ED Basics

ED Solutions That Nobody Ever Told You About

May 16, 2022

Just about everyone has heard of Viagra®, even if they’re unfamiliar with the specifics of erectile dysfunction.

Viagra (sildenafil) is one of the most popular drugs in the world and is often considered the first line of treatment against erectile dysfunction

Since hitting the market in 1998, it's been used by tens of millions of men to help improve the quality and duration of their erections.

Although it’s undeniably the most popular ED treatment option, it’s not the only erectile dysfunction treatment available. Here are some effective ways to treat ED that are alternatives to Viagra.

Vacuum Pumps 

Vacuum pumps (or penis pumps) are erection devices (and sometimes sex toys) that use air pressure to draw blood into your penis and create an erection. These devices have been around in many forms for decades and consist of a cylinder and pump to pull blood into the penis. They're simple and effective for many men.

Although the exact design and features can differ, the core principles are the same for most vacuum erection devices. 

  1. A plastic cylinder slides over the penis and is pressed against the groin skin, creating a sealed tube around the penis.
  2. The user activates the battery or hand powered pump to gently pull air out of the cylinder and create a vacuum in the cylindrical space.
  3. Blood begins to rush into the penis, and after a few minutes, the penis becomes erect.
  4. A release valve is depressed to release the seal on the vacuum cylinder so you can slide the device off.
  5. Some men use a constriction band at the base of the penis to keep blood trapped in the penis and sustain the erection for longer. 

It’s important to note that constriction bands can only be used for about 30 minutes. Much longer and they can lead to nerve damage or circulation issues. 

Penis pumps are an effective and often affordable way for many men to get stronger erections without pharmacological intervention.

Penis Injections 

Penis injections use a tiny needle to inject medication directly into the soft tissue of your penis.

The most common injected medications for ED are a combination of alprostadil, phentolamine, and papaverine. 

These drugs work in much the same way as oral medications for erectile dysfunction. They both work by dilating your blood vessels and relaxing the muscle tissues in your penis. This helps to increase the amount of blood flowing into the penis and decrease the amount flowing out, resulting in a strong erection that will last through intercourse. 

The prescribing doctor will show you the proper techniques for using injectable ED medications before you try it on yourself. 

After the injection, most men experience an erection within ten minutes that can last for up to an hour or until orgasm.


Not all causes of erectile dysfunction are physical. Mental health plays a critical role in the erection process, and issues with self esteem, confidence, stress, anxiety, or body image can result in erectile dysfunction. 

In fact, stress, anxiety, and depression are three of the major psychological causes of erectile dysfunction. Treating mental health conditions like these can reduce the risk and/or eliminate the symptoms of ED when done right. A therapist can help, as can regular mindfulness, hobbies, and other stress- or anxiety-reducing efforts. 

In addition, those dealing with stress are more likely to use alcohol, cigarettes, or recreational drugs to escape these feelings. 

If you have a clean bill of physical health but still experience difficulties maintaining erections, it could be a sign of a mental or emotional struggle. Talking with a therapist may help you find potential paths forward for your mental well-being and improve erections in the process. 

Other Medications

Viagra isn't the only oral medication for ED. Cialis® (tadalafil) and Levitra® (vardenafil) are both oral medications that work by the same mechanism of action as Viagra. They are PDE5 inhibitors, for phosphodiesterase-5, and they work about as well as Viagra based on clinical research since they were all introduced about 20 years ago.

Cialis also comes in a low dose (2.5 and 5 mg) that can be taken daily instead of "on demand." For many men, this is an attractive way to "be ready" without taking a medication in the hours before intercourse.

Lifestyle Changes 

Lifestyle changes can not only help to reduce the severity of erectile dysfunction but can help to improve your overall health as well. 

Erections rely on strong and consistent blood flow. During an erection, your penis can hold as much as seven times its normal blood volume.

Anything and everything that's good for your circulatory system will be good for your sexual function, too.

Conversely, everything harmful to blood flow also means a higher chance of sexual dysfunction. 

Eating a Balanced Diet

Unhealthy foods can have a severe impact on your blood flow and may result in erectile dysfunction over time. 

For example, foods that are high in saturated fat, sodium, and sugar can contribute to cardiovascular disease, atherosclerosis (narrowed arteries), high blood pressure, and diabetes. These foods can also lead to obesity, which has a strong connection to the development of erectile dysfunction.

Replacing unhealthy and processed foods with more vegetables, fruits, whole grains, nuts, and legumes can reduce your risk of developing medical conditions like the above, while improving blood circulation.

Treat the condition and many men will find their erectile strength improves concurrently.

Getting More Exercise 

Like a mediocre diet, a sedentary lifestyle devoid of exercise can lead to issues with blood circulation too.

Getting up off your sofa and exercising more can improve cardiovascular function and blood flow significantly. A daily walk of just 20-30 minutes can be enough to improve metabolic and cardio function and strengthen erections.

You don't have to become a long-distance runner to reap the benefits of regular exercise. Create a weekly workout routine that consists of four 40-minute sessions of moderate intensity exercise. Or, make daily 20-minute walks a priority. Either way, try to include cardio exercises such as fast walking, jogging, rowing, or swimming, as well as regular resistance training or weight lifting. 

Bottom line: anything you do above and beyond just sitting can help.

Avoiding Negative Influences 

Alcohol abuse and smoking are two key risk factors in the development of ED. If you're consuming more than a dozen drinks a week, it may be time to cut back. Quitting smoking entirely is also a great way to reduce your risk of ED.

An occasional alcoholic beverage isn't too bad for you, but drinking to excess can cause your blood to thin, blood pressure to drop, and make it more difficult to keep an erection. Excessive drinking over the course of years can lead to permanent nerve damage and erectile dysfunction.

Smoking cigarettes can also lead to a wide array of health concerns for your blood and heart. In fact, smoking is considered the leading cause of erectile dysfunction in men under 40. No amount of smoking is healthy, and you should consider quitting entirely to help erection strength and reduce your risk of cancer, cardiovascular issues, and more. 

The Takeaway

Viagra is a great option for many men with ED, but there's more than one way to treat this common issue. 

The most universally beneficial approach is to make changes to your diet, physical health, and cut bad habits. These changes can take some time to produce results, but they can help with the symptoms of ED as well as improve longevity in most guys.

Other Viagra alternatives for ED include penile injections, vacuum pumps for those that don’t want to deal with needles, therapy for mental health, and even other oral medications.

Rex MD is the easiest way to get ED meds delivered to your door, if approved, with free online consultations, free delivery and no copays. Click here to get started. 


FDA approves Viagra | History.com

How an erection works | University of Iowa Hospitals & Clinics

Association of Diet With Erectile Dysfunction Among Men in the Health Professionals Follow-up Study | NCBI

Walking for good health | Better Health

Physical Activity to Improve Erectile Function: A Systematic Review of Intervention Studies. | NCBI

Symptoms & Causes of Erectile Dysfunction | NIDDK

Alcohol intake and risk of erectile dysfunction: a dose-response meta-analysis of observational studies). | PubMed

Effects of cigarette smoking on erectile dysfunction | NCBI

Vacuum device placed around the penis to treat erectile dysfunction | NIDDK

Impact of penile injections on men with erectile dysfunction after prostatectomy | PubMed

Erectile dysfunction and mental health in a general population of older men | PubMed

Obesity and sexual dysfunction, male and female | International Journal of Impotence Research