Treatment Options for Erectile Dysfunction

Ideal for men who have postsurgical ED (e.g., after prostatectomy) Water-based pumps demand use in the shower

What Tests Will a Urologist Do if I Have ED?

If not, or if your insurance is insufficient to bring down Cerebral’s costs, you’ll be better off with BetterHelp. Cerebral’s affordability through insurance will depend on your plan. Regardless of your coverage specifics, there’s still a $30 monthly charge to access the Cerebral platform, and all other billing is through your insurance. So, if you have a $30 co-pay for therapy visits, you’d pay about $36.92 per weekly visit over the course of a year. That’s nearly $12 less than the best possible rate you could get from BetterHelp with its maximum financial aid.

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However, if you’re uninsured or your insurance doesn’t cover Cerebral’s services, the costs would climb dramatically. Out of pocket, Cerebral costs $95/month for medication plans (psychiatry), with medication billed separately. Therapy costs $295/month, or just over $68/session. That’s a lot cheaper than out-of-pocket costs for in-person therapy, but it’s also much pricier than financially assisted sessions from BetterHelp. The top telehealth providers for therapy and psychiatry take your privacy seriously, using things like dedicated video conferencing and messaging software to prevent intrusion.

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Associated clinicians are also bound by all the same laws restricting the dissemination of patient information that apply to in-person therapy and psychiatry. But these platforms deal in various data pools, including medical records, messaging, payment and insurance information, and more. Some have policies that state the exact amount of time they’ll keep this information in their databases. Some allow you to make specific requests to delete your data; others don’t. Talkspace stands alone among these companies for two reasons. Penis pumps are essentially little vacuum chambers out of which you pump the air after inserting your penis. Some do this with manual pumps, while others work electronically.

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As the air is sucked out of the chamber, the vacuum force in its place applies suction to your penis, causing it to fill with blood.35 Penis pumps occupy a specific section of ED research that focuses

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on treatment for men who've undergone radical prostatectomies or similar surgeries that have caused their ED.36 In some

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First, it allows you to manually delete messaging information between you and your doctor if you switch doctors and want a clean slate. Having all your old messages accessible to your new doctor may introduce certain prejudices in treatment, or you simply may want to start from scratch for your own sake. Whatever the case, we appreciate this option from Talkspace. Second, Talkspace states it will retain your data only as long as your account is active. That means it’s gone once you fully delete your account.

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Other companies will retain the same data for up to ten years. The companies in this part of our guide are all benefactors of a combined tech and telehealth boom in the late 2010s and early 2020s. As such, they all offer sleek, responsive interfaces with good apps and reliable communications. Cerebral has an edge here, thanks to the positive experiences we had in extensive testing. None of these companies ever let us down through our sessions, but Cerebral’s platform felt simultaneously more accessible and more discreet than others.

The Fast Facts

Cerebral also had our preferred therapist selection tool. Again, this win was marginal, with BetterHelp and Talkspace offering platforms that others may very well prefer. Any man who has lost or failed to achieve an erection would tell you there are undeniable emotional and psychological effects from the experience. Fear, anger, stress, and disappointment are just some of the most common responses to such an event.29 There are myriad physiological reasons a sex. power tablet man can have a one-time erectile hiccup that isn’t ED, but the anxiety surrounding that experience can fuel future failures. cases, another side effect of such surgeries is a phenomenon in which the penis retreats somewhat into the body.

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We often steer men toward shockwave treatment because research suggests it could have lasting positive effects on erectile health.18 The only downside is that you have to see a urologist to have the treatments performed on you. At-home devices exist, but they’re typically unregulated, potentially dangerous, and universally very loud. Having the treatments in a clinical setting provides you with the peace of mind that they’re being performed correctly with the best possible equipment, but they can be very expensive over the course of treatment. By comparison, penis rings offer a degree of efficacy for a very low price. But it’s important to remember that you can use penis rings even if you’re also undergoing shockwave treatment (though, ideally, not at the exact same time).

