8 Treatment Types for ED
In this article, we'll look at eight of the most prevalent ED treatments and compare the costs, effectiveness, and side effects for each.
In the past 25 years, treatments for erectile dysfunction have advanced significantly. Today, the 52% of men who experience problems with erectile function have more options available than ever before. Many men will try more than one approach in their quest to find the treatment that delivers optimal results. Others will transition from one treatment option to another when they develop an intolerance or resistance to a specific treatment or as the severity of their ED symptoms increase.
While some physicians are aware of the full range of treatments available, others may not have the full picture. By keeping up with the latest treatment trends, men with ED can make sure that they choose the ED treatment that fits their budget, minimizes side effects, and delivers optimal results.
Oral ED medication
When the "little blue pill" was introduced in 1996, it transformed the possibilities for men with erectile dysfunction. Oral ED mediation is relatively inexpensive, has relatively few side effects, and is effective for a high percentage (up to 80 percent) of men who use them. Because of these factors, oral ED medication has become the most popular treatment and is often the first approach to ED that a physician or urologist will recommend to a patient.
Cost: Moderate. Oral ED medication costs between $10 and $20 per treatment.
Effectiveness: High. 70-80 percent of men report that oral ED medication is effective for them. However, effectiveness tends to diminish for older men.
Side effects: Minimal. Vision changes, muscle pains, low blood pressure, headaches, flushing, gastrointestinal issues. A small percentage of men discontinue oral ED medication due to side effects.
Injectable ED medication
Injectable ED medications (also known as intracavernosal ED medications) were approved by the FDA in 1995. They have a high rate of success, producing an erection in up to 80% of patients. A study of the effectiveness and satisfaction rates for long-term users of injections found that about 70% of men were highly satisfied with this therapy.
However, injections can cause side effects, including fainting, dizziness and low blood pressure. For men who have difficulty administering the injection, pain, infection, bruising, and scarring can occur. As many as 15-20% of men discontinue the treatment because they find it unpleasant or painful.
Cost: Moderate. Injectable ED medication costs between $10 and $20 per treatment.
Effectiveness: High. Approximately 80 percent of men experience an erection, and about 70 percent of men reported being highly satisfied with this type of treatment.
Side effects: Moderate. While the majority of men experience manageable side effects, as many as 15-20 percent discontinue the treatment due to pain or discomfort.
Urethral ED medication
ED medication in an insertable, pellet form was approved by the FDA soon after injectable medication. A vasodilator pellet is inserted into the urethra (the opening of the penis) using a MUSE (Medicated Urethral System for Erections) where the medication is rapidly absorbed.
Urethral ED medication is more expensive and has a lower success rate in treating ED than injectable or oral medication. However, it can be recommended for men who do not see any benefit from taking oral ED medication and who are unable or prefer not to perform injections.
Cost: Expensive. MUSE costs approximately $60 per treatment.
Effectiveness: Moderate. According to Harvard Health, only 50% of men see results from this type of ED treatment, compared to approximately 80% of men who use oral or injectable medication.
Side effects: Moderate. As many as 30% of men experience penile pain as a result of using urethral ED mediation. Other, less common side effects include bleeding, spotting, low blood pressure and dizziness. Female partners can experience burning or itching, possibly as a result of contact exposure to the medication.
ED rings are tight-fitting, elastic rings or loops that constrict the base of the penis to prevent blood outflow, a condition known as venous leakage that prevents or reduces the strength of the erection.
Because they prevent outflow, ED rings can be an excellent complementary therapy to oral, injection, and urethral medications, all of which are vasodilators that primarily address blood inflow. ED rings also work well with vacuum erection devices (also known as penis pumps), and in fact, most of these devices are shipped with some type of constriction ring included. See more detailed information about ED rings here.
Cost: Inexpensive. Constriction rings come in a variety of styles and materials. However, even the most expensive rings can be used multiple times, making them one of the most inexpensive ED treatments on a cost-per-use basis.
Effectiveness: Moderate. Few ED rings have undergone clinical trials. However, a clinical trial of the Xialla ED ring found that 66% of patients reported significant erectile function and sexual function.
