Erectile Dysfunction (ED, Impotence)

  • Medical Author:
    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Quick GuideSex-Drive Killers Pictures Slideshow: Causes of Low Libido

Sex-Drive Killers Pictures Slideshow: Causes of Low Libido

What drugs treat erectile dysfunction?

Medications for erectile dysfunction include the following:

  • Testosterone
  • Oral phosphodiesterase type 5 (PDE5) inhibitors (sildenafil [Viagra], vardenafil [Levitra], tadalafil [Cialis]), avanafil [Stendra])
  • Intracavernosal injections (papaverine, phentolomine, and PGE1 [Trimix], alprostadil injection [Caverject, Edex])
  • Intraurethral suppositories (MUSE)
  • L-arginine

A doctor can help decide what medication(s) may be the best for the patient. This is an important step to do so the doctor can help choose the best and safest drug(s) and other treatments so that men with other medical problems can get individualized care appropriate for their medical conditions.

What is the treatment for erectile dysfunction?

The following are treatments for erectile dysfunction:

  1. Working with doctors to select medications that do not impair erectile function
  2. Making lifestyle improvements (for example, quitting smoking and exercising more)
  3. Taking drugs to treat ED such as sildenafil (Viagra), vardenafil (Levitra), tadalafil (Cialis), or avanafil (Stendra)
  4. Inserting medications into the urethra (intraurethral suppositories: MUSE)
  5. Choosing treatments and drugs according to each individual’s medical condition
  6. Injecting medications into the corpora cavernosae (intracavernosal injections)
  7. Vacuum constrictive devices for the penis
  8. Penile prostheses
  9. Psychotherapy

Adjusting medications that may cause or contribute to erectile dysfunction

Many common medications for treating hypertension, depression, and high blood lipids can contribute to erectile dysfunction (see above). Treatment of hypertension is an example. There are many different types (classes) of antihypertensive medications (medications that lower blood pressure); these include beta-blockers, calcium channel blockers, diuretics (medications that increase urine volume), angiotensin converting enzyme inhibitors (ACE inhibitors), and angiotensin receptor blockers (ARBs). Antihypertensives may be used alone or in combination to control blood pressure. Different classes of antihypertensives have different effects on erectile function. Inderal (a beta-blocker) and hydrochlorothiazide (a diuretic) are known to cause erectile dysfunction, while calcium channel blockers and ACE inhibitors do not seem to affect erectile function. On the other hand, angiotensin receptor blockers (ARBs) such as losartan (Cozaar) and valsartan (Diovan) may actually increase sexual appetite, improve sexual performance, and decrease erectile dysfunction. Therefore, choosing an optimal antihypertensive combination is an important part of treating erectile dysfunction.

Lifestyle improvements

Quitting smoking, exercising regularly, losing excess weight, curtailing excessive alcohol consumption, controlling hypertension, and optimizing blood glucose levels in patients with diabetes are not only important for maintaining good health but also may improve or even prevent erectile function. Some studies suggest that men who have made lifestyle improvements experience increased rates of success with oral medications.

Oral phosphodiesterase type 5 (PDE5) inhibitors

The common PDE5 inhibitor drugs approved in the United States are sildenafil (Viagra), vardenafil (Levitra), tadalafil (Cialis), or avanafil (Stendra). Actual head-to-head trials between these drugs have not been done to date to see which is the superior drug. Details on each of these medications for erectile dysfunction are outlined below.

Medically Reviewed by a Doctor on 2/25/2016

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