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    Improving erectile dysfunction without pills

    Q. How can you improve erectile dysfunction without pills?

    A. Although Viagra, Cialis, and similar medications for erectile dysfunction (ED) are heavily promoted and help many men improve their performance, other factors can contribute to ED that men can alter. And there is reason to do so: Risk factors for ED are the same that cause cardiovascular disease, heart attacks, and diabetes. Pravin Rao, director of reproductive medicine and surgery at Johns Hopkins University, explains that an erection requires healthy blood vessels, just as other functions of the body do. ED, he says, “might be the first sign of a larger metabolic syndrome putting men at risk for other conditions.”

    Research has shown that ED can often be improved through lifestyle changes like weight loss, exercise, stress reduction or psychotherapy, and a healthier diet. Quitting smoking can also improve men’s sexual function.


    Some medications cause or contribute to ED, including treatments for high blood pressure, anxiety, and depression. Rao says that switching medications or treating them in other ways may help. The catch is that some of these conditions also contribute to ED, so men shouldn’t leave them untreated.

    Rao says that some patients notice a benefit from herbal medications and other alternative treatments, but there’s currently no solid evidence these help beyond the strong psychological effect seen when men adopt any treatment, including a placebo, to improve ED. Although pills are the preferred medical treatment, men who don’t respond to them have other options including medication injections, vacuum devices, penile bands, and implants.