Can erectile dysfunction be reversed?

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Can erectile dysfunction be reversed?

Yes, some cases of erectile dysfunction can be reversed once the underlying cause is addressed. That said, whether or not you can reverse ED really depends on the cause(s) of the condition. For example, if you’re taking a medication that’s affecting erectile function, stopping or switching may rectify your down-there difficulties. (Remember, though, you should never stop or adjust your medication regimen without first speaking to a healthcare provider.)

“Research consistently demonstrates that comprehensive lifestyle interventions can dramatically improve sexual health—and are paramount in preventing and managing erectile dysfunction,” says Faysal Yafi, MD, an associate professor of urology and medical director of the Department of Urology’s Men's Health Program at the University of California, Irvine.

Medication-induced ED is considered easier to reverse (unless you’re unable to stop the drug causing it). Reversing ED through lifestyle changes, however, is usually a longer-term process that can take anywhere from months to years. Mild to moderate ED has a higher chance of being reversed than advanced cases of ED, which are often still treatable but may require more significant medical intervention.

Can erectile dysfunction be cured?

Yes, theoretically, ED can be cured. But again, it all comes down to the cause. If a medication is the culprit, scientific literature suggests that changing or stopping it should restore erectile function. If a hormonal imbalance is causing erectile problems, the right treatment should solve it. For example, studies have found that men diagnosed with low testosterone saw marked improvements in erectile function after starting testosterone therapy.

Unfortunately, there are other scenarios where there is no permanent cure for erectile dysfunction. Nerve damage, chronic health conditions, surgical procedures, and certain medical treatments can all result in ED that’s either irreversible or much more difficult to reverse.

A common one is prostate cancer treatment; in one study, 60% of patients reported erectile problems following prostate cancer surgery. That’s because treatments for prostate cancer—including surgery, hormone therapy, and radiation—can damage or destroy nerves important for erectile function.

Moderate to severe ED, which is characterized by persistently being unable to achieve or sustain an erection long enough for satisfactory sex, is complicated and may not be curable. But many cases can still be successfully treated with the right medical care. It’s important to catch ED early as it can worsen (and become harder to treat) over time if left untreated, Dr. Yafi says.

“Persistent ED lasting more than 3-6 months should be evaluated,” Dr. Yafi says. “This is particularly important if accompanied by cardiovascular symptoms, diabetes indicators, hormonal imbalance signs, or psychological distress.”

Ways to reverse erectile dysfunction

Now that you know it’s possible to reverse ED, the next big question is, “how?” For some people, ED can be reversed with medication adjustments or lifestyle changes like quitting smoking and exercising more. It’s important to work with a healthcare provider to figure out the underlying cause (or causes) of your condition so they can recommend the right treatment.

As mentioned, some cases of the condition are more complicated and may require medication or more advanced forms of treatment. That said, here are some strategies you can try that may help reverse your ED.

Exercise often

Getting enough exercise isn’t just good for overall health; it can improve erectile health, too. In fact, physical inactivity is a well-established, reversible risk factor for ED, and research shows that increasing physical activity can improve erectile function and wellbeing.

“Regular physical exercise emerges as a critical factor, with studies showing that men who engage in daily physical activity can greatly reduce their ED risk,” Dr. Yafi says.

Exercise encourages healthy blood flow, which is crucial for getting an erection. Along with being an important promoter of heart and blood vessel health, studies show that regular exercise can also enhance the production of nitric oxide, a natural compound in the body responsible for dilating blood vessels and encouraging blood flow to the penis.

Research indicates regular exercise may be able to reverse mild to moderate ED caused by vascular issues over time. One study found that 40 minutes of moderate to vigorous aerobic exercise (e.g. jogging, swimming, cycling) four times a week improved erectile function in men experiencing vascular ED.

Keep in mind that exercise alone may not be enough to reverse ED; studies suggest that a combination of lifestyle factors, including diet and weight management, can be the most effective in reversing ED or reducing symptoms.

Make certain dietary changes

While no one food will fix or cure ED, what you eat can play a significant role in erectile function, Dr. Yafi says. Research finds that regularly consuming processed foods and foods high in saturated fat can lead to high cholesterol and plaque buildup in arteries—two factors that can negatively impact blood flow everywhere, including down there.

So, if you’re wondering “can erectile dysfunction be reversed?” consider heeding Dr. Yasi’s advice to “adopt a balanced, nutritious diet.”

