How to Fix Erectile Dysfunction: Getting Checked, Lifestyle Changes and Medicine

Fixing erectile dysfunction starts with finding the cause, because the NIDDK says clinicians treat the underlying cause when possible and otherwise focus on improving sexual function.¹ For most men that means three steps in order: get checked (ED can accompany heart disease and diabetes), change what lifestyle trials show can help, and ask about a prescription medicine if that is not enough. No pill, pump or supplement fixes an unaddressed cause, and nothing here is a guarantee.

Step 1: Why get checked before trying to fix it?

ED is often a vascular signal. In a cohort of 9,457 men in a prostate cancer trial, new ED was linked to a 25% higher hazard of later cardiovascular events, though the link is observational.⁴ The 2024 Princeton IV panel advises treating men with ED as at risk for cardiac events until proven otherwise.⁵ A first visit should cover medical, sexual and mental health history, a physical exam and sometimes blood tests, and a review of medicines that could contribute.⁶¹ Our guide to who to see for ED and what they should check covers the visit.

Step 2: Which lifestyle changes have trial evidence?

The weight-loss trial concluded that lifestyle changes were associated with better sexual function in about one third of obese men with ED at baseline, which also means most did not reach a normal score.² Lifestyle change is worth doing, and it is not a quick fix.

Step 3: What if the cause is a medicine, mood or hormone?

• Medicines. A clinician may adjust a dose or switch a medicine that contributes. Do not stop one on your own.¹
• Anxiety and stress. The NIDDK says counseling may help when mental health or emotional issues contribute, and a partner can be invited.¹
• Low testosterone. If testosterone is also low, a clinician may prescribe it alongside a PDE5 inhibitor.¹ For that question see whether ED is related to low testosterone.

Step 4: What do ED medicines add?

PDE5 inhibitors are the main drug class, oral medicines that improve blood flow to the penis.¹ In the Viagra label's diary data from about 1,600 patients, weekly success rates averaged 1.3 on 50 to 100 mg versus 0.4 on placebo, and one trial in men with diabetes reported 57% improved erections versus 10% on placebo.⁸ The labels also set hard limits: sildenafil and tadalafil are contraindicated with nitrates, and alpha-blockers call for caution.⁸⁹ A prescription is a clinician decision, not a do-it-yourself fix. For which products carry FDA approval, see what ED pills are FDA-approved.

What about pumps, injections and surgery?

The NIDDK also lists injectable medicines and urethral suppositories, vacuum erectile devices (possible coldness, numbness, bruising and weakened ejaculation), and surgery reserved for men who have not improved with other options.¹ These are usually discussed with a urologist.

Sponsored: Quattro from Vea Health, one online route

This section is sponsored: we have a financial relationship with Vea Health. It describes one online option for step 4 and does not replace steps 1 to 3.

Vea Health describes Quattro as a compounded sublingual dose combining sildenafil, tadalafil, vardenafil and apomorphine, prescribed only after a licensed clinician reviews your health history, with no charge unless a clinician approves it.¹⁰ It is compounded, so it is not FDA-approved and the FDA does not verify its safety, effectiveness or quality before marketing.¹¹ The Viagra label says combinations with other ED treatments have not been studied.⁸ The NIDDK advises talking with a health care professional before ordering an ED medicine online, so tell any clinician about every medicine you take and your heart history.¹

What should not wait?

Seek urgent care for an erection lasting more than 4 hours, or for sudden vision or hearing loss after an oral ED medicine.¹ New chest pain with sexual activity, fainting or breathlessness calls for an in-person visit first.⁴

Bottom line

The most reliable way to fix ED is to find and treat the cause, add exercise and weight management where they apply, and use a prescribed medicine for what remains. Expect gradual change, and ask a clinician about anything that does not improve.

Your questions

Can erectile dysfunction be fixed without pills?

Sometimes. In a trial of obese men, a weight-loss and activity program raised the average IIEF score from 13.9 to 17, and about one third of obese men with ED improved. Results depend on the cause, so a check-up comes first.

How much exercise helps erectile dysfunction?

A systematic review of 10 studies concluded about 40 minutes of moderate-to-vigorous aerobic exercise four times a week, roughly 160 minutes weekly for 6 months. A separate meta-analysis of 7 trials found a 3.85-point IIEF gain.

Should I see a doctor before trying to fix ED?

Yes. ED can accompany heart disease and diabetes, and the NIDDK says clinicians treat the underlying cause when possible. A clinician also checks that medicines are safe with your other medications, for example nitrates.

Is there a permanent fix for ED?

It depends on the cause. If a medicine, weight, inactivity or stress is contributing, addressing it can improve function. Other causes are managed rather than cured, and no source we reviewed supports a guaranteed fix.

Read next

Part of our guide: Getting ED Treatment: Doctors, Online Prescriptions and FDA-Approved Options

• What ED Pills Are FDA-Approved?
• Erectile Dysfunction Doctor: Who to See First and What They Should Check
• Online Cialis Prescription: Can It Be Sent to Your Pharmacy?
• Viagra Alternatives Over the Counter: What the Evidence Shows