My Medicine Cabinet: 7 Tips for Dealing With Erectile Dysfunction
Our Medicine Cabinet series explores what real people keep on hand and consider essential for their particular needs — even if a doctor didn’t prescribe it.
Key takeaways:
Erectile dysfunction (ED) is common, affecting up to 30 million people in the U.S.
If you are experiencing ED, you should look at ways to improve your nutrition, exercise, and sleep, and reduce your stress.
If you take pills for ED, make sure you’re taking them correctly.
Dr. Mehul Patel never planned on becoming a urologist. During medical school, “If you asked me during the first 2 years what a urologist was, honestly, I would have had no idea,” the 32-year-old from Atlanta admits. “But [urology] happened to be one of my first rotations, and I loved it.”
Erectile dysfunction (ED) is one of the most common conditions that Mehul sees in his practice. ED happens when a person with a penis consistently cannot maintain, get, or keep an erection long enough to have satisfying sexual intercourse. It’s a common problem that affects up to 30 million people in the U.S.
People with ED symptoms usually go to their primary healthcare provider first for treatment.
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“If they want a little more information, or they don’t do so well with initial therapies, they’ll often come to a urologist,” he says. While Mehul typically sees patients who are older, ED is not limited by age. He has seen men as young as 18 affected by it.
Stress, depression, low testosterone, nerve problems, and some medications can all contribute to ED. But it’s most commonly a blood-flow problem and can even be a warning sign of heart disease, he says.
“Blood flow to the penis is very important for erections,” Mehul says. “As you can imagine, things that affect blood flow to other parts of the body also affect blood flow to the penis.”
“All the things you think about that can affect your heart, a lot of times that will affect your erections, too,” he says. So, he urges people to focus on diet, exercise, sleep, and reducing stress.
Here are seven things Mehul recommends to help people experiencing erectile dysfunction:
1. Get a good night’s sleep
When patients are stressed, they often don’t sleep well. Making sure to get a good night’s sleep goes hand in hand with stress reduction. Patients will often ask about any supplements that might help with restful sleep. While there is no definitive evidence to support their benefit, if needed, you can try things like melatonin to help with sleep.
2. Adopt a heart-healthy approach to diet and exercise
“The heart-healthy diet can work for erectile dysfunction, too,” Mehul says. It may not be what patients want to hear, but studies have suggested a vegan or plant-based diet can actually help your overall health, including ED. Reducing red meat, eating more vegetables, and drinking less alcohol is also beneficial. Exercise can also keep your heart healthy.
3. Testosterone levels can be a cause
Mehul says some men may have low testosterone levels. It’s one of the things he checks when people come in to be tested for ED. While normalizing testosterone levels alone won’t solve everything, getting it back to a normal level may help, he says.
4. Make sure to take erectile dysfunction pills correctly
Mehul says that many people will try pills once and stop using them. This is often because, much of the time, patients are taking them improperly. They will go out for dinner, have a few drinks, come home, and take it. “People just think that's magically going to work,” says Mehul.
However, for a pill like Viagra, the best practice is to take it on an empty stomach at least 1 hour before having sex, so it can get into your system. And if you are taking a medicine like Cialis, that pill can be taken much earlier in the day. But people must take the pills as directed for them to work. On top of that, including some stimulation also doesn’t hurt.
“You’ve got to try it a couple of times before you say, ‘Hey, this did not work for me.’”
5. Amino acids might help
“Occasionally, we’ll recommend supplements,” Mehul says. “It’s kind of a soft call and not necessarily something that has been proven to work.” But some amino acids — like arginine, carnitine, and citrulline — can help support cardiovascular health, he says. He’ll recommend supplements if he wants to give patients more options that are not just erectile dysfunction pills.
6. If pills alone don’t work, try a vacuum erection device
When oral medications have been unsuccessful, there are still other options.
“There’s a vacuum erection device,” Mehul says. “It’s a device that helps pull blood into the penis and then basically uses a constriction ring at the end of the penis to keep the blood in there.”
Other devices are also available. Some patients consider getting a penile implant or prosthetic, Mehul says. But that is not quite a bedside-table remedy. It requires surgery.
7. Restorative therapies aim to restore blood flow
Some people with ED look for ways to get an erection without having to take pills. Restorative therapies include shockwave therapy to the penis, platelet-rich plasma (PRP) injections, and stem cell therapy.
“But they’re all investigational,” Mehul says. Many mens’ health clinics have these therapies available, but Mehul cautions people to restrict their use to only clinical trials, since restorative therapies are still being studied.
Know you’re not alone
The biggest thing to keep in mind is that ED doesn’t have to be a taboo topic. It’s too common to avoid talking about.
“One thing that we definitely stress to patients is that if they feel like they’re alone in this,” they’re not, Mehul says. ED is so common that it can affect up to half of people by the time they are 40 and up to 80% by the time they are 70. “Just knowing they’re not alone is very important.”
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