The latest treatments for erectile dysfunction focus on faster-acting options, non-drug therapies, and improved surgical devices. The biggest recent shift is the arrival of a topical gel that works in minutes without a pill, alongside growing interest in shockwave therapy as a way to address the underlying cause rather than just manage symptoms. Here’s what’s actually available now and what’s still unproven.
Eroxon: The First Over-the-Counter Gel
The newest FDA-cleared option is Eroxon, a topical gel applied directly to the tip of the penis. It’s the first erectile dysfunction treatment available without a prescription in the United States. In clinical testing, 62.6% of men noticed an erection within 10 minutes of application, and 55.7% were able to have penetrative sex within 15 minutes. That speed is a significant advantage over oral medications, which typically require 30 to 60 minutes of lead time.
Eroxon works through a physical mechanism rather than a chemical one. The gel creates a warming and cooling sensation that stimulates blood flow locally. Because it doesn’t enter the bloodstream the way pills do, it avoids the drug interactions and cardiovascular concerns that make traditional medications off-limits for some men, particularly those taking nitrate-based heart medications. The trade-off is that it doesn’t work for everyone, and its success rates in trials were somewhat lower than those reported for prescription pills in ideal conditions.
Faster Oral Medications
For men who prefer a pill, the PDE5 inhibitor class (the family that includes sildenafil) now has a faster-acting member. Avanafil was designed specifically to work more quickly, and its effects last around 5 hours compared to about 4 hours for sildenafil. It can be taken closer to sexual activity, with a shorter waiting window than older options in the same class.
All PDE5 inhibitors work the same way: they relax blood vessels in the penis to improve blood flow during arousal. The differences between them come down to how fast they kick in, how long they last, and their side effect profiles. Avanafil tends to produce fewer headaches and facial flushing than sildenafil, likely because it’s more selective in which blood vessels it targets. Your doctor can help determine which one fits your situation, but it’s worth knowing that the newer option exists if you’ve found older pills inconvenient or poorly tolerated.
Low-Intensity Shockwave Therapy
Shockwave therapy is the treatment generating the most interest as a potential way to restore natural erectile function rather than just temporarily boosting it. The procedure uses low-energy sound waves directed at penile tissue to stimulate new blood vessel growth and improve blood flow at a structural level.
A systematic review and meta-analysis of seven randomized controlled trials found that shockwave therapy produced a statistically significant improvement in erectile function scores compared to sham (placebo) treatment. Men who received the real therapy saw their scores improve by an average of 6.4 points on the standard erectile function scale, compared to 1.65 points in the sham group. That’s a meaningful difference, roughly equivalent to moving from moderate dysfunction into the mild range.
Treatment protocols vary, but most involve sessions spread across several weeks, often five to six sessions with a break period, then another round. The appeal is obvious: a treatment that actually repairs the vascular damage behind ED rather than working around it each time. The caution is that results vary significantly between studies, and there’s no universally standardized protocol yet. Many clinics offer it, but insurance rarely covers it, and sessions typically cost several hundred dollars each.
PRP Injections Don’t Hold Up in Trials
Platelet-rich plasma injections, sometimes marketed as the “P-Shot,” involve drawing your blood, concentrating the platelets, and injecting them into penile tissue. The theory is that growth factors in the platelets promote tissue repair. Clinics across the country charge significant sums for this procedure, so the clinical evidence matters.
A prospective, double-blind, placebo-controlled trial published in the Journal of Urology tested two PRP injections spaced one month apart in 61 men with mild to moderate ED. The result: men who received PRP saw their erectile function scores improve from 17.4 to 21, but men who received a placebo injection improved from 18.6 to 21.6. There was no significant difference between the two groups. The procedure was safe, with only minor adverse events, but the researchers concluded they found no evidence that PRP outperformed placebo. If a clinic is offering this as a proven treatment, that claim isn’t supported by the best available evidence.
Stem Cell Therapy Is Not FDA-Approved
Stem cell injections for ED are actively being studied in early clinical trials, but no stem cell product is FDA-approved for treating erectile dysfunction. The only stem cell products currently approved in the United States are blood-forming stem cells derived from umbilical cord blood, and those are exclusively approved for blood production disorders.
The FDA has specifically warned consumers about clinics marketing unapproved stem cell treatments for a range of conditions. Any clinic offering stem cell therapy for ED today is doing so outside the FDA approval process. That doesn’t necessarily mean the science won’t eventually support it, but right now, you’d be paying out of pocket for an experimental treatment with no guaranteed efficacy or safety profile. The risks include infection, immune reactions, and the possibility that the cells simply don’t do what’s claimed.
Penile Implants Have Gotten Better
For men who don’t respond to medications, gels, or other therapies, inflatable penile implants remain the most reliable long-term solution. The latest generation of these devices has improved meaningfully. Current models use advanced biocompatible silicone that’s more durable and carries a lower infection risk than earlier versions. Most modern implants also incorporate antibiotic coatings that reduce post-surgical infection rates, which was historically the biggest concern with the procedure.
An inflatable implant consists of a small pump placed in the scrotum and two cylinders inside the penis. Squeezing the pump fills the cylinders with fluid, creating an erection that feels natural and can be maintained as long as desired. Satisfaction rates among men who get implants are consistently above 90% in long-term studies, making it one of the most satisfying treatments in all of urology. The surgery itself typically takes about an hour, and most men return to sexual activity within four to six weeks.
Treatment Doesn’t Have to Be Stepwise
One important shift in how doctors approach ED: you don’t have to start with the least invasive option and work your way up. The American Urological Association guidelines now emphasize shared decision-making, stating that it’s valid for men to begin with any type of treatment regardless of how invasive it is. If you already know pills aren’t for you, or if your ED is severe enough that a gel or medication is unlikely to help, you can discuss going straight to shockwave therapy or even an implant.
For men who take nitrate medications for heart conditions, PDE5 inhibitor pills are off the table entirely because the combination can cause a dangerous drop in blood pressure. But options like Eroxon gel, penile implants, and lifestyle changes (regular exercise, weight management, improving cardiovascular health) remain available. The landscape is broader than it was even a few years ago, and the right choice depends on what’s causing your ED, how severe it is, and what matters most to you in terms of convenience, spontaneity, and long-term results.