Tens of millions of Americans are affected by a condition that can be difficult to discuss: erectile dysfunction, a condition that makes it difficult to get or keep an erection firm enough for sexual intercourse.

“If you can help someone with this condition, you’re actually helping two people—not just the person experiencing erectile dysfunction, but also their partner,” says David Chang, M.D., a urologist at Palisades Medical Center.

Two main treatment options for erectile dysfunction include prescription medications and penile implants. But which option might be the best choice for you? Dr. Chang sorts out the benefits and disadvantages of each.

Pros of Erectile Dysfunction Medication

Prescription medications work by improving blood supply to the penis and can produce an erection sufficient for intercourse when combined with sexual stimulation. Dr. Chang says the advantages of medication include:

• Convenience. Medications start working between 15 and 60 minutes after you take a dose. You can time intercourse accordingly but will need foreplay with your partner for the full effect.
• Satisfaction of both partners. An erection provoked by these drugs will closely mimic a man’s natural erection in terms of length and quality.

Cons of Erectile Dysfunction Medication

Medications have certain disadvantages, including:

• Expense. Some health insurers limit the number of pills you can obtain each month, and out-of-pockets costs can be high.
• Effectiveness. While they work for about 70 percent of all men, medication doesn’t produce satisfying erections for everyone. Men with blood vessel damage or trauma to the pelvis are even less likely to benefit.
• Side effects. Most common are headaches, facial flushing, stuffy nose, nausea and diarrhea. “Some people find these to be very disturbing,” he says.

Pros of Penile Implants

Penile implants are devices placed inside the penis to enable people with erectile dysfunction to achieve an erection. They come in various versions. The most common squeezes water from a reservoir under the abdominal wall into two cylinders in the penis to inflate it before intercourse.

Dr. Chang says the advantages of penile implants include:

• Reliability. “In contrast to medication, a penile implant is always ready to go,” he says. “It takes about 30 seconds to pump it up.”
• Accessibility. Many private health insurers cover penile implant surgery even when they don’t cover erectile dysfunction medications.
• Staying power. Erections can last as long as you’d like.

Cons of Penile Implants

Penile implants pose certain downsides, including:

• Surgery. All such devices require surgery, which presents possible complications such as infection, bleeding and pain.
• Less length. “Many people feel the size of their erection is not as long as they might have achieved naturally,” Dr. Chang says. “It can be upsetting.”
• Learning curve. It can be challenging to learn how to manipulate the pump that inflates the penile implant. “You need some degree of manual dexterity to squeeze and inflate it, which can be a bit difficult,” he says.

Who Is a Candidate for Each?

Certain men are better candidates for either erectile dysfunction medications or penile implants. Medications are more effective, for example, for men who don’t have significant blood vessel damage (such as from diabetes) and don’t have problems with their pelvic anatomy (from surgery or an accident).

“The best candidates for these medications have partial erectile dysfunction, where they need a little boost,” Dr. Chang says.

Men with blood vessel damage or anatomical problems with their pelvis are better candidates for penile implants. “But basically anyone with erectile dysfunction who isn’t satisfied with their current sexual abilities with or without erectile dysfunction medication may also be candidates,” he says.

Talking to Your Partner

Dr. Chang recommends keeping open lines of communication with your partner when considering any treatment for erectile dysfunction. He offers these tips to smooth the process:

• Reassure your partner you’re attracted to them and that your need for treatment has no bearing on your feelings for them.
• Involve them in the treatment decision-making process. “Getting help for erectile dysfunction benefits both people in the relationship, so make sure your partner gets to share their opinion,” Dr. Chang says.

Next Steps & Resources:

• Meet our source: David Chang, M.D.
• To make an appointment with a urologist near you, call 800-822-8905 or visit our website.

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.