Few investigations of erectile dysfunction lead to specific interventions, so extensive testing cannot be justified in routine practice. Specific correctable underlying causes such as androgen deficiency or pituitary tumour should be sought, even though they are rare. Their treatment may be gratifying and has implications for general health (e.g. general energy and well-being, risk of osteoporosis).
The cost to you for ED drug therapy varies considerably, depending on the pharmacy price, prescription co-pays, and your level of health plan coverage. Nationally, the out-of-pocket cost per pill ranges from approximately $15 to $20. Even if private insurance covers it, you may be limited to four doses per month. Here are a few things you can do to contain costs:
The downside to these prostheses includes the standard risks of surgery, the very low risk of infection — less than 2 percent in most patients, slightly higher in diabetics — and a slight drop in penis length versus a natural erection or other ED treatments. Also, unlike with other methods, any hope for a natural erection is abolished once a pump is implanted. The cost for surgical options varies, and insurance coverage is typically good.

Cavallini, G., Modenini, F., Vitali, G., & Koverech, A. (2005, November). Acetyl-L-carnitine plus propionyl-L-carnitine improve efficacy of sildenafil in treatment of erectile dysfunction after bilateral nerve-sparing radical retropubic prostatectomy. Urology, 66(5), 1080-5. Retrieved from http://www.sciencedirect.com/science/article/pii/S0090429505006515
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Unlisted ingredients are potentially toxic. This may be because they are dangerous substances which are always dangerous for human consumption (e.g. commercial-grade paint). Unlisted ingredients which are safe for human consumption in some situations may also be dangerous if they are included in ED medications. For example, medicines used to treat diabetes have been found in counterfeit ED drugs. While these drugs can be taken safely by diabetics, in non-diabetics they can cause fatal hypoglycaemia (very low blood sugar).
The presently marketed formulation of prostaglandin E1 is inconvenient. It needs to be kept frozen due to the lability of the prostaglandin in solution. This makes prostaglandin E1 awkward to use, especially if the patient must travel. Improved formulations such as a lyophilised powder and a transurethral gel formulation of prostaglandin E1 as well as an effective oral medication have been developed and should become available in the near future.
The following products are considered to be alternative treatments or natural remedies for Erectile Dysfunction. Their efficacy may not have been scientifically tested to the same degree as the drugs listed in the table above. However there may be historical, cultural or anecdotal evidence linking their use to the treatment of Erectile Dysfunction.

While studies are limited, it has been shown that male sexual dysfunction can also negatively impact the sexual function of female partners. A study comparing the sexual function of women with partners with erectile dysfunction to those without showed that sexual arousal, lubrication, orgasm, satisfaction, pain and total score were significantly lower in those who had partners with erectile dysfunction. Later in that study, a large proportion of the men with erectile dysfunction underwent treatment. Following treatment, sexual arousal, lubrication, orgasm, satisfaction and pain were all significantly increased. It was concluded that female sexual function is impacted by male erection status, which may improve following treatment of male sexual dysfunction.
There are risks associated with circumventing the healthcare system which occur when prescription-only drugs are purchased on the black market. People with genuine ED may remain untreated because the counterfeit products they purchase do not contain an effective dose of the stated active ingredient. This may discourage patients from seeking professional treatment in the future because they think it will not work for them.
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ED is easily and successfully treated! If your sex drive is unaffected, but you experience problems achieving or sustaining erection for a period of four to five weeks, you may have ED. Talk to your doctor immediately. Don’t delay—erectile dysfunction doesn’t “just go away!” Additionally, ED could be a sign of a serious, even life-threatening complication, such as congestive heart failure or kidney disease. Ignoring your ED because it’s embarrassing could jeopardize your health.
Vacuum erection device: This can be used if you are unable to achieve or sustain an erection. It is a clear plastic tube that is placed over the penis and then sealed off. A vacuum is created by a pump-like action which draws blood into the penis and creates an erection. You then place a penile ring around the base of the penis near the pubic bone to sustain the erection.
Poor sleep patterns can be a contributing factor for erectile dysfunction, Mucher says. One review published in the journal Brain Research emphasized the intricate relationship between the level of sex hormones like testosterone, sexual function, and sleep, noting that testosterone levels increase with improved sleep, and lower levels are associated with sexual dysfunction. Hormone secretion is controlled by the body’s internal clock, and sleep patterns likely help the body determine when to release certain hormones. 
None of the ED drugs is safe to take with cardiac drugs called nitrates because it could cause a dangerous drop in blood pressure. Drugs that many men take for urinary symptoms, called alpha blockers, can also lower blood pressure, so take them at least four hours apart from ED drugs. Your doctor may start you on a smaller dose of the ED drug if you already take an alpha blocker, or may recommend the alpha blocker tamsulosin (Flomax), which affects blood pressure less.
The first stem cell study for the treatment of ED was published in 2004. This study used embryonic stem cells to treat ED. At this time, there is a total of 36 published basic studies assessing stem cell therapy for ED, with two clinical trials. The mechanism of action of stem cells is to generate angiogenesis with subsequent increase in cavernosal smooth muscle cells within the corporal bodies.46
There is a potential for drug overdose and drug–drug interaction when there is more active ingredient in a medication than is stated, or when a substitute is used for the active ingredient. Drug–drug interactions are interactions that can occur when an individual takes two medicines at the same time. Sometimes the medicines are incompatible and can interact dangerously, putting the person’s health at risk.
physical illness – erectile dysfunction is frequently associated with conditions affecting the blood flow in the penis. Diabetes, high cholesterol, hypertension (high blood pressure), cigarette smoking and obesity are often involved, and there is a strong association between erectile dysfunction and cardiac (heart) disease. Men who have multiple sclerosis may also experience erectile dysfunction
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