The Doctor Service erectile dysfunction prevention and treatments

Erectile Dysfunction – Prevention & Treatment

Prevention of Erectile Dysfunction

Having a medical assessment helps to prevent the cause of erectile dysfunction before considering ED treatment. If necessary, a physical examination or further lab tests may be tested…

Treatment options can be with tablets or therapy depending on the cause. Therapy based treatments include counselling, cognitive behavioural therapy and psychotherapy such as focused sex group therapy.

For psychological problems, often a short course of tablets to help with erections may help to build confidence. But they may not be the best way to manage psychological causes of erectile dysfunction in the long term.

Erectile Dysfunction Treatment

Viagra, Sildenafil & others – Phosphodiesterase-5 inhibitors (PDE-5)

There are various medical treatments that have been shown to work for the majority of men, and PDE-5 inhibitors such as Viagra are the most commonly used. These have revolutionised the management of ED, with their demonstrated efficacy, ease of use, good tolerability, excellent safety, and positive impact on quality of life.

How do PDE-5 inhibitors work?

PDE-5s help with muscle relaxation of the arteries to the penis, resulting in increased blood flow to the penis and therefore a penile erection.

Different PDE-5 inhibitors

Different medicines can be tried, such as Viagra (sildenafil), Cialis (tadalafil), Levitra (vardenafil) or Spedra/ Stendra (avanafil). These drugs have a brand name, which are made by pharmaceutical company which invented the medicine, and non-branded names, also known as generics, which are the names in the brackets.

Viagra is the most popular drug. Like the others, it works by widening the blood vessels once a man is already aroused to help get and maintain an erection. It works within one hour and can help one initiate or maintain an erection usually up to 4 hours after taking it.

A common misconception is that using the drug will cause erections at any time and could cause erections that don’t end. In fact, the man must be sexually stimulated for the drug to work and in most men the erection will go away after climax is reached.

Side-effects can occur though, with some more common than others. More common effects can include headaches, visual disturbances and dizziness. The other medications work in a similar way, but Cialis can work for much longer – up to 72 hours, and Avanafil has been shown to work faster – within 15 minutes.

Other Options

Sildenafil (Viagra) was a prescription only medicine until recently, and it can be bought directly from pharmacies following pharmaceutical consultation. However all other PDE-5 inhibitors remain prescription-only, so it must be prescribed by a suitably qualified medical professional. These drugs can sometimes interact with other drugs and foods, so you should follow any medical advice you have been provided. If these treatments aren’t working, there are other options. These include injections, creams, vacuum pumps, rings, external splints, vibrators

Nutrition may have a big role to play in managing and prevention of ED, with many studies showing ED is affected by what we eat. There is a lot of research going on, with still emerging evidence.

ED is a topic often not discussed. However, it is a common condition that can seriously affect a man’s confidence, and sex relationships. There are many different treatments that have been shown to work; however, it is important to consider the causes of why you have ED too.

If you would like further information and treatment, please visit The Doctor Service Erectile Dysfunction page for further information.

Edited by Dr Kiran Sodha & The Doctor Service


  1. Guidelines on Male Sexual Dysfunction: Erectile dysfunction and premature ejaculation; European Association of Urology (2015)
  2. Melnik T, Soares BG, Nasello AG; The effectiveness of psychological interventions for the treatment of erectile dysfunction: systematic review and meta-analysis, including comparisons to sildenafil treatment, intracavernosal injection, and vacuum devices. J Sex Med. 2008 Nov 5(11):2562-74. doi: 10.1111/j.1743-6109.2008.00872.x. Epub 2008 Jun 17.
  3. Nehra A, Jackson G, Miner M, et al; Diagnosis and Treatment of Erectile Dysfunction for Reduction of Cardiovascular Risk. J Urol. 2013 Jan 9. pii: S0022-5347(13)00009-8. doi: 10.1016/j.j
  4. (2017). Erectile dysfunction – NICE CKS. [online] Available at:
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