“Nutritional strategies should focus on nitrate-rich foods, omega-3 fatty acids, and antioxidant-rich options while reducing processed foods and saturated fats,” he explains.

Studies have found that the Mediterranean diet, which emphasizes whole grains, fruits, vegetables, and lean proteins, to be most effective for preventing ED. There’s not enough research to say whether healthy eating patterns alone can reverse ED. But studies do show that improving diet quality can help prevent or treat ED when combined with other lifestyle changes like getting more exercise and quitting smoking. (In case you missed it, a mixture of methods can be essential to seeing success when treating or reversing ED, at least according to science.)

Quit smoking

It’s pretty well known that smoking is bad for you, and yes, that applies to erections as well. Studies have shown that harmful chemicals found in cigarettes, such as nicotine and carbon monoxide, can damage blood vessels throughout the body, including in the penis. This can lead to restricted blood flow to the area.

Though more research is needed, current evidence suggests that stopping smoking can reverse ED. As for cannabis? The research is mixed. Some studies suggest that ED is twice as prevalent in men who smoke marijuana, while other research concludes it has no significant negative effects on sexual function. Further research is required to improve our understanding of the relationship between cannabis and ED.

Limit alcohol consumption

Chronic or excessive alcohol use can impact erectile function. People dependent on alcohol commonly report experiencing sexual dysfunction, including ED, low sex drive, and ejaculation issues. Alcohol is a depressant that affects the central nervous system and can interfere with the brain signals involved in sexual arousal. Long-term use of alcohol has also been shown to decrease testosterone levels, which can lead to ED.

Further study is warranted, but research indicates that ED caused by long-term alcohol use can be reversed. Similar to smoking, studies have shown that abstaining from alcohol improved ED symptoms in men with alcohol use disorder.

While heavy drinking has been closely linked to ED, you don’t have to knock back a bunch of booze regularly to experience sexual side effects. “Even moderate alcohol consumption can reduce erectile function,” Dr. Yafi says.

That’s why when it comes to ways to reverse ED, “alcohol reduction is crucial,” according to Dr. Yafi.

Weight management

Another lifestyle change that could potentially help reverse ED is weight loss. Obesity is associated with a higher risk for moderate to severe ED; some studies report that up to 42% of men with obesity experience ED. Excess body fat can contribute to ED by causing problems with blood circulation and lowering testosterone levels. It can also increase the risk for more serious health conditions like heart disease and diabetes—two conditions that are linked to ED.

“Particularly promising is the impact of weight management—even a modest 10% weight loss can restore erectile function in many overweight individuals,” Dr. Yafi says. “Each point reduction in body mass index can potentially improve sexual function.”

Research backs this up, with one study showing that 15% weight loss in men with obesity significantly improved erectile function. Meaningful weight loss can often be achieved through diet and exercise, but more advanced cases may require prescription weight loss medication (e.g. Zepbound, Wegovy) or bariatric surgery in conjunction with lifestyle changes.

Zepbound Important Safety Information: Read more about serious warnings and safety info.

Wegovy Important Safety Information: Read more about serious warnings and safety info.

Pelvic floor exercises

Pelvic floor exercises, also known as Kegel exercises, are an easy, low-impact strategy that may boost sexual function. As the name suggests, these strength-training moves target muscles surrounding the pelvis and are often recommended for people with bladder and bowel control issues and pelvic organ prolapse.

Doing Kegel exercises on their own isn’t likely to reverse ED, but they may contribute to improved sexual function. Studies are limited, but there is some evidence that pelvic floor exercises may help with ED and premature ejaculation by strengthening muscles and encouraging better blood circulation in the area. They’re also very easy to do: just squeeze (as if you’re holding in urine or drawing your penis up and in) and release. Pelvic floor treatments appear to be most effective for ED associated with the condition known as chronic prostatitis, which is typically more of a muscle problem than a prostate issue.

Stress reduction

While it may manifest physically, ED doesn’t always have a physical cause. It can also be triggered by emotional or psychological issues, including anxiety, depression, low self-esteem, performance anxiety, and relationship problems. If your ED is caused by mental health issues, taking steps to manage stress and your overall mental health—which may include therapy and/or medication—could help reverse it.

“Stress reduction cannot be overlooked,” Dr. Yafi says. “Chronic stress elevates cortisol levels, which can negatively impact testosterone and sexual function. In clinical studies, mindfulness and meditation techniques have demonstrated a significant improvement in erectile function.”

