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Note: Many Aetna pharmacy benefit plans exclude coverage of drugs for lifestyle enhancement or performance. Please check benefit plan descriptions for details. Under these plans, sildenafil citrate (Viagra), vardenafil hydrochloride (Levitra) and tadalafil (Cialis) are covered only when required by state regulation or when a plan sponsor has elected an optional rider under the pharmacy plan, or, for indemnity or PPO plans without a separate pharmacy benefit, when the plan sponsor has added optional coverage under the medical plan.

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There are several areas of the brain involved in sexual behavior and erections. In psychogenic ED, the brain may send messages that prevent (inhibit) erections or psychogenic ED may be related to the body's response to stressors and the release of chemicals (catecholamines) that tighten the penile muscles, preventing them from relaxing.
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There several causes of erectile dysfunction. For example obesity, stress, consumption of drugs, diabetes, anxiety, older age, etc. Many useful and advanced treatments are available to elevate the disease. These are some surgical treatments and few have the involvement of pills and tablets. These treatments can cause some side effects. The most modern and effective treatment is called Kegel exercises. This treatment does not have any side effects. It makes it more popular.

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Your doctor will do a physical exam and ask you questions about your symptoms. He or she may do a blood or urine test. Your doctor may consider other tests to rule out other conditions.

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The doctor or nurse will ask about your lifestyle and relationships, and any problems you might be having.

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Other potential biological causes of ED include injury to nerves, certain medications, and low levels of testosterone.

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    Sildenafil is available as oral tablets at doses of 25 mg, 50 mg, and 100 mg. Patients should take sildenafil approximately one hour before sexual activity. In some men, the onset of action of the drug may be as early as 11-20 minutes. It's best for men to take sildenafil on an empty stomach for best results since absorption and effectiveness of sildenafil can be diminished if it is taken shortly after a meal, particularly a meal that is high in fat. Sildenafil and the other PDE5 inhibitors don't cause an immediate erection. Sexual stimulation is necessary for these medications to work.

    PDE5i medications do not work like an aphrodisiac and will not increase desire or libido.
    The question is how much exercise you need to do before it has an effect. This was what the scientists asked themselves when they first began to review the published literature.

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    The foods you eat can have a direct impact on erectile dysfunction, Dr. Mucher says. A diet rich in fruit, veggies, whole grains, and fish, and with fewer servings of red meat and refined grains, decreases the risk for ED.

    An erection problem occurs when a man cannot get or keep an erection that is firm enough for intercourse. You may not be able to get an erection at all. Or, you may lose the erection during intercourse before you are ready. Erection problems do not usually affect your sex drive.
    Because it is a hydraulic device, it can give you the hardest erection possible. IPPs have high satisfaction rates among patients AND their partners. (Read this first-hand account from a happy patient.) And once you are done having sex, you push the button in the scrotum and it deflates.

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    Medicines to help produce erections – pills such as sildenafil (Viagra®), tadalafil (Cialis®), or vardenafil (Levitra®) − are typically used in combination with other therapies or devices. Since the drugs might not produce an erection because they need the nerves responsible for erections to be healthy, penile injections or vacuum devices might be offered. See Managing Male Sexual Problems Related to Cancer to learn more.

    Picture of vasodilator injection into penis. A vasodilator such as prostaglandin E1 can be injected. If the blood vessels are capable of dilating, a strong erection should develop within five minutes.
    L-citrulline can be converted to L-arginine in the body. L-arginine widens blood vessels, increasing blood flow.

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    Burnett AL. Evaluation and management of erectile dysfunction. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016:chap 27.

    Erectile dysfunction occurs when sexual stimulation or arousal does not result in enough blood flow to your penis, even though you may still have the urge. For some men there is a physical or medical reason for this. For others the problem is related to thoughts or emotions.
    Professor and Vice Chair of Urology, Emil Tanagho Endowed Chair in Clinical Urology Refer A Patient Make A Gift About Disclaimer Subscribe to our newsletter Contact Us Accessibility Privacy Policy Terms of Use A-Z Website List Patient Referral and E-Consult

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In fact, one common reason many younger men visit their doctor is to get erectile dysfunction medication. Often, men with erectile dysfunction suffer with diabetes or heart disease, or may be sedentary or obese, but they don’t realize the impact of these health conditions on sexual function. Along with erectile dysfunction treatment, the doctor may recommend managing the illness, being more physically active, or losing weight.

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Top Picks Talking to Your Partner About ED Penis Enlargement: Does It Work? ED: Tips for Talking With Your Doctor Men's Super Foods: Some Fight ED Photos: When Your Body Won't Cooperate 10 Things That Can Deflate Your Erection further reading Slideshow: Erectile Dysfunction Causes Healthy Sex Life: Better Health Evaluator from WebMD How to Talk With Your Doctor About ED Managing Sexual Concerns if You Have BPH Symptoms of Male Sexual Problems Preventing Male Sexual Problems Sex Problems in Men Topics

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The U.S. FDA (Food and Drug Administration) has a list of 29 OTC products that claim to treat erectile dysfunction. Patients should avoid these because many contain harmful ingredients. Other natural or herbal remedies such as DHEA, L-arginine, ginseng, and yohimbe are supplements that have been used but have not been proven safe and effective according to some researchers. Before using such compounds, individuals should consult their doctor. According to some experts, acupuncture does not effectively treat erectile dysfunction. Other home remedies for reducing ED symptoms include diet changes such as eating blueberries and citrus fruits and drinking red wine.

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