Because impotence can sometimes result from a combination of psychological and physical factors, counseling may help reduce anxiety and overcome the condition. The consultant may recommend counselling in combination with other treatments.

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Abnormal levels of sex hormones like testosterone, prolactin, and estrogen cause a small percentage of impotence cases. There are medications that can restore this balance.

Firstly the penis is placed in a hollow plastic chamber. Secondly air is pumped out of the chamber. This creates a vacuum, which draws blood into the penis to cause an erection. Thirdly a firm rubber band is then transferred from outside of the chamber to the base of the penis. Finally the blood remains trapped in the penis.Unfortunately, the penis is only rigid beyond the band, resulting in a ‘floppy’ erection, which tends to hang downwards. The rubber band can stop ejaculation. In addition it usually it becomes uncomfortable after 20 to 30 minutes.Vacuum erection devices avoid surgery. They are inexpensive. Vacuum erection devices are unpopular because the rubber band is unsightly and the devices are so mechanical and cumbersome. For many people they take much of the pleasure away from sexual activities.

Phosphodiesterase type 5 (PDE5) inhibitors are a group of medications most commonly used to treat erectile dysfunction. Men of all ages may take it, usually one hour before intercourse. Some PDE5 inhibitors work rapidly, between 16 and 25 minutes and are also effective in most men presenting with erectile dysfunction. Other PDE5 inhibitors restore the ability to get an erection for a longer period, thus freeing the patient from the constraints of having to plan sexual activity. Increased bloodflow to the penis causes the erection. These tablets act by relaxing the smooth muscle in the penis, which in turn allows the blood to flow into the penis more freely, thereby inducing an erection. Men taking medications containing nitrates, usually prescribed for heart problems such as Angina can not use these tablets, as it could cause a sudden drop in blood pressure. The same is true for men using recreational drugs e.g. “Poppers”. Common side effects experienced are headaches and flushing of the skin and less commonly a blocked nose, indigestion, visual disturbances and a prolonged erection. Unlike self-injection therapy, which gives a spontaneous erection, you will need sexual stimulation for these tablets to work. Alcohol or a heavy meal will impair the effect. It does not work for premature ejaculation and will be effective in about 50% of erectile dysfunction cases.