A complex interaction between the brain, the spinal nerves and the penis, culminating in an influx of blood into spongy spaces of the penis, allows an erection. When a man cannot get or sustain an erection firm enough for sexual intercourse on a regular basis, he has erectile dysfunction, also known as male impotence. The variety of causes for erectile dysfunction means that not all treatments will work for every man suffering from impotence.
Underlying Conditions
Many underlying medical conditions, including the drugs used to treat them, can cause impotence, primarily by interfering with blood flow to the penis. Some common examples include heart disease, diabetes, high blood pressure and Parkinson's disease.
Medications known to cause impotence include drugs used to treat high blood pressure, several types of anti-depressants, anticholinergics and cancer-fighting drugs. In some cases, addressing the underlying condition or switching drugs can remedy impotence without any further treatment.
Drugs
Oral medications approved for treating erectile dysfunction include tadalafil, with brand name Cialis; sildenafil, brand name Viagra; and vardenafil, brand name Levitra, according to the Mayo Clinic. The Merck Manual explains that all of these drugs work by inhibiting an enzyme called PDE5, which has the ultimate effect of relaxing muscles in the penis so more blood can flow in and fill the spongy spaces to cause an erection.
Some men cannot use these drugs because of potentially dangerous interactions with other medications. The Mayo Clinic reports that for these men, direct injection of the drug alprostadil into the base of the penis using a fine gauge needle can prompt an erection in 5 to 20 minutes. Alprostadil can also be inserted as a suppository in the penis.
Vacuum Device
A vacuum constriction device or penis pump to treat erectile dysfunction consists of a tube that fits over the penis connected to a pump that sucks air out of the tube. The resulting vacuum pulls blood into the penis, causing an erection that is maintained by sliding a tension ring onto the base of the penis. The tension ring is removed after sex.
Surgery
The Mayo Clinic outlines surgical options for treating erectile dysfunction. A surgeon can implant rods on either side of the penis to treat erectile dysfunction. The rods can either be inflatable using an external device to control when an erection occurs and how long it lasts, or the rods can be semi-rigid, keeping the penis constantly firm but bendable.
The surgery is effective but expensive and generally not advised unless other methods have failed. In rare cases, men suffer from erectile dysfunction because of leaky blood vessels in the penis. In such cases, a doctor might advise surgery to repair the blood vessel.
