Treatments
Every ED treatment, in the order doctors try them
Nobody starts with surgery. Treatment follows a fairly consistent ladder — and knowing which rung you are on tells you what to ask for next.
Start here
These treat the cause rather than the symptom. They are slower than a pill and they are the only things on this page that make the underlying problem better. Do these alongside whatever else you choose.
Lifestyle changes
The only approach that treats the cause rather than the symptom — and the only one that also lowers your risk of a heart attack.
- Prescription
- Not needed
- Typical cost
- Free to low cost
- How fast
- 6 weeks to 6 months
- How well it works
- Meaningful improvement for many men; often enough on its own in milder cases
Read the full guide
Counselling and sex therapy
For ED that is driven by anxiety, depression, or what is happening in the relationship — and as support alongside any physical treatment.
- Prescription
- Not needed
- Typical cost
- $60–$200 per session; often partly covered by insurance
- How fast
- 6 to 20 sessions is typical
- How well it works
- Strong for anxiety-driven ED; improves outcomes when added to medical treatment
Read the full guide
First choice
Where nearly every man begins. Effective for roughly two thirds of men, cheap as generics, and low risk apart from one absolute contraindication.
Pills (Viagra, Cialis, and the rest)
Four prescription tablets that relax the arteries in the penis so more blood can get in. Where nearly every man starts.
- Prescription
- Yes — including from an online clinic
- Typical cost
- $1–$5 per dose for generics; far more for brand names
- How fast
- 15 to 60 minutes, depending on which one
- How well it works
- Roughly 6 or 7 men in 10 respond well
Read the full guide
If pills do not work
Both of these work when pills have genuinely failed, including in men with nerve damage from diabetes or prostate surgery. Neither is as bad as it sounds.
Vacuum erection devices
A cylinder and pump that draw blood into the penis mechanically, held in place with a ring. No drugs, no needles, works with almost any cause.
- Prescription
- Available over the counter, but get a prescription one
- Typical cost
- $100–$500 once; often covered by Medicare Part B
- How fast
- Works the first time you use it correctly
- How well it works
- Produces a usable erection for roughly 3 in 4 men
Read the full guide
Injections and urethral suppositories
A tiny needle into the side of the penis that produces an erection directly, without needing arousal first. The most reliable option short of surgery.
- Prescription
- Yes, and the first dose must be given in a clinic
- Typical cost
- $10–$40 per dose, depending on the formulation
- How fast
- 5 to 20 minutes
- How well it works
- Works for 7 to 9 men in 10, including many pill non-responders
Read the full guide
Only if the tests say so
Useful for a specific group of men and heavily oversold to everyone else.
Testosterone therapy
Genuinely useful if your testosterone is measurably low. Widely oversold to men whose levels are normal.
- Prescription
- Yes, after two confirmed blood tests
- Typical cost
- $30–$150 a month, plus ongoing monitoring bloods
- How fast
- 3 to 6 months for full effect
- How well it works
- Reliably improves libido and energy when levels are truly low; less reliable for erections
Read the full guide
When nothing else has worked
Permanent, irreversible, and with the highest satisfaction rate of anything on this page. Those facts sit together uncomfortably — take the decision slowly.
Penile implants
Surgery that places a device inside the penis. The highest satisfaction rate of any ED treatment — and the only permanent, irreversible one.
- Prescription
- Surgical referral to a urologist
- Typical cost
- $15,000–$25,000 without insurance; often covered with documentation
- How fast
- 4 to 6 weeks of healing before use
- How well it works
- Satisfaction above 90% in most published series
Read the full guide
Not proven — be careful here
Marketed hard, priced high, and still classed as investigational. Included so you can recognise the pitch.
Shockwave therapy
Sold aggressively by cash-pay clinics at $3,000 or more. Still classed as investigational, and not FDA-approved for ED.
- Prescription
- No — which is part of the problem
- Typical cost
- $3,000–$6,000 for a course, almost never covered
- How fast
- Claims of 1 to 3 months after a course of sessions
- How well it works
- Unproven. Considered investigational by professional bodies.
Read the full guide
Not sure which of these applies to you?
The causes determine the options. Start by working out what is actually going on, then come back to this page.