Erectile dysfunction (ED) is a much more common condition than you might think. It affects men of all ages and can have a significant impact on quality of life, self-esteem, and interpersonal relationships. It’s no surprise, then, that one of the most typed searches online is: “What is the best treatment for erectile dysfunction in the UK?“. This seemingly simple question hides a complex reality: there is no single “magic pill” or one-size-fits-all therapy.
The ‘best’ treatment is the one chosen after an accurate specialist diagnosis, tailored to the specific causes of your condition, your medical history, your expectations, and your lifestyle. A superficial approach or self-diagnosis based on generic information found online rarely leads to lasting results and, in some cases, can be counterproductive.
In this article, we will clearly and in detail explore the options available in the UK in 2025, guided by the expertise of Prof. Fabio Castiglione, Consultant Urologist and Andrologist in London, to help you understand which treatment path might be best suited to you.
What is the best treatment for erectile dysfunction in the UK? Diagnosis in 2025
Before discussing treatments, it is essential to understand how a specialist arrives at an accurate diagnosis. Proper classification is the first and indispensable step in identifying the most effective therapy.
Prof. Castiglione’s advanced diagnostic pathway includes:
- Comprehensive medical history: An in-depth discussion of your medical, sexual and psychological background. This includes questions about the quality of erections (morning, spontaneous, during masturbation), libido, any chronic conditions (such as diabetes, high blood pressure or heart disease), and lifestyle factors.
- Standardised questionnaires: Tools such as the International Index of Erectile Function (IIEF) help to objectively assess the severity of the condition and to monitor treatment progress.
- Blood tests: To evaluate hormone levels (particularly testosterone), blood sugar profile, lipid levels, and other indicators of general health that may affect erectile function.
- Advanced vascular assessment: Dynamic penile echo-colour Doppler is a fundamental specialist test. It enables real-time evaluation of penile blood flow before and after pharmacological stimulation, distinguishing between arterial causes (insufficient blood supply), veno-occlusive causes (excessive venous leakage), or mixed.
- Comorbidity and medication review: Many health conditions and their treatments can contribute to ED. Commonly prescribed medicines, such as certain diuretics (e.g. furosemide), antihypertensives and antidepressants, can affect erectile function. Careful review of these polytherapies is crucial.
Prof. Castiglione’s team adopts a multidisciplinary and integrated approach, ensuring that every aspect of the condition is considered in order to define a truly personalised treatment plan.
Overview of treatment options in the UK (from first-line therapies to surgery)
Once the diagnosis is complete, a range of therapeutic options becomes available. Let’s look at them in detail, from the simplest to the most advanced.
Lifestyle and prevention: The foundation
Often underestimated, lifestyle modification is the first and most important intervention.
- Weight control and nutrition: Maintaining a healthy weight supports cardiovascular health.
- Regular physical activity: Aerobic exercise improves circulation.
- Sleep quality: Adequate rest is essential for testosterone production.
- Stop smoking and limit alcohol: Both are major enemies of vascular function.
- Stress management: Relaxation and mindfulness techniques can make all the difference.
- Pelvic floor exercises: These can improve erection control and rigidity.
Are you looking for the best treatment for erectile dysfunction in the UK? The answer is a personalised solution. Contact Prof. Fabio Castiglione for a specialist consultation at +447830398165.
Oral medications (PDE5 inhibitors)
These are the most well-known first-line therapy. They work by increasing blood supply to the penis in response to sexual stimulation.
- Sildenafil, Tadalafil, Vardenafil, Avanafil: Although they belong to the same class, they differ in duration of action and speed of onset. Tadalafil, for example, can be taken in a low daily dose, offering greater spontaneity.
- Warnings: They are not aphrodisiacs and require stimulation. They are contraindicated in men taking nitrate medication for heart disease.
Topical therapies and external devices
- Local creams (e.g. Alprostadil): Applied directly into the urethra, they can induce an erection. Effectiveness varies.
- Vacuum erection device (VED): A cylinder is placed over the penis to create negative pressure, drawing blood into the penis. An elastic ring at the base maintains the erection. It is a safe, mechanical solution but requires practice.
Intracavernosal injections (ICIs)
When tablets are ineffective or contraindicated, micro-injections directly into the penis are a highly effective second-line therapy.
- Medication (e.g. Alprostadil): Patients are trained to self-inject before intercourse.
- Efficacy and risks: Around 85% success rate. Risks include pain, bruising, and, rarely, priapism (a prolonged, painful erection requiring urgent medical attention) or fibrosis.
Regenerative therapies: P-Shocks and Shock Waves (Li-ESWT)
This is the field in which Prof. Castiglione has pioneering experience. The aim is not only to treat symptoms but to act on the underlying cause, improving penile tissue health.
- Low-intensity shock waves (Li-ESWT): Use acoustic energy to stimulate new blood vessel formation (neoangiogenesis) and improve erectile tissue function. Non-invasive and painless.
- P-Shocks (PRP + P-Shocks + shockwave): Prof. Castiglione’s advanced personalised protocol. It combines shock waves with the infiltration of PRP (platelet-rich plasma), obtained from a simple blood sample. PRP growth factors work synergistically with shock waves to promote tissue and vascular regeneration. Particularly suitable for men with vascular or diabetic ED, with the goal of restoring natural erectile function.
