How medicines fit in

The treatment option that is right for you will depend on factors that are specific to you. No single erectile dysfunction treatment is suitable for everyone. Before you find the treatment that is best for you - and to get the best out of this treatment - you will need to keep working with your doctor.

Before you are prescribed treatment, please consider committing to a healthier lifestyle as that could make a difference too.

First line treatments

Oral therapy

The first type of treatment your doctor will consider is oral therapy - that is, prescription tablets. You might hear them referred to as 'PDE5 inhibitors' or by their individual product names.

Oral treatments require sexual stimulation in order to work and help men with erection problems have sex naturally. When a man is aroused, these treatments help the blood vessels in the penis relax. This allows blood to flow into the penis and improves erectile function. Once sex is over the erection goes away.

There are 3 types of oral therapy available. All three work in the same way, but do have some differences. Talk to your doctor to see which of these, if any, is right for you.

It is important to remember that, as with all drugs, oral therapy is not suitable for everyone. In patients with some conditions or on some treatments, oral treatment cannot be prescribed.

Overall, though, these medicines are proven to be effective and well - tolerated in men with ED. Oral therapy is the most commonly prescribed treatment for erection problems.

SIDE-EFFECTS: As with all medicines PDE5 inhibitors have possible side effects. Common side effects include headache, dizziness, effects on vision, flushing, stuffy nose, indigestion, a sensation of a pounding heartbeat, abdominal pain, reflux, nausea, back pain and muscle pain.

Hormonal therapy

In a small number of cases, erection problems can be caused by a hormonal imbalance. This must be diagnosed by your doctor through blood tests. In such cases, it may be possible to restore hormone levels by appropriate hormone replacement.

Further treatments

Intracavernosal injections

This involves injecting a medicine directly into the base of the penis and is a very effective form of ED treatment.

An intracavernosal injection relaxes the blood vessels, increasing blood flow into the penis, and making it easier for men to have an erection. After learning the procedure, men and/or their partners find it fairly easy to administer the injection.

As with all treatments for erectile dysfunction, there are patients with certain conditions or on some treatments who are not suitable for treatment with intracavernosal injections. Talk to your doctor for more information.

SIDE-EFFECTS: The most common side effect of this treatment is pain in the penis. Other common side effects include swelling and skin discolouration at the site of injection, prolonged and painful erections, tender lump in the penis and penis becoming scarred, bent or kinked.

Transurethral Therapy

This treatment involves inserting a pellet into the urethra - the tube in your penis that urine passes through - via the opening at the end of the penis with a disposable applicator. The medicine is then absorbed through the wall of the urethra into the surrounding tissues where it increases the flow of blood into the penis, which causes an erection.

As with all treatments for erectile dysfunction there are patients with certain conditions or on some treatments who are not suitable for treatment with transurethral therapy. Talk to your doctor for more information.

SIDE-EFFECTS: The most common side effects of this form of treatment include aching in the penis, testicles, legs and perineum and warmth or a burning sensation in the urethra. Minor urethral bleeding can occur if the treatment is not correctly administered.

Mechanical treatments

In some cases, a doctor will prescribe a vacuum constriction device for men with an erection problem.

This consists of a plastic cylinder which is placed over the penis. Air is then pumped out with an attached pump. This creates a vacuum, drawing blood into the penis leading to an erection. The erection is maintained by trapping the blood in the penis with a constricting band at the base of the penis. This treatment has a high rate of success.

As with all treatments for erectile dysfunction there are patients with certain conditions or on some treatments who are not suitable for treatment with vacuum devices. Talk to your doctor for more information.

SIDE-EFFECTS: The side effects associated with vacuum devices include bruising, pain in the penis and failure to ejaculate.

Third-line treatments

The last form of treatment, one which is only suggested when all other treatments have failed, is penile prosthesis. These are essentially splints which are inserted surgically into the penis.

There are two types. The first consists of semi - rigid rods that keep the penis upright all the time, but that allow the penis to be bent downwards out of the way when not required. The second is a hydraulic pump which causes a stiffening of the penis when a pump - implanted in the scrotum - is activated.

Three ways to get the best from your treatment

1. When you visit your doctor, try to give them as much information as possible to help in your diagnosis and in determining the possible cause of ED.
2. Make sure you read the information that comes with your treatment and that you use it correctly.
3. Give yourself enough time to get used to your treatment - don't put yourself under too much pressure to perform the first few times you try it.

There are no shortcuts

It might seem easier to take a shortcut and try and get treatments from the internet. But a lot of these treatments are likely to be fake and could have serious consequences to your health. The only way to be certain your erectile dysfunction treatment is suitable for you, genuine, and from a legitimate, regulated source is to talk to your doctor.

There are some legitimate online pharmacies which are registered with the Royal Pharmaceutical Society of Great Britain.

Worried about talking to your doctor?

Talking to your doctor is the only way to make sure that the treatments you get are genuine. If you are tempted to buy from any other sources - illegitimate websites, emails, friends - you risk leaving yourself open to harmful ingredients such as:

• Boric acid
• Lead-based road paint
• Talcum powder
• Floor wax

Think you have got fake medicine? Email the Medicines and Healthcare Products Regulatory Agency at counterfeit@mhra.gsi.gov.uk.