Erectile dysfunction treatment: your options for ED caused by physical, psychological, and lifestyle factors

Written with
Dr Matthew Chan

How to treat erectile dysfunction: it’s about matching treatments to causes

Figuring out how the best treatment for erectile dysfunction (ED) can be a little confusing. A good place to start is to work out what’s causing the problem.

You can speak to your doctor to understand whether your problem is psychological, physical, or lifestyle-related (or a mixture of all 3). They’ll sort out any tests and give you the diagnosis you need. 

Once you know what’s causing your ED, you can start the most effective treatment plan. The good news is that there are many ED treatment options available, no matter what’s holding your boners back.

We’ve asked our team of experts to break down these treatments, so you know what’s available and how to get started. In our expert line-up we have:

We’ll be covering:

Part 1: Treating the psychological causes of ED 

Psychological erectile dysfunction is a broad umbrella term for all the emotional and mental factors that can impact your erections. 

The options below can help you treat erectile dysfunction naturally. This means no pills, no pumps, no penis injections – just sustainable, long-term erectile dysfunction treatment for psychological ED. (Sounds more appealing, in our humble opinion.)

Therapeutic treatment

  • Psychosexual therapy (which can include CBT, sensate focus, and couples counseling) is a recommended treatment for pretty much all psychological ED causes
  • Psychological therapy can help with non-sexual mental health problems, which can in turn help with erectile dysfunction (because your mental health has a big impact on your erections) 

Communication-based treatment 

  • Community support, either anonymously on our forum, or on one of our live video calls (this can be anonymous too). These platforms let you vent to guys who get it, and hear firsthand advice on how to solve your ED issues 
  • Communication with a partner, friend, or someone else you trust can be a huge relief – and having an open conversation might even be enough in itself to reduce your ED symptoms

Treatment you can try solo

  • Mindfulness, meditation, and guided imagery all contribute to your ability to stay in the present moment and ultimately stay calm – they’ll help you enjoy sex, instead of overthinking it
  • Learning more about erectile dysfunction is empowering, and taking away the mystery can make you feel more in control. (You’re already researching ED – so keep it up)
  • Sex education is the best way to deepen your understanding of sex, and believe it or not, this can be the key to unlocking an incredible sex life
  • Relaxation, breathing, and grounding exercises or podcasts are great tools to tackle stress and anxiety
  • Mindful masturbation (or directed masturbation) applies the principles of ‘staying present in the moment’ in a sexual context 
  • Eating well, getting enough sleep, and exercising regularly all help contribute to a more balanced, relaxed state of mind. Our lifestyle section will help you get started on this one

FYI: you can try all of these treatments with our trial, in the total privacy of your home.

“Psychosexual, psychological, and mindfulness-based techniques can be incredibly effective for men dealing with ED. One-on-one therapy might be inaccessible to some people, but Mojo uses the same techniques therapists use, so more men can see the results.”

Amanda Barge, psychosexual and relationship therapist

We’ve got a deep-dive on psychological ED treatment here, if you’d like to know more. 

Part 2: Treating the physical causes of ED

There are also lots of physical ED reasons you might be struggling to get it up, and these can affect different guys in different ways. 

ED pills 

For lots of men with physical erectile dysfunction, ED medication can be helpful for a one-off erection, but pills won't provide a longer-term cure for your erection issues.

“Pills are ‘cause agnostic’, which is a fancy way of saying that they work, but they don’t address the underlying issue.”

Dr Matthew Chan, medical doctor

The most widely used drugs for ED belong to a group of medicines called PDE5 inhibitors. You probably know them by their brand names – the most famous one is Viagra.

How do PDE5 inhibitors help you get an erection?

PDE5 is an enzyme in the walls of blood vessels. It affects how our blood flows and how our cells communicate with each other and other parts of the body.

PDE5 inhibitors stop this PDE5 enzyme from working for a short period of time. This temporary block causes the blood vessels to relax and increases blood flow to the penis, allowing you to get an erection. 

These pills can be great for physical ED, but they’re not so effective for psychological erection problems: 

“These medications help keep blood in the penis to help you maintain an erection. However, if you’re anxious about sex, your body is in a state of ‘fight or flight’ and is busy sending blood to your skeletal muscles and brain. There’s no blood going to your penis for the medication to keep in there, so it won’t help you get erect.”

