approved devices work well for about 75% of patients.”

Low-intensity shockwave treatment (LISWT)

One of the newest therapies for ED is known as low-intensity shockwave treatment (LISWT) or shockwave therapy. “Shockwave therapy emits pulses of energy into the tissues of the penis, which generates a natural healing process,” explains Dr. Liroff. “The tissues respond by increasing blood flow, which helps you get an erection.”

You’ll likely need about six shockwave treatments, spaced over a few weeks. It may take up to three months to see maximum results. “LISWT causes mild tingling, but most patients don’t find it painful,” says Dr. Liroff. “When a licensed provider gives you shockwave therapy, it’s safe and has a minimal risk of side effects.”

It’s important to know the difference between true shockwave therapy and counterfeit versions. A similar-sounding treatment known as radial wave therapy (rWT) is available at healthcare clinics and even non-medical facilities. Though it promises results, it has no science to back up its claims.

“Shockwave therapy has data to show that it stimulates blood flow and generates new blood vessels,” explains Dr. Liroff. “Radial wave therapy doesn’t have these results, and studies have shown that it’s equal to no treatment.”

Meet With A Urologist

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Surgery for ED

Penile prosthesis surgery, sometimes called a penile implant, might be an option if less invasive treatments haven’t worked for you. “There are different types of implants, depending on your needs and preferences,” says Dr. Liroff. “See a urologist who has experience in penile implant surgery to discuss your options.”

Do ED Supplements Work?

Steer clear of herbal medications and “natural supplements” for ED. No studies have proven that they work, and they could be dangerous. 

“The FDA doesn’t regulate ED supplements, so you don’t know what you’re getting,” says Dr. Liroff. “At best, you’re paying for something that won’t give you results. And at worst, you could experience dangerous interactions and side effects.”

Is Topical ED Gel Safe?

One of the newest therapies for ED is a gel you apply directly to the penis. This treatment is not yet sold in the U.S. 

“We need more clinical trials to show that an ED topical gel is as effective as other options,” says Dr. Liroff. “Pills, injections, pumps and shockwave therapy all produce good results and have evidence to show that they work.”

Use caution with unproven ED treatments

Platelet-rich plasma (PRP) and stem cell therapy are two of the newest potential therapies for ED. However, there’s no solid evidence of their effectiveness.

“Right now, PRP and stem cell therapy are unproven,” says Dr. Liroff. “Some small studies say they could help with ED, but others show no results. There are also a lot of questions about how much is effective and which patients might benefit. It’s best to skip these therapies until we have more information.”

Speak to your provider about ED

It can be difficult to address ED with your provider, but remember you’re not alone: ED affects 30 million men in the U.S.

“Don’t be embarrassed to tell your provider about ED,” says Dr. Liroff. “Your sexual health is an important part of your overall health, and we’re here to help you be your best.”


Reviewed by Stephen Liroff, M.D., a board-certified urologist and Physician in Charge at Henry Ford West Bloomfield Urology Clinic.

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