ED treatment options: what works and what to try first

If you’re dealing with erectile dysfunction (ED), you have options — and most are straightforward. Some treatments work the same day, some take lifestyle changes or therapy. This page explains the main choices so you can talk to your doctor and pick what fits your life.

Medical treatments that usually help

Oral pills (PDE5 inhibitors) are the most common first step. The main ones are sildenafil (Viagra), tadalafil (Cialis), vardenafil, and avanafil. Sildenafil and vardenafil usually kick in within 30–60 minutes and last around 4–6 hours. Tadalafil can take a bit longer but may last up to 36 hours, which some people prefer. Avanafil often works faster — sometimes in 15–30 minutes.

Important safety note: never take PDE5 inhibitors with nitrates (common in some chest pain meds). That combo can dangerously lower blood pressure. If you have heart disease, uncontrolled blood pressure, or serious liver/kidney issues, review options with a provider.

If oral pills don’t work, other medical choices include:

• Penile injections (alprostadil) — effective for many men who don’t respond to pills.
• Urethral suppositories (MUSE) — a small pellet inserted into the penis.
• Vacuum erection devices — a non-drug mechanical option that pumps blood into the penis.
• Penile implants — a surgical option with high satisfaction for long-term ED.

Fix root causes and use practical tips

ED often links to lifestyle and medical issues. Improving these can boost results from any treatment:

• Get active and lose excess weight — even modest weight loss helps.
• Control diabetes and high blood pressure — better control often eases ED.
• Quit smoking and cut down on heavy drinking — both damage blood flow.
• Talk with a therapist if performance anxiety, depression, or relationship stress are present — sex therapy works.

Thinking about buying ED meds online? Many legitimate telehealth and pharmacy services exist, but be careful. Only use pharmacies that require a prescription, show clear contact info and licensing, and have real patient reviews. Avoid sites with unbelievably low prices or no prescription requirement. Our site has a helpful article, “Top 5 Reliable RexMD Alternatives for Prescription ED Pills: 2025 Guide,” that compares trusted telehealth providers and what to expect from each.

When ordering online, use secure payment methods, check shipping privacy, and keep a copy of your prescription. If a product looks different from what you expected or causes odd side effects, stop taking it and contact your doctor right away.

Quick checklist before you try anything: confirm medical causes with your doctor, review drug interactions (especially heart meds), consider lifestyle changes, and pick a treatment route you’ll stick with. If you want more specific buying tips, read our guides on safe online pharmacies and prescription alternatives.