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So, the rings can help you immediately, provided your ED is mild enough, even as you work toward more lasting erectile health through other treatments. Can be uncomfortable or awkward to use Men with very large or small penises may have a hard time Difficult to differentiate among brands and models Penis rings, known colloquially as cock rings, look a lot like rubber gaskets that you’d see in the plumbing aisle of a home improvement store. They’re thin, round, and flexible O shapes that you fit around the base of your penis to constrict blood flow. Because they’re bigger than your penis is thick when it’s flaccid, they won’t stop blood from flowing in, but if you can get the blood in there and the penis thickens, they can stop that blood from flowing out. For some men, the use of rings also provides an additional physical or psychological stimulus, increasing the odds of a successful erection.

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The best part about rings is that you can use them in conjunction with just about any other ED treatment on the market, from PDE5 inhibitors and supplements to shockwave devices and penis pumps. However, penis rings come with a unique set of risks, most notably the danger of completely cutting off blood flow to the penis and the possibility of something called penile entrapment. Cases of entrapment, which are more commonly seen with metal penis rings, occur when you can get the ring on, but you can’t get it off.34 This can result in numerous complications, but it’s fairly easy to manage with the help of a medical professional, who will likely need to remove the ring by force (e.g., with bolt cutters or a saw). In our estimation, the rings offered by Hims are among the best out there. They come in two sizes that should serve the vast majority of men, and they’re flexible enough to come off safely when it’s time to remove them. They’ve been shown to work for other types of ED, as well, but the majority of the research seems to focus on postoperative ED.

Check with your doctor first to reduce risk of complications

And that only covers psychogenic ED that starts from one or two minor physiological issues that are easily corrected, like fatigue or overconsumption of alcohol. There are also countless cases of psychogenic ED that arise from other psychological concerns that have physiological effects on the body.30 For example, chronically elevated cortisol levels in patients with anxiety can lead to episodes of ED. So, too, can depression have significant effects on libido.31 Treating these issues directly, through talk therapy, psychiatric medication, or a combination of the two, should have similar effects as treating high blood pressure in men whose hypertension is causing erectile issues. By treating the root cause of the ED, you can, in theory, eliminate the ED. There are inherent risks with any kind of healthcare, including both psychiatry and talk therapy.

We've Got The Icing For Your Cake

While the latter certainly seems safe, there’s always a risk of exposing underlying trauma or deepening symptoms of anxiety or depression along your journey.32 For some patients, these twists and turns are inevitable parts of the healing process. Psychiatry presents more obvious risks, as psychiatric medications each come with their specific sets of potential side effects and contraindications.33 You and your consulting health professional — typically a psychiatric mental health nurse practitioner in the telehealth space — will have to review these potential risks to determine which medication would best suit your needs. Sildenafil and tadalafil — the active ingredients in Viagra and Cialis, respectively — remain the most reliable treatments for erectile dysfunction, but some men may prefer to avoid medications of any kind. Others, of course, discover through consultation that they aren’t viable candidates for prescription ED treatments. Still others may want to throw everything but the kitchen sink at the problem and use a multipronged treatment approach that includes prescription ED medication and devices.

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For all of these groups, there are physical treatment devices that can help. There are essentially three main types of physical devices you can use to combat ED, one of which is intended to treat the condition itself, while the other two are intended to help with immediate erectile performance: Shockwave devices rely on low-intensity shockwave therapy (LI-SWT) to apply acute pressure with acoustic shock waves that stimulate blood flow and repair penile tissue toward healthier erections.18 Penis rings apply physical pressure at the base of the penis to restrict blood flow out of the penis after an erection is achieved. They may also aid in physical and psychological arousal. Penis pumps apply vacuum pressure to the penis to draw blood into it and create an erection. Shockwave treatment and vacuum erection assistance are very much medical treatments, whereas penis rings have roots in the fetish community and have been adopted as a practical solution for men with ED. Some research has also highlighted the potential for pumps to help with Peyronie’s disease, a painful curvature of the penis that involves calcium

• Aging and Pills: Effectiveness may decrease with age; consult a healthcare provider.
• Lifestyle Factors: Exercise, diet, and stress management improve overall sexual health.
• Abstinence from Smoking: Smoking can impair blood flow, reducing pill efficacy.

deposits around the shaft.37 As with other device-based therapies, you might want to use penis pumps as one part of a multipronged treatment approach.

• Impact on Heart Health: Some pills may affect blood pressure or cardiovascular system.
• Compatibility with Conditions: Men with hypertension or heart disease should consult a doctor.
• Monitoring: Regular health check-ups recommended during use.