Angus Barge, co-founder of Mojo 

Our handy table breaks down the different kinds of ED pills available:

Side effects of oral erectile dysfunction treatment

Common side effects for ED meds include headaches, stomach upsets, and nasal congestion.  

This isn’t a complete list, so it’s important to read the information provided in the box your medication came in, and to listen to any instructions from your doctor.

Risks of ED pills

You should also tell your doctor about any other drugs you're taking or health conditions you have before taking any meds for ED. 

ED drugs aren’t safe to take with cardiac drugs because they can trigger a dangerous drop in blood pressure when taken together. 

Other meds that help with urinary symptoms can lower blood pressure too, but your doctor might be able to reduce the dose of any ED pills prescribed to keep within safe limits.

It's also important to be mindful that using ED pills could lead you to form a dependency on this medication to get an erection.

"Men can become dependent on erection pills like Viagra. It can actually make the situation worse by adding a psychological element, because they may begin to think they can't get hard without popping a pill."

Angus Barge, co-founder of Mojo 

Penis pumps and vacuums

You probably know it as a penis pump, but it’s got an even less sexy medical name too. A vacuum constriction device (VCD) is a piece of kit some men with ED use to get an erection, and it comes in 3 parts: 

  1. An acrylic cylinder that fits over the penis
  2. A pump that can either be operated by hand or batteries depending on the model
  3. A band that you place tightly around the base of the penis once the pump has done its thing

Once your penis is inside the cylinder, you use the pump to create a vacuum. This draws the blood up into the penis, causing it to get hard.

To hold the blood in place, put the band around the base of the penis. This can help you maintain an erection for about 30 minutes – but it’s important to do your homework before you get pumping. Overuse can leave you bruised and damage your penis. 

ED rings

You can use an ED ring to prolong your erection by placing it around the base of your penis once you’re erect, to slow blood flow away from the penis. 

If you’re thinking of giving an ED ring a try, here are some tips:

  • Use lube to help gently ease the ring on and off 
  • Wash the ring with warm water and mild soap before you use it
  • Be careful not to catch your pubes (trust us)

Hormone replacement therapy 

If your erectile dysfunction is down to abnormal hormone levels, your doctor might suggest hormone replacement therapy (HRT).

HRT can help restore your hormones to normal levels, which should improve ED. Depending on what hormone you’re taking, HRT might involve taking pills, rubbing gel on your skin, or getting injections. 

"Remember, you shouldn't consider replacing hormones themselves (e.g. self medicating with testosterone), as that can be dangerous without doing the right tests and getting medical advice."

Dr Matthew Chan, medical doctor

Physiotherapy, rehab, and at-home pelvic floor exercises

Physiotherapy and rehab tend to be used to help solve erectile dysfunction caused by injury, trauma, or the effects of surgery. It depends on what you’re recovering from, but braces, aids, and supports may be used in addition to physio exercises.

Your pelvic floor can be too tight or too weak, and erections can be improved when men use pelvic floor exercises regularly.

Mojo’s guided pelvic floor training sessions are a great way to test drive these exercises in your own time. You can try them here.

Vascular surgery

If ED is caused by a blockage or leak within the veins of the penis, vascular surgery can remove or go past the hold-up. This can restore better blood flow, so natural erections can return. 

But this type of surgery is very rare, and surgeons follow pretty narrow guidelines to decide who could benefit from it once other treatments have failed.

Penile medication for ED

For some guys, medication works best when it’s given locally to the penis. That’s a less terrifying way of saying ‘injecting your penis’. 

Alprostadil is a prescription drug that makes your blood vessels expand, and encourages blood flow around the body. When it’s administered to the penis, this can help you get hard.

There are 2 ways of doing this: 

  1. Self-injection: A fine needle is inserted into the base of the penis and a dose of alprostadil is injected to produce an erection that lasts about 1 hour. Not for the faint-hearted

  2. Alprostadil urethral suppository: A tiny pellet is inserted inside your urethra (the tube you pee out of). This produces an erection that lasts from 30 minutes to 1 hour

Penis implants for ED

Implant surgery is a rare treatment option for erectile dysfunction because, like all operations, it’s invasive and carries some risks. But for some hard-to-treat cases, surgery can be the right call.

