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The little blue pill is only one way to get back to passionate pursuits. Only one-quarter of men diagnosed with erectile dysfunction ED actually seek treatment for the problem, according to a study published in the October issue of The Journal of Sexual Medicine. More than 6 million men with erectile trouble were included. And they are nearly percent effective in total.

Among one-quarter of men who did seek treatment, phosphodiesterase type 5 inhibitors PDE5i were overwhelmingly the preferred option: Three-quarters took the pills — that is, Viagra sildenafil , Cialis tadalafil , or Levitra vardenafil — which are largely considered the first line of treatment for ED.

Other options, such as injections or vacuum devices, were grossly underused. And even then, they may not stick with it: And of those, only 50 percent will ever refill it.

So there is much attrition every step of the way. For some patients, though, talking through options is a necessary step, since degradation of the smooth muscle cells in the penis can prevent drugs like Viagra from doing their job.

Darius Paduch, an associate professor of urology and reproductive medicine at Weill Cornell Medical College. That may not be enough. And realize that stimulation — even just the mental kind — is still necessary to wake up your penis. Still not rising to the occasion?

It may be time to try one of these second-line treatments:. A shot to the penis may sound like the last thing any man would attempt—but prostaglandin E1 injections, or a lprostadil , are actually effective in about 90 percent of men with ED, said McVary. The shots work much faster than the pills — you can expect to be erect within 10 to 15 minutes, whereas pills take can take an hour or two to kick in.

Shots may be an especially appealing option to younger guys with lots of stress, which can prevent the pills from working. Insert them as a suppository into the tip of your penis, so the meds are absorbed through the lining of your urethra. That also means the prostaglandin pellets take longer to kick in — about 20 minutes to half an hour. How it does the job: Your penis may also take on a bluish color for the same reason, noted Paduch. But for some guys, this option is much more preferable to popping a pill or performing injections.

This amino acid can enhance blood flow down below by boosting the production of nitric oxide, a chemical that dilates your vessels.

When your penis stops working, you may automatically assume low testosterone is to blame. But the truth is, a shortage of testosterone is the cause of erectile dysfunction only about 5 percent of the time, said McVary. Which way should you take your T? His rally remarks pretty much validate what she wrote. Sex Hormones May Be Lurking in Your Food And realize that stimulation — even just the mental kind — is still necessary to wake up your penis.

It may be time to try one of these second-line treatments: Prostaglandin E1 injections A shot to the penis may sound like the last thing any man would attempt—but prostaglandin E1 injections, or a lprostadil , are actually effective in about 90 percent of men with ED, said McVary. Testosterone replacement therapy When your penis stops working, you may automatically assume low testosterone is to blame. What to Read Next. Trump turns on Fox News and says new attorney general will look at locking up Democrats in wild rally speech.

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