Everyone has different tactics for alleviating stress, but ones scientifically backed for wellbeing include the aforementioned meditation as well as deep breathing, progressive muscle relaxation, yoga, going for walks, spending time in nature, and making room for quality time with loved ones or pets.

Though sex therapy and stress management techniques may improve your sex life, they’re not always a sure ED cure. That’s because ED is a complicated condition that can be caused by a mix of psychological and physical factors. While research is mixed on the best way to manage psychogenic ED, studies have found the most effective treatment to be a combination of prescription medications, such as Viagra (sildenafil) and Cialis (tadalafil), and psychological interventions. Along with encouraging more blood flow to the penis, studies have also found these medications to boost confidence, which may alleviate psychological stress around sex.

Though ED medications on their own may help address some of the physical symptoms of ED, they won’t address the root cause if it is truly psychological, which is why therapy may be an important part of your treatment plan. A clue that you could be dealing with psychogenic ED could be if you are still experiencing nighttime and morning erections, and only having issues when it comes to sexual activity. In some cases, medications to manage the underlying mental health issue may be necessary.

Viagra Important Safety Information: Read more about serious warnings and safety info.

Cialis Important Safety Information: Read more about serious warnings and safety info.

Get quality sleep

As you may have experienced personally, a good night’s sleep cannot be underestimated. Sleep is critical for the healthy functioning of every system in the body; inconsistent or disrupted shut-eye has been linked to numerous health problems, including high blood pressure, depression, obesity, cognition issues, and—you guessed it—ED.

The link between poor sleep and erectile function isn’t fully understood, but studies suggest sleep deprivation can lead to hormonal imbalances such as decreased testosterone production. Shift work, jet lag, and obstructive sleep apnea—all of which tend to be characterized by a lack of zzz’s—have all been linked to a higher prevalence of ED.

More research is needed, but studies suggest treating underlying sleep issues may reverse ED in some cases. For example, studies have found that treating sleep apnea using a CPAP machine yielded significant improvements in erectile function.

If you’re struggling with falling asleep or inconsistent sleep, modifying your routine (such as reducing screen exposure and avoiding caffeine before sleep) may help. And if these smaller DIY tactics don’t seem to help your nighttime woes, be sure to consult a healthcare provider. They’re best equipped to determine what might be causing your sleep struggles and how to best address them—and, in doing so, hopefully address your ED as well.

Look into your medication

As mentioned above, sexual dysfunction can be a side effect of certain medications. Medication-induced ED is quite common and can happen with a wide range of prescription drugs. The medications that have the highest frequency of ED include:

Benign prostatic hyperplasia and hair loss medications, such as finasteride
Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs)
Antiepileptics, such as gabapentin and topiramate
Antihistamines, such as diphenhydramine (Benadryl)
Pain medications and sedatives, such as oxycodone
Blood pressure medications, such as spironolactone or beta-blockers
Acid reflux medications, such as famotidine (Pepcid) and ranitidine (Zantac)

It’s also worth noting that other medical therapies that have been shown to cause down-there difficulties are stimulants, such as amphetamine (Adderall), chemotherapy, and radiation.

Stopping or adjusting medication doses—under the guidance of a healthcare professional!— may improve erectile function or even reverse ED. But, again, never stop or change any medication without speaking to your healthcare provider first, as it could pose a risk for serious side effects.

Finasteride Important Safety Information: Read more about serious warnings and safety info.

Experimental approaches to reverse ED

In addition to the more traditional ways of reversing ED (such as those above), there are also emerging or experimental treatments that aim to target the condition in new ways. These options have largely been used to treat ED in studies (vs. real-life applications).

Low-intensity shockwave therapy

Low-intensity shockwave therapy (LiSWT) usually involves a series of noninvasive treatments during which a practitioner uses a handheld medical tool to deliver low-intensity shockwaves to the base of the penis. It appears to work most effectively when ED has occured because of impaired blood flow to the penis—so-called “arteriogenic” ED. That might be because the shockwaves delivered during LiSWT may encourage more blood flow to the penis by boosting blood vessel function and to stimulate the formation of new blood vessels in the penis. Studies to date have not proven this treatment to be effective, and it may need to be repeated, but some suggestion of efficacy exists.

