Is Erectile Dysfunction Treatment Guaranteed?
Success rates, what to do when medication doesn’t work, and the full treatment ladder.
Part of the Access Doctor Erectile Dysfunction guide.
Short answer: No treatment carries a 100% guarantee — but the vast majority of men with ED respond well to MHRA-approved medication. Those who do not respond to one approach have a range of effective alternatives. There is an effective treatment option for almost every man with ED.
Get ED Treatment Online
Access Doctor is a GPhC-registered online pharmacy. Our pharmacist independent prescribers assess your suitability for ED medication via a confidential online consultation. Discreet next-day delivery.
Start Consultation →Primary vs Secondary Erectile Dysfunction
| Type | Description | Treatment |
|---|---|---|
| Primary ED | Rare — man has never been able to sustain an erection | Requires specialist assessment; often has complex underlying cause |
| Secondary ED | Common — previously normal erectile function that has declined | Usually temporary and reversible with appropriate treatment |
How Effective Are ED Treatments?
| Treatment | Success rate | Notes |
|---|---|---|
| Sildenafil (Viagra) | ~82% of users | First-line; take 1 hour before sex; lasts 4–6 hours |
| Tadalafil (Cialis) | ~81% of users | 36-hour duration; available as daily 5mg |
| Vardenafil (Levitra) | ~80% of users | May work slightly faster than sildenafil in some men |
| Avanafil (Spedra) | ~77% of users | Fastest onset (~15–30 minutes); good tolerability |
| Penile injection (alprostadil) | ~85% of users | Effective when oral drugs fail; nerve-independent mechanism |
| Vacuum erection device | ~75% of users | No drug interactions; useful when oral medication is contraindicated |
| Penile implant | 90–95% satisfaction | Permanent surgical option; used when all other treatments have failed |
Non-Surgical Treatment Options
Oral PDE5 Inhibitors
All four MHRA-approved oral ED medications are available from Access Doctor following a clinical consultation. For guidance on choosing between them, see our tadalafil vs sildenafil comparison and full 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. See our guide to lifestyle changes for erectile dysfunction.
Psychological Therapy
Sex therapy, CBT, and couples counselling are effective for men with psychologically-driven ED and can be used alongside medication for best results. See our guide to psychological erectile dysfunction.
Vacuum Erection Devices
Effective in approximately 75% of men. A useful option for men who cannot take oral medication or who prefer a non-pharmacological approach.
When ED Medication May Have Limited Effect
- Severe nerve damage — complete cavernous nerve removal during prostate surgery means oral PDE5 inhibitors may have limited effect without intact nerve signalling; penile injection therapy or implants may be needed
- Very severe vascular disease — near-complete penile arterial insufficiency limits blood flow regardless of medication
- Poor adherence — taking with food, insufficient time before sex, or inadequate sexual stimulation all reduce effectiveness
- Untreated underlying conditions — poorly controlled diabetes, severe depression, or untreated hypogonadism impair response to medication
In all these cases, alternative or combination treatments remain available. For post-surgical ED specifically, see our guide to surgery and erectile dysfunction.
Frequently Asked Questions
Are ED medications guaranteed to work?
No treatment is 100% guaranteed, but PDE5 inhibitors have high success rates (77–82%). Those who don’t respond to one medication have a range of effective alternatives.
What happens if ED medication doesn’t work?
Your prescriber may try a higher dose, a different medication, or investigate underlying causes. Further options include penile injection therapy, vacuum erection devices, and surgical implants.
What are primary and secondary erectile dysfunction?
Primary ED is rare (never been able to sustain an erection) and requires specialist assessment. Secondary ED is common (previously normal function that has declined) and is usually reversible.
Does treating diabetes help ED?
Yes. Improving blood glucose control, blood pressure, and cholesterol can meaningfully improve erectile function in men whose ED is driven by diabetes.
Is ED treatment available on the NHS?
Yes, under specific conditions. Access Doctor provides a convenient alternative for faster, discreet access without waiting for a GP referral.
Can ED in diabetes be reversed?
In some cases, improved diabetes management combined with ED medication can restore satisfactory erectile function. Early intervention and tight glucose control give the best prognosis.
References
- National Institute for Health and Care Excellence (NICE). Erectile dysfunction: Clinical Knowledge Summary. Updated 2023. cks.nice.org.uk/topics/erectile-dysfunction
- NHS. Erectile dysfunction (impotence). nhs.uk/conditions/erection-problems-erectile-dysfunction
- Lue TF. Erectile dysfunction. N Engl J Med. 2000;342(24):1802–1813. PubMed: 10853004
Medical disclaimer: This article is for informational purposes only and does not constitute medical advice. ED treatments are prescription-only medicines requiring clinical assessment. In a medical emergency, call 999.