1. Oral Medication — PDE5 Inhibitors - Sildenafil (Viagra), Tadalafil (Cialis), Vardenafil (Levitra), Avanafil (Stendra/Spedra). First-line therapy in \~70–80% of cases, especially those with vascular or mild‑moderate issues.
2. Low‑Intensity Shockwave Therapy (Li‑ESWT / ESWT) - A non‑invasive, drug‑free option that stimulates new blood vessel growth in penile tissue, potentially addressing some underlying causes of ED rather than just symptoms.
3. Penile Injections & Urethral Suppositories - Penile injections (e.g. alprostadil alone or in combination such as Trimix) provide rapid effect, often within minutes; effective when oral meds fail.
4. Vacuum Erection Devices (VED / Penis Pump) - A non-drug, non-surgical device that uses vacuum suction to induce an erection, maintained via a tension ring. Safe and effective, with no systemic side effects, but erections may feel less natural and ejaculation is restricted while the ring is in place.
5. Penile Implant Surgery - Last-resort surgical option, used when other treatments fail. Includes inflatable or semi-rigid implants inserted into the penis.
ED is common and treatable. Start with lifestyle improvement and a specialist consultation, then consider first-line treatment with oral PDE5 inhibitors. If those fail, long-term options like shockwave therapy, injections, or devices may help. Surgery is reserved for persistent, severe cases. Additionally, addressing stress or mental health can be as crucial as medical or device-based interventions.
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