See a healthcare professional to confirm the cause and rule out underlying conditions
Review and treat contributing factors such as diabetes, high blood pressure, high cholesterol, obesity, smoking, alcohol use, stress, anxiety, and depression
Improve lifestyle habits with regular exercise, healthy diet, weight loss if needed, good sleep, and smoking cessation
Review current medications with a clinician to identify drugs that may contribute to ED
Use oral PDE5 inhibitors such as sildenafil, tadalafil, vardenafil, or avanafil if appropriate
Avoid PDE5 inhibitors if taking nitrates or if otherwise medically contraindicated
Consider vacuum erection devices
Consider counseling or sex therapy for psychological or relationship-related causes
Consider testosterone testing and treatment if low testosterone is confirmed
Consider intracavernosal injections or intraurethral therapy if oral medications are ineffective
Consider penile implants for severe or refractory ED
Seek urgent care for sudden ED with pain, penile injury, or erection lasting more than 4 hours