There are 2 types of penile implants: 

  1. Semi-rigid (bendable) penis implants are made of 2 easy-to-bend silicone rods that are permanently inserted into the penis. These make the penis firm enough for sex but you can still bend it downwards to pee

  2. Inflatable penis implants involve fluid-filled cylinders being inserted lengthwise along the inside of the penis. These are connected to a manual pump placed between the testicles, which is used to inflate the tubes and form a natural-feeling erection

Part 3: Treating the lifestyle causes of ED 

Here, we’re breaking down some day-to-day lifestyle choices that could be impacting your erection, with some expert tips for each.

These can not only help improve erectile dysfunction, but can also prevent erection issues popping up in the first place. 

Eat a healthy diet

  • If you’re short on time, try blending up some fruits and veggies to get all your goodness in one
  • Stay seriously hydrated (2 liters every day, at least)
  • Try Brazil nuts for a libido boost
  • If you want to know more, we’ve got a deep-dive on all the specific foods that can strengthen your erections

Get enough exercise

  • Try focusing on ‘movement’ instead of ‘exercise’ – this could mean taking the stairs, cycling to work, or going for a walk with a friend instead of a sit-down coffee
  • If you find the gym tedious, try different activities until you find one you love. Reconnecting with a sport you enjoyed as a kid could be the way to go
  • This should help keep your BMI in check, which can help to strengthen your erections

Avoid or limit alcohol

  • If you want to keep drinking, order a glass of water with your alcoholic beverage, don’t mix spirits with sugary drinks, and stick to beers with less than 6 ingredients
  • If you’re thinking about cutting out or drastically cutting down on booze, take a look at some sober-curious networks, like Club Soda
  • And, of course, Alcoholics Anonymous is free, global, and can help people who want to get sober

Secure plenty of sleep 

  • If possible, give yourself a bedtime and stick to it 5 days a week. If you work irregular hours, just do your best to get to bed 8 hours before you need to get up again (this will be more like 10 hours if you’re a teen)
  • Keep your bed a phone-free zone
  • No social media after 11pm (the blue light really does mess with you)

Avoid or cut down on recreational drugs 

  • Drugs, including cocaine, can cause erection issues
  • Some people associate certain drugs with certain friend groups or activities, and you might have to remove yourself from these people or events for a while (we know it’s asking a lot, but put your health first) 

Quit or cut down on cigarettes

  • Nicotine has a direct effect on erections, especially if smoking before having sex
  • Start by cutting out one ‘smoking routine’ from your day – like the cigarette with your morning coffee, or the smoke when you’re waiting for the bus
  • Eliminate another ‘smoking routine’ the next week, and the week after, and so on, and you’ll find you’ve cut down in a more manageable way 

Avoid steroids 

  • Anabolic steroids can reduce your testosterone levels and your libido, which can be a real recipe for ED
  • If you’ve been using steroids heavily, you may want to talk to your doctor about treatment options
  • And if you’ve been using steroids to look a certain way or perform better in sporting activities, try opening up to someone you trust, or reaching out to online communities of men who have been through the same thing

Take care of your mental health 

We know living a healthy lifestyle is much easier said than done, so we asked Aron for some expert advice on how to stay motivated:

“Keep your goal in mind when you make decisions. Let’s say you’re deciding what to eat for dinner tonight. Without a goal in mind you may let laziness win and choose a food delivery. Deliberately considering your goal can be enough to encourage you to cook for yourself instead. It sounds so simple, but if you keep this mindset, making the right decision gets easier and easier until it’s simply routine.

Pairing this with visualization and mindfulness meditations can seriously boost your progress.”

Aron Hywel Snowsill, nutritionist and lifestyle expert

Remember: making these changes could be the key to better erections and mind-blowing sex. Pretty great motivation for a health kick, if you ask us. 

Erection experts

No matter what triggered your erection issues, Mojo is here to help. We understand that even if your ED started as a physical problem, the psychological impact of a bad experience in the bedroom can make matters much worse. 

Try out all the tools you’ll need to get your erections back on track with our trial – no strings attached.

After all, it is our speciality.

Mojo aims to provide useful wellbeing resources to its users; however, you should not solely rely on opinions or advice available on the Website or given by the Community. Always seek advice from a qualified medical doctor or other healthcare professional before acting.

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