When most people think about erectile dysfunction (ED) treatment, their minds jump straight to the “little blue pill.”
And for good reason.
Oral medications like sildenafil (Viagra) and tadalafil (Cialis) have helped countless men regain confidence and intimacy.
But ED is rarely a one-size-fits-all condition. It often stems from several factors, including blood flow issues, nerve damage, and hormone imbalances. Accordingly, treatment options have expanded to include more than medication.
Our experts at Golden Gate Urology in Berkeley, California, often remind patients that ED isn’t just a performance issue. It can also be a window into your overall health, exposing underlying conditions such as diabetes, heart disease, or high blood pressure.
We address men's health issues holistically, which means looking at more than medication.
PDE5 inhibitors (like sildenafil, tadalafil, and vardenafil) remain the first line of treatment for many men. They’re effective, widely available, and relatively safe when prescribed appropriately. For our patients who respond well, they’re life-changing.
But not everyone tolerates them. Side effects, such as headaches, flushing, or indigestion, can interfere. And for men with certain heart conditions or those taking nitrates, these medications aren’t safe. That’s when we help you explore your other options.
If you’ve been told that medication is the best and/or only path to managed ED, you’ve been misled. The path to restored sexual function doesn’t look the same for everyone.
Here are some popular treatment options we discuss with our patients.
They may not sound glamorous, but vacuum erection devices (sometimes called pumps) are a highly effective, drug-free option. These devices create negative pressure around the penis, drawing blood into the erectile tissue. A constriction ring helps maintain the erection.
They’ve been around for decades, but modern versions are discreet, easy to use, and effective. If you can’t take medication or want a noninvasive solution, these can be an excellent choice.
A new, exciting frontier in treating ED, low-intensity extracorporeal shockwave therapy (LiSWT) uses sound waves to stimulate blood vessel growth and improve circulation in penile tissue.
Unlike medications, which treat the symptom, shockwave therapy aims at the root cause: poor blood flow. It’s noninvasive, usually painless, and performed in the office.
Research is ongoing, but studies suggest it may offer lasting improvement for many men.
Sometimes ED isn’t just about circulation — it’s about hormones. Low testosterone levels can lead to reduced libido, fatigue, and difficulty achieving or maintaining erections. In these cases, testosterone replacement therapy (TRT) may be the best path forward.
Hormone therapy isn’t a quick fix, and it requires close monitoring, but restoring hormone balance can dramatically improve your sexual health and overall well-being.
When other treatments fail, penile implants provide a permanent, reliable solution. We surgically place the implants inside the penis, allowing you to achieve an erection on demand.
There are two main types: malleable (bendable rods) and inflatable implants. Inflatable implants, in particular, have advanced significantly. Today, they’re discreet, natural-looking, and have high satisfaction rates among patients and partners.
Surgery is a big step, but it can change the game for men with severe ED.
No conversation about ED treatments would be complete without discussing lifestyle. The habits that support cardiovascular health (regular exercise, a balanced diet, managing stress, and not smoking) also support sexual health.
We encourage patients to think of ED as a medical condition and an opportunity. It’s a chance to take stock of overall wellness, make healthier choices, and improve quality of life in multiple ways.
ED is more common than you might realize, and nothing to be ashamed of. Easily accessible, potent ED medications are revolutionary, but they’re only one piece of the puzzle for most men.
If you struggle with ED, the most important step is having an open conversation with our team. Together, we can explore the cause, rule out underlying health issues, and find the treatment that fits your lifestyle and goals.
When you’re ready to take your sexual health in a new direction, call our friendly staff at 510-255-0013 or schedule an evaluation online.
