Treatment for erectile dysfunction depends on whether the problem is caused by psychological or physical factors, or a combination of these. Even if erectile dysfunction has a physical cause, it often has adverse psychological effects that make the problem worse and treatment more complicated. The following treatments have a reasonable chance of success:
Treatment to modify reversible causes
Change in current medication e.g. blood pressure medication
Hormone replacement with male hormone testosterone
Corrective surgery in case of penile curvature (Peyronie’s disease) and trauma
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First-line treatment
Oral treatment
Vacuum constriction devices
Psychosexual therapy
Second-line treatment
Intra-cavernosal injection therapy
Third-line therapy
Surgery (prosthesis)
The least invasive treatment should be considered first. Non-surgical treatments work for 60 to 70% of men and may make surgery unnecessary. Although treatments like injections are effective more than 80% of the time, up to 60% of men may eventually drop out of treatment. Sometimes, once men can get an erection again, they realise they have overestimated its importance in their relationships. They may decide that the nuisance or cost of the treatment is not worth the effort.
Reviewed by Dr Werner Botha Specialist Urologist, Cape Town Medi-clinic.
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