What are some organic treatments for erectile dysfunction (ED)?

From the Guidelines

Organic erectile dysfunction treatments should prioritize lifestyle modifications, including regular exercise, weight management, and a Mediterranean diet, as these approaches have been shown to improve erectile function by enhancing cardiovascular health and blood flow 1.

Key Recommendations

• Regular exercise, such as walking or swimming for 30 minutes daily, can improve erectile function by enhancing cardiovascular health and blood flow.
• Weight management is crucial as obesity contributes to ED.
• A Mediterranean diet rich in fruits, vegetables, whole grains, and healthy fats supports vascular health.
• Reducing alcohol consumption to moderate levels (no more than 2 drinks daily) and quitting smoking can significantly improve erectile function.
• Stress reduction through techniques like meditation, yoga, or deep breathing exercises for 10-15 minutes daily helps manage psychological factors contributing to ED.

Supplements and Alternative Therapies

• Supplements that may help include L-arginine (1000-2000mg daily), which increases nitric oxide production to improve blood flow; ginseng (900mg three times daily); and DHEA (50mg daily) for men with low testosterone.
• Acupuncture treatments, typically 1-2 sessions weekly for 4-6 weeks, have shown some benefit.

Important Considerations

• These approaches work by addressing the underlying causes of ED, including poor blood flow, hormonal imbalances, and psychological factors.
• Treatment should be individualized, and patients should discuss their options with a healthcare provider before starting any new therapies.
• The American College of Physicians recommends that clinicians initiate therapy with a PDE-5 inhibitor in men who seek treatment for erectile dysfunction and who do not have a contraindication to PDE-5 inhibitor use 1.

From the FDA Drug Label

The population was 86% White, 6% Black, 6% Hispanic, and 2% of other ethnicities, and included patients with ED of various severities, etiologies (organic, psychogenic, mixed), and with multiple co-morbid conditions, including diabetes mellitus, hypertension, and other cardiovascular disease. The population was 78% White, 14% Black, 7% Hispanic, and 1% of other ethnicities, and included patients with ED of various severities, etiologies (organic, psychogenic, mixed), and with multiple co-morbid conditions, including diabetes mellitus, hypertension, and other cardiovascular disease.

Organic erectile dysfunction treatments are not explicitly mentioned in the provided drug labels as a specific treatment option. However, tadalafil is mentioned as a treatment for erectile dysfunction (ED) of various etiologies, including organic causes.

• The studies included patients with ED of organic etiology.
• Tadalafil was shown to be effective in improving erectile function in men with ED, including those with organic causes. 2 2

From the Research

Organic Erectile Dysfunction Treatments

Some organic erectile dysfunction treatments include:

• Lifestyle changes, which are central to the management of organic ED, as well as treating underlying problems such as endocrine disorders, neurological problems, and cardiovascular disease 3
• Symptomatic treatments, including:
  • Tablets, such as phosphodiesterase 5 inhibitors (PDE5Is) like sildenafil, tadalafil, and vardenafil 4, 5, 6
  • Injections, such as intracavernosal injection 3, 7
  • Intraurethral medication 3
  • Vacuum pumps 3, 7
  • Penile implants 3, 7
• Regenerative medicine, which may play a future role in the treatment of organic ED 3

Phosphodiesterase 5 Inhibitors

Phosphodiesterase 5 inhibitors (PDE5Is) are a type of medication used to treat erectile dysfunction, and include:

• Sildenafil, which has the greatest efficacy but also has the highest rate of overall adverse events 4
• Tadalafil, which has intermediate efficacy and the lowest overall rate of adverse events 4
• Vardenafil, which has similar overall adverse events to sildenafil but a markedly lower global efficacy 4
• Avanafil, which has similar overall adverse events to sildenafil but a markedly lower global efficacy 4
• Udenafil, which has similar global efficacy to tadalafil but higher overall adverse event rates 4

Other Treatment Options

Other treatment options for organic erectile dysfunction include:

• Testosterone replacement therapy, which may be used to treat low testosterone levels that contribute to ED 7
• Vacuum erection devices, which can help to improve erectile function 7
• Penile prostheses, which can be used to treat ED that is not responsive to other treatments 7