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Last updated October 11, 2019. 2 minute read

If ED medications don't work, is there any hope?

Keep in mind that the medication can be more effective once someone has used them more than once. Anxiety can be an issue, but familiarity with the effects plays a role, as well.

Written by Health Guide
Reviewed by Dr. Jefferson Chen, MD

If you’re someone that’s been struggling with erectile dysfunction (ED), you may have been prescribed sildenafil (brand name Viagra), tadalafil (brand name Cialis), vardenafil (brand name Levitra), or another medication known as a phosphodiesterase-5 inhibitor. These medications are effective for most patients, but not all. If you’re in this frustrating situation, here are a few things to consider.

Vitals

  • ED medications are effective for most patients, but not all.
  • Some healthcare providers recommend using ED medication to masturbate first so that the effect is not experienced in what might be a high-pressure situation.
  • The simplest, non-medication treatment is the use of a vacuum device.
  • If that is not sufficient, a medication called alprostadil can be used, either as a penile suppository or as a penile injection.

Give it time

Keep in mind that the medication can be more effective once someone has used them more than once. Anxiety can be an issue, but familiarity with the effects plays a role, as well. In fact, some healthcare providers recommend using the medication to masturbate first so that the effect is not experienced in what might be a high-pressure situation.

Change the dose

If you aren’t able to have a satisfactory erection for sex on your current dose of ED medication, you may benefit from a higher dose. Speak with your healthcare provider to see if a higher dose of ED medication would be right for you.

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Underlying medical issues

Another reason ED medications may not work is that ED may be caused by an underlying health condition. This can include issues with the nerves, blood vessels, or hormones. If ED medication isn’t working for you, talk to a healthcare provider about getting evaluated for other things that could be causing your ED.

Other options

The simplest, non-medication treatment is the use of a vacuum device. By creating a vacuum in a tube around the penis, blood is forced into the penis, causing it to swell. The placement of a ring at the base of the penis keeps the blood from draining out when the vacuum tube is removed. The penis can release its blood volume when the ring is removed. The ring should be removed after 30 minutes to prevent damage to the penis. Some men find that the use of a ring, or tourniquet, alone helps them keep erections longer. However, using these devices is not without risks. The pressure of the pump can damage blood vessels in the penis, which could worsen erectile dysfunction.

If that is not sufficient, a medication called alprostadil can be used, either as a penile suppository or as a penile injection. It is a vasodilator and causes blood to rush into the penis. When inserted into the penis as a pellet with an applicator, it is called MUSE for Medicated Urethral System for Erections. It is not easily used, has a number of contraindications including causing very low blood pressure, and is painful for many patients. Nevertheless, for some properly chosen patients, it works well and is satisfactory.

Some patients find that the surgical placement of a rod, semirigid implant, or a newer, inflatable implant, gives satisfactory results.

Learn more about erectile dysfunction here.