Side effects: Minimal. ED rings have none of the side effects of drugs and can be used by men who are unable to tolerate ED medication. A very small percentage of men may experience temporary discomfort and numbness when using an ED ring, especially if the ring is the wrong size.
ED pumps, which are also called penis pumps, vacuum pumps, or vacuum erection devices, are a popular treatment for ED because they are effective, low risk, and relatively low cost. Pumps work by creating a vacuum that encourages the inflow of blood to the penis to create an erection. Pumps are a popular ED treatment because they are effective, low risk, and relatively inexpensive.
For some men, pumps provide a way to avoid more invasive ED treatment methods such as surgery. For others, using a pump in combination with other treatments, such as ED medication, penile implants, or injections, can enhance overall results.
Cost: Moderate. While high-quality, medical-grade ED pumps cost several hundred dollars, they can be used multiple times at a very moderate cost per use.
Effectiveness: High. ED pumps are a proven, effective way to treat erectile dysfunction by stimulating blood inflow, with studies showing satisfaction rates of up to 85%.
Side effects: Minimal. Men who use ED pumps report minimal side effects, which can include priapism (persistent and sometimes painful erection) or mild subcutaneous (under the skin) bleeding caused by excessive air pressure created in the pump cylinder.
Penile splints and rigidity devices
Penile splints, also known as external penile support devices or rigidity devices, are flexible structures that hold the penis erect during sexual intercourse. While inexpensive options can be purchased in standards sizes, premium models require customers to take measurements for a custom fit.
While penile splints and other rigidity devices are relatively new and unproven ED treatments, the National Center for Biotechnology Information stated that the "unique and technologically innovative design" of some devices deserves mention as an option for patients who want to avoid invasive or pharmacological treatments.
Cost: Moderate. Penile splints cost around $300 and can be used multiple times at a moderate cost per use.
Effectiveness: Unknown. The effectiveness of this type of ED treatment is currently unknown, because there have been no documented research or clinical trials to prove the efficacy of the treatment.
Side effects: Minimal. According to top vendors of penile splints, users experience no side effects.
ED shockwave therapy
Research into the use of ultrasound, or shockwaves, to treat ED began in the 1990s. The treatment is based on the premise that ultrasound can stimulate the growth of endothelial cells that control vascular relaxation and contraction. By increasing the number of endothelial cells in the penis, researchers hoped to increase erectile function.
In a small pilot study of 20 men conducted in 2010 and a larger study of 67 men conducted in 2012, shockwave therapy measurably improved erectile function and penile rigidity. However, it is important to note that the class 2 device used in these early studies is not currently available outside of a clinical trial. The shockwave ED therapies available to consumers today are delivered using a class 1 medical device, which has not been proven to deliver any therapeutic benefit.
Cost: High. Shockwave therapy costs $2,500 or more, and because it's not an approved therapy, it is not covered by most healthcare plans.
Effectiveness: Unknown. Early trials indicate promising results, but more research is needed into the short- and long-term effects of shockwave therapy.
Side effects: Minimal. Side effects have been minimal in early pilot studies and include bruising of the skin and skin infections that can make erections and sexual intercourse difficult or painful.
ED surgery and penile implants
First developed in the 1970s, penile implants are one of the oldest ED treatments. ED surgery to insert inflatable or flexible rods into the penis is a higher-risk treatment option and is usually reserved for men who do not see results from less invasive ED treatments such as oral and injectable medication or ED rings and other wearable devices. In addition to the rods, a pump is inserted into the scrotum that enables the wearer to inflate the device and create an erection.
While implants are seen as a last resort by many men, the treatment has consistently high satisfaction rates and few side effects, suggesting that men with advanced or treatment-resistant ED should consider implants to restore erectile function.
Cost: Very high. Penile implant costs range from $16,000 to $19,000.
Effectiveness: High. This treatment has a satisfaction rate of 90%, and those satisfaction levels remain high over the long term. A 2019 study of 51 men found that 60% were still using the device with high satisfaction 20 years after receiving the implant.
Side effects: Minimal. The side effects of penile implants are largely related to the risks associated with surgery, such as infection, bleeding, and the formation of scar tissue. In rare cases, an implant can malfunction and require additional surgery for removal or repair.