If you have erection problems, you can't have or keep an erection for long enough to have satisfying sex.

You may feel embarrassed or ashamed. These feelings stop many men seeing their doctor.^[20] But erection problems are very common. And thanks to recent advances in medicine, most men can find a treatment that works.

Key points about treating erection problems

• Sildenafil (brand name Viagra), tadalafil (brand name Cialis), and vardenafil (brand name Levitra) are tablets that are safe for most men and are likely to help.

• Alprostadil is another treatment that may help. It's available as injections and as pellets that you insert into your penis.

• Viagra and similar drugs aren't always free on the NHS. Your usual doctor can prescribe them, but you may have to pay. These drugs are only available free if you have particular medical conditions, or you are very distressed by your erection problems. For more, see Treatment for erection problems on the NHS.

• Some men find that vacuum pumps or penile rods or tubes help.

• Some people find it helpful to talk to a counsellor or a psychotherapist. This form of talking treatment is called psychosexual therapy.

• If you have a regular partner or a spouse, it may help to involve them when talking about treatments for erection problems. To learn more, see Do my partner and I need psychosexual therapy or counselling?

• Be cautious about buying 'herbal' treatments for erectile dysfunction over the internet. There have been instances where a product has contained undeclared (and unregulated) prescription medicine.

Treatment for erection problems on the NHS

Drugs for erection problems can be prescribed on the NHS only if you have one of the following causes for your problems:^[21]

• Diabetes, multiple sclerosis, Parkinson's disease, polio, prostate cancer, a severe injury to your pelvis, a disease that affects your nerves that is due to a problem in one of your genes, spina bifida, or an injury to your spinal cord

• You are having dialysis to treat kidney failure

• You have had major pelvic surgery, a kidney transplant, or your prostate removed

• Or if you were already having treatment from the NHS on 14 September 1998.

However, you can also get drug treatments if you are suffering severe distress because of your erection problems. You may need to see a specialist to get a prescription. Examples of what may count as severe distress are:

• If the problem is ruining your relationship

• If you feel seriously down

• If you don't want to see friends or lead a normal social life

• If you can't face going to work.

Treatments for erection problems

Which treatments work best? We've looked at the best research and given a rating for each treatment according to how well it works.

For help in deciding which treatment is best for you, see How to use research to support your treatment decisions.