Is Erectile Dysfunction Treatment Guaranteed? Success Rates and Options

Can erectile dysfunction be guaranteed to respond to treatment? The short answer is: no treatment carries a 100% guarantee — but the good news is that most men with ED respond well to MHRA-approved medication, and those who do not respond to one approach have a range of effective alternatives. This guide covers the types of ED, its causes and symptoms, and the full spectrum of available treatments — from lifestyle changes to oral medication to surgical options.

Understanding Erectile Dysfunction

Erectile dysfunction is defined as the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual intercourse. It affects more than 40 million men globally. While most common in men over 40, it can affect men of any age. For a foundational understanding, see our guide to ED: the basics.

Primary vs Secondary ED

Physical and Psychological Causes

ED has numerous potential causes — both physical and psychological — which often interact. Key physical causes include cardiovascular disease, diabetes, hypertension, hormonal imbalances, neurological conditions, and medication side effects. Psychological causes include performance anxiety, depression, stress, and relationship difficulties. For a comprehensive breakdown, see our guide to what causes erectile dysfunction.

How Effective Are ED Treatments?

Non-Surgical Treatment Options

Oral Medications (PDE5 Inhibitors)

Access Doctor provides all four MHRA-approved oral ED medications — sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra), and avanafil (Spedra) — via online consultations with our GPhC-registered pharmacist independent prescribers. For guidance on choosing between them, see our tadalafil vs sildenafil comparison and full ED medication comparison guide.

Lifestyle Changes

Weight loss, regular exercise, improved diet, quitting smoking, and reducing alcohol have all been shown in controlled studies to improve erectile function. For men with lifestyle-related ED, these changes can sometimes reverse symptoms entirely without medication. See our complete guide to lifestyle changes for erectile dysfunction.

Psychological Therapy

Sex therapy, cognitive behavioural therapy (CBT), and couples counselling are effective for men with psychologically-driven ED. These approaches can be used alongside medication for best results.

Vacuum Erection Devices

A vacuum erection device (VED) creates a seal around the penis and uses negative pressure to draw blood in, creating an erection. A constriction ring maintains the erection. VEDs are effective in approximately 75% of men and are a useful option for men who cannot take oral medication.

When Might ED Treatment Not Work?

• Severe nerve damage (e.g., complete cavernous nerve removal during prostate surgery) — oral medications may have limited effect without intact nerve signalling
• Very severe vascular disease with near-complete penile arterial insufficiency
• Poor adherence to treatment instructions (taking with food, insufficient time before sex)
• Untreated underlying conditions (e.g., poorly controlled diabetes, severe depression)

In these cases, alternative treatments — penile injection therapy, vacuum devices, or penile implant surgery — remain available options. For post-surgical ED specifically, see our guide to can surgery cause ED.