Psychosexual support
Especially in younger men, ED often has a psychological component (performance anxiety, stress, relationship difficulties). Working with a psychosexual therapist or sexologist can be decisive, either alone or alongside medical therapies.
Penile prosthetic surgery
For the most severe cases, where all other therapies have failed, implantation of a penile prosthesis is the definitive solution.
- Types: Malleable implants (semi-rigid) or inflatable hydraulic implants (allowing a natural-looking erection via a concealed pump).
- Satisfaction: This option has the highest patient and partner satisfaction rate (over 90%) in appropriately selected cases.
Ready to answer the question, “What is the best erectile dysfunction treatment in the UK?” for your situation. Call Prof. Fabio Castiglione’s team today at +447830398165.
How to choose “the best treatment” for you: A personalised approach
Treatment choice follows a clinical algorithm based on:
- Age and severity: A young man with mild, anxiety-related ED will follow a different path from a 70-year-old with diabetes and severe ED.
- Cause of ED: Vascular ED (confirmed by Doppler) may be best addressed with shock waves or P-Shocks, whereas hormonal causes may require replacement therapy.
- Comorbidities: Patients with heart disease on nitrates cannot use PDE5 inhibitors. Diabetic patients may respond less well to oral medication and may benefit more from regenerative or injectable therapies.
- Concomitant medications: The impact of medicines such as diuretics must be reviewed, and background therapy optimised in collaboration with the patient’s GP or specialist.
- Patient preferences: Adherence is crucial. The final decision must be shared, taking into account practicality, invasiveness and expectations.
The “best” treatment is therefore the one that maximises effectiveness, safety and quality of life in your specific case.
Frequently Asked Questions (FAQs)
What is the treatment with the highest success rate for erectile dysfunction?
It depends on how “success” is defined:
- Penile implants: Highest satisfaction rates (over 90%) for patients unresponsive to other therapies.
- Intracavernosal injections: Very high efficacy (about 85%) in inducing erections.
- Regenerative therapies (P-Shocks): Promising results in improving natural erectile function in selected patients.
- Oral medications: Effective in around 70% of men.
The right choice depends on the underlying cause and treatment goals.
Can a 70 year old man still have erections?
Absolutely. Age is not a disease. Although some physiological changes are normal, a healthy 70-year-old man can and should have a satisfactory sex life. Often, ED in this age group is linked to treatable medical conditions. With the right diagnosis and treatment, erectile function can be maintained or restored.
What is the treatment offered by the NHS for erectile dysfunction?
The NHS’s standard pathway usually involves lifestyle advice as a first step. Subsequently, Sildenafil may be prescribed, but often with limitations on quantity. For more advanced therapies such as injections, VED, or prostheses, a urological specialist consultation is necessary, which can involve long waiting lists. Innovative therapies such as shock waves or Pshocks are generally not available through the NHS for ED.
Can furosemide cause ED?
Yes, it is a possibility. Furosemide is a powerful diuretic that can reduce blood volume and blood pressure, factors that can theoretically contribute to erection difficulties. If you suspect that your medication is causing ED, never stop it on your own. Talk to your doctor and a specialist such as Prof. Castiglione to evaluate alternatives or solutions.
“Erectile Dysfunction Test”: What to Expect in Evaluation?
A specialist assessment is not a single “test”. It is a path that includes an in-depth discussion (anamnesis), the completion of questionnaires (IIEF), blood tests to check hormones and general health, and, in the cases indicated, a dynamic penile echocolordoppler to assess blood flow.
“ED pills” and online shopping in the UK: is it safe?
Buying ED drugs online requires extreme caution. In the UK, it is legal to only buy them through registered online pharmacies that require a valid prescription or online consultation with a licensed doctor. Avoid sites that sell “Viagra” or “Sildenafil” without a prescription: the risk of receiving counterfeit, ineffective or dangerous products is very high. Safety always comes first.
Your search for “what is the best treatment for erectile dysfunction in the UK?” ends here. There is no single answer, but the right one for you. Discover it with Prof. Fabio Castiglione: call +447830398165 for a specialist visit.
The services of Prof. Fabio Castiglione
At his Erectile Dysfunction Clinic London, Prof. Castiglione offers a complete and cutting-edge pathway:
- Precision diagnosis: Use of all the latest technologies, including dynamic penile echo-color-Doppler, to identify the exact cause of the problem.
- Personalized treatment plans: From optimized oral medication prescription, to training for injections, to regenerative protocols such as Pshocks and shock waves (Li-ESWT).
- Specialist surgery: Prof. Castiglione is one of the leading experts in the implantation of penile prostheses, offering a definitive solution to the most complex cases.
- Constant follow-up: The path does not end with the prescription. Prof. Castiglione and his team monitor progress, optimize therapies and support you in the long term.
Conclusions
Erectile dysfunction is no longer a taboo or a life sentence. From lifestyle changes to innovative regenerative therapies and definitive surgical solutions, there is an effective option for almost every man. The most important step is the first: seeking help from a qualified professional who can guide you through a thorough diagnostic process and recommend a treatment plan based on scientific evidence and your individual needs. Do not leave it to chance – rely on proven expertise.