Platelet-rich plasma (PRP) or stem cell injections

Platelet-rich plasma (PRP) is plasma (i.e. the liquid portion of blood) that contains a high concentration of platelets, cell fragments rich in growth factors that can help with healing and tissue regeneration. It’s created by drawing blood and then processing the sample in a centrifuge to separate and concentrate the platelets. In the case of ED, PRP is injected into the tissue of the penis, potentially increasing blood flow to the area and, in turn, enhancing erectile function.

Similarly, stem cells can also be extracted from the body and then injected into the penis, where they may help restore dysfunctional muscle or cells of the blood vessel lining—two effects that could address ED.

Stem cell therapies have not effectively treated erectile dysfunction, nor are they approved for use by the FDA. Guidelines written for healthcare providers on how to treat erectile dysfunction do not recommend using these treatments except in carefully controlled experiments. Further information on these investigational treatments is evolving.

PRP and LiSWT treatments are considered experimental because there have been limited results published to date, and the benefits of treatment, if any, are not clear.

Other ways to treat erectile dysfunction

If lifestyle changes aren’t working, don’t despair—there are lots of other effective methods for treating ED. The first-line treatment for ED is often prescription medication, specifically PDE5 inhibitors, which facilitate erections in part by dilating blood vessels and increasing blood flow to the penis. Here are the most common ED pills—all approved by the US Food and Drug Administration (FDA):

Viagra (sildenafil). Approved in 1998, Viagra is the “OG” ED treatment. Sildenafil is the generic version of Viagra that works in the exact same way but is typically a lot cheaper than the brand-name version.

Cialis (tadalafil). Another popular option for treating ED is Cialis (tadalafil being the generic and more cost-effective version). Cialis has been found to be just as effective as Viagra and may last longer (up to 36 hours). Some may prefer this medication due to the option for daily dosing instead of as-needed.

Vardenafil. This PDE5 inhibitor is only available in generic form, though you may know it by its now-discontinued brand name of Levitra. It usually starts working in about 30–60 minutes.

Stendra (avanafil). The most recently approved medication for ED, Stendra, is fast-acting and usually starts working within 15 minutes.

In addition to the aforementioned pills, you can also find some PDE5 inhibitors in newer formulations. While these formulations are not specifically FDA-approved, their active ingredients have been FDA-approved for ED. Two examples—both of which also require a prescription—include:

Daily Rise Gummies. These fruit-flavored gummies contain tadalafil (the active ingredient in Cialis) and are taken daily (vs. as-needed) to allow for more spontaneity.

Ro Sparks. Made with sildenafil and tadalafil (the active ingredients in Viagra and Cialis, respectively), this 2-in-1 treatment dissolves under the tongue for fast-acting effects.

Keep in mind that these medications are not a permanent cure for erectile dysfunction, but they can certainly help alleviate symptoms.

“For men already using prescription ED medications, lifestyle approaches can also enhance treatment effectiveness,” Dr. Yafi says. In other words, don’t understand the power of combining treatments—something he emphasizes.

While oral medications are commonly discussed for the treatment of ED, there are also injectable medications that can be useful for those who do not respond to oral treatments.

Severe or medication-resistant ED can still be treatable, but may require a more intensive approach. A non-surgical option is a penis pump or vacuum erection device, which uses a suction chamber to usher more blood to the penis. Studies have found these devices to be particularly helpful for men who’ve undergone prostate removal surgery. Sometimes this treatment is combined with oral medication for a more noticeable effect.

Depending on the severity of your condition, your healthcare provider may also recommend a bit of a more invasive treatment: a penile implant. This is a surgical procedure that involves implanting an inflatable or flexible device designed to mimic an erection.

What types of erectile dysfunction are permanent?

Though ED can cause a great deal of distress and can be complicated to treat, the good news is it’s usually not permanent. Even in cases where ED is irreversible (for example, ED resulting from nerve damage or surgery), it’s still often treatable with medication, medical devices (e.g. penis pump), or surgery.

However, there are some situations where ED can last for life. Severe nerve damage due to injury, surgery, or certain health conditions may result in permanent ED. For example, advanced kidney disease and diabetes-related complications like peripheral neuropathy can lead to irreversible nerve damage. As mentioned, removal of the prostate gland or prostate cancer treatment can also cause significant trauma to the area that may result in permanent ED.

Other issues like Peyronie’s disease (abnormal curvature of the penis) and scar tissue in the penis can cause more complicated cases of ED. Still, they’re not always permanent and may be able to be treated with medication or surgery.

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