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Physician-led · Confidential · Est. 2009

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IndexTreatments

Seven treatments for ED, from least invasive to most.

We work down that ladder, not up it. Where a treatment's evidence base is thin, we say so here rather than in the small print — because the difference between 'proven' and 'promising' is the difference between medicine and marketing.

Treatments
09
Well established
07
Emerging
01
Investigational
01

How to read this page

Every treatment carries one of three grades. They are applied by our medical director and reviewed annually.

Well established
Supported by large randomized trials and recognised in professional practice guidelines.
Emerging
Encouraging trial data, but protocols and long-term durability are still being established.
Investigational
Plausible mechanism, limited or inconsistent human evidence. Offered only with a full explanation of that limitation.

01The ladder

Erectile dysfunction, least invasive first.

Nothing at all, then a mechanical device, then a non-invasive procedure, then drug therapy, then injections, and only at the end surgery that cannot be undone.

01Well established

Oral Medication (PDE5 Inhibitors)

First-line

Sildenafil, tadalafil, vardenafil and avanafil remain the best-studied treatment for erectile dysfunction. Dosed and timed correctly, they work for the majority of men who take them.

Onset
20–60 minutes
Duration
4–36 hours
Visits required
One consultation
Downtime
None
Read the full protocol
02Well established

Vacuum Erection Devices

Device

A vacuum device draws blood into the penis mechanically and a constriction ring holds it there. No medication, no interactions, and a central role in rehabilitation after prostate surgery.

Onset
2–3 minutes
Duration
Up to 30 minutes
Systemic risk
None
Ongoing cost
One-time purchase
Read the full protocol
03Emerging

Acoustic Wave Therapy (Li-ESWT)

In-clinic procedure

Low-intensity extracorporeal shockwave therapy delivers focused acoustic pulses to the erectile tissue with the goal of stimulating new blood vessel growth. Promising, but still an area of active research.

Session length
15–20 minutes
Course
6–12 sessions
Anesthesia
None required
Downtime
None
Read the full protocol
04Well established

Testosterone Replacement Therapy

Hormonal

Where erectile dysfunction sits alongside biochemically confirmed hypogonadism, correcting testosterone can restore libido, energy and treatment response. Where it does not, testosterone is the wrong tool.

Diagnosis
Two morning blood draws
Routes
Injection, gel, pellet
First reassessment
8–12 weeks
Monitoring
Ongoing, lifelong
Read the full protocol
05Well established

Intracavernosal Injection Therapy

Self-administered

A very fine injection of alprostadil, or a compounded combination such as Bimix or Trimix, produces a reliable erection in most men — including many for whom pills have stopped working entirely.

Onset
5–15 minutes
Duration
30–60 minutes
Response rate
High
Training
In-clinic, supervised
Read the full protocol
06Investigational

Platelet-Rich Plasma Therapy

In-clinic procedure

Platelet-rich plasma prepared from your own blood is injected into the erectile tissue in the hope of stimulating repair. The concept is plausible; the human evidence is thin.

Session length
45–60 minutes
Course
Typically 2–3 sessions
Source material
Your own blood
Evidence status
Investigational
Read the full protocol
07Well established

Inflatable Penile Prosthesis

Surgical

A three-piece inflatable prosthesis is implanted entirely within the body and controlled by a concealed pump. Reserved for men who have exhausted other treatments — and consistently the highest-rated among them.

Procedure
Outpatient, 45–90 minutes
Recovery
4–6 weeks before use
Device life
Commonly 15+ years
Reversibility
Not reversible
Read the full protocol

02Related conditions

Two conditions that are not rungs on that ladder.

Both frequently sit alongside erectile dysfunction and interact with it, and both need their own diagnosis and their own plan.

08Well established

Peyronie's Disease Treatment

In-clinic procedure

Peyronie's disease is scar tissue within the penis causing curvature, pain, or deformity. It frequently coexists with erectile dysfunction and requires its own treatment plan.

Phases
Acute, then stable
Injection course
Up to 4 cycles
Traction
Daily, several months
Surgery
For stable disease only
Read the full protocol
09Well established

Premature Ejaculation Treatment

First-line

Premature ejaculation affects a substantial share of men and responds well to a combination of behavioral technique, topical agents and, where appropriate, medication.

Prevalence
Roughly 1 in 3 men
First-line
Behavioral + topical
Onset of medication
1–2 weeks
Overlap with ED
Common
Read the full protocol

Not sure which

Choosing a treatment is not your job.

This page exists so you can see what we do and how honestly we rate it — not so you can arrive having already decided. Which treatment fits depends on your arterial inflow, your hormone panel, your medication list and your own priorities, and none of those are visible from a website.

Come in, get assessed, and let the results of that assessment choose. It is a considerably better method than picking the option with the most compelling paragraph.

How assessment works

Next step

Start with a conversation, not a prescription.

Ninety minutes with a physician who does only this. A full diagnostic workup, a written plan, and a clear price before anything begins.