Erectile dysfunction is one of the most common issues men experience in the bedroom, affecting 40 percent of men at age 40 and as many as 70 percent by age 70. Many more men occasionally struggle to get or maintain erections, even without full-blown ED.
Most guys already know the most common fixes for erectile difficulties: medications like sildenafil (Viagra) and tadalafil (Cialis), sex therapy. But today, there are more options for those who don’t want to take a pill or don’t find that therapy is enough.
These alternative ED treatments have emerged over the past few years and hold the potential to help men attain more frequent, firmer, and longer-lasting erections.
The Latest Treatments For Erectile Dysfuction
This penile ring connects to an app that measures and displays the intensity, duration, and frequency of your erections and orgasms.
It’s like a “Fitbit for your penis,” says urologist Robert Valenzuela, M.D.
This data allows you to see what variables tend to influence your sexual response, like diet, exercise, or medications.
“I basically recommend it to all my patients who come in complaining about problems with their erections,” says Valenzuela.
The FirmTech ring can also be worn as a preventative measure to determine if you’re developing ED, he adds. “Most guys who show up show up too late; the tissue isn’t functioning well,” he explains. “[With FirmTech], we can see and monitor how their erections are functioning.” However, about 10 percent of men aren’t able to use the ring, as their scrotums are too short for it to fit around, he adds.
During this treatment, a wand delivers sound waves to the penis in a way that mimics a microtrauma. This causes healing and growth factors to flood to the penis, creating new blood vessels and tissue.
One 2013 study found that shockwave therapy led to “a significant clinical improvement of erectile function and a significant improvement in penile hemodynamics [blood flow] without any adverse effects (1).”
There are two types of shockwave therapy used for erectile dysfunction: radial, which anyone can use as it is not FDA-regulated, and focal, which needs to be provided by a medical professional.
Focal therapy targets specific tissue within the penis, while radial is more spread out. Urological surgeon Lanna Cheuck, D.O. recommends focal therapy. “Focal is more effective because it penetrates the surface of the skin, and it treats the actual tissue inside the penis,” she says.
Since shockwave therapy was first offered in 2002, “we’ve seen some very good responses,” says Cheuck. It’s best for those with mild to moderate ED. The biggest risks are mild discomfort or skin irritation during the procedure, which typically go away after it’s finished.
Platelet Rich Plasma
For this procedure, your blood is drawn and spun in a centrifuge to isolate platelet-rich plasma (PRP), which contains growth factors that stimulate new blood vessels and tissue in the penis.
A 2021 study found that 69 percent of men who received a P shot (compared to 27 percent in a placebo group) saw significant improvements in erectile function after six months (3).
The ‘tox isn’t just for the face. A 70-person study on the effects of Botox for ED from 2021 found that patients had improved erectile firmness after two weeks, and over half of those who received botox were able to penetrate a vagina, compared to only one person in the control group (2).
An erection requires relaxation of the penile muscles, which are usually retracted, and botox can facilitate that.
“When you inject Botox into the corporeal tissues in the penis, it relaxes them so blood can flow into them,” Cheuck explains. And more blood flow leads to easier erections.
Botox on any part of the body poses the risk of paralysis, but this is uncommon. “We’ve been doing it since about 2017, and we have not seen any complications,” says Valenzuela.
Botox works best for mild to moderate ED, but those with more severe ED usually experience moderate improvement. A lot of people like this treatment because it can be done within half an hour and lasts from six months to a year.
Stem Cell Therapy
Stem cell therapy has been used to treat everything from cancer to diabetes, so it’s no surprise that it could also aid erections.
During this treatment, cells extracted from the patient’s own bone marrow are injected into the cavernosal tissue of the penis to restore the tissue.
The use of stem cells on the penis, however, has only just arisen over the past few years.
“We can’t yet say this works and everyone should use it,” says Valenzuela. “Medical associations all have the same feeling that it’s still in the experimental phase and we don’t know how well it works on people.”
Still, Valenzuela has used stem cells on some patients and seen good results. In addition, a 2021 review of research on stem cell therapy for ED (4) concluded that “there are rapidly expanding and promising results from the reported clinical studies indicating that stem cells could indeed be a potential treatment for patients with ED although more studies are necessary.”
Valenzuela says this treatment works best for people with mild or situational ED: “If it’s not functioning at all, the likelihood is you’re not going to respond.”
For this cutting-edge treatment, genes are injected into the penis to enhance erectile function. Gene therapy for ED is in its infancy, as scientists are still discovering what genes are involved in erectile functioning. Current research is largely limited to rodent studies (5).
“Any kind of gene therapy is considered experimental at this point,” says Cheuck. “I would not recommend it to anyone unless they’re in a specific study.” But it’s one to keep an eye on.