Survey Unveils: Which Alternative ED Treatments Are Worth a Shot, According to 33 Urologists

Between Us Clinic Survey Reveals Urologists’ Top ED Treatment Recommendations: Diet, Exercise, and Mindfulness Meditation Lead the Way.

Urologist thinking about alternative erectile dysfunction clinic

Erectile dysfunction is one of the most common sexual issues in men. Having erectile dysfunction can weigh heavily on both men and their partners.

Unfortunately, some try to take advantage of vulnerable men, marketing alternative ED treatments that simply do not work.

These could be the kinds of treatments advertised on the radio, found at the back of your newspaper, or seen in online ads.

But are all alternative treatments bad? The short answer is “no.” Some alternative treatments can have a tremendously positive effect.

To set the record straight, we surveyed and interviewed 33 leading urologists to help you understand which alternative ED treatments are worth trying, and which you should absolutely avoid!

Stem cell therapy

Chart showing how many urologists recommend stem cell therapy for erectile dysfunction

Let’s start with the treatment that came in last and is the least recommended.

Stem cell therapy is one of the hottest, but unproven and most expensive ED treatments that is floating around in the market.

Stem cells are undifferentiated cells that have the potential to develop into various types of cells in the body. The hope is that by injecting them, we can harness their regenerative capabilities to repair and regenerate the tissue.

But, while this holds promise, outcomes vary between different parts of the body, and injecting them into the penis doesn’t necessarily work.

While stem cell therapy has been shown to rejuvenate tissue in other applications, not all urologists are convinced that this applies to erectile dysfunction as well, promoting more research.

Why urologists advise against it?

There is no convincing evidence that stem cell therapy will reverse ED. Although it rejuvenates tissue in other applications, the injected cells quickly exit from the penis due to its rich blood supply.

Scott D. Miller , Board Certified Urologist, and Medical Director of Wellstar Urology.

It is expensive and the protocols have not been worked out yet. Research is being done to get a better understanding of the potential for stem cell therapy but it is not ready for prime time yet.

Elizabeth Kavaler , Board Certified Urologist and Urogynecologist and Medical Director of Total Urology Care of NY.

There has been no evidence to date that stem cell therapy is beneficial for erectile function.

This may change in the coming years as advances in therapy and regulations regarding what constitutes proper and responsible administration of stem cell therapy take effect.

Zamip Patel , Urologist and Andrology Expert, and Medical Director of Cryos International

The real answer here is not yet. There is very promising research that indicates that stem cell therapy may be of benefit to patients suffering from ED.

However, the research is limited in size and the methods of treatment and evaluation need to be standardized.

At this point, stem cell therapy for ED should only be conducted within the confines of a clinical study by experts who are able to address any concerns that may arise during treatment.

Jonathan Beilan , MD, Adviser for Marius Pharmaceuticals, and Assistant Professor at USF Department of Urology.

Why urologists say “it depends”?

Stem cell therapy is an emerging treatment modality for ED, particularly in cases where erectile dysfunction is due to penile tissue damage. While early research and clinical trials show promise, it is still considered experimental.

Patients should only consider stem cell therapy within the context of well-designed clinical trials until more definitive evidence is available regarding its safety and efficacy.

Justin Houman, Board Certified Urologist, Men’s Sexual Health Specialist, and Medical Director at Bastion Health.

Embryonic Stem Cell Therapy is probably amongst the most interesting future treatment for ED issues.

This regenerative treatment makes a lot of sense on multiple levels – improved viability of erectile tissue, reduced inflammation, rejuvenation of cells, etc.

There are reports of benefits from Stem Cell Therapy, but as of now, to my knowledge, its use is not allowed in the US and patients interested in this therapy need to have it performed in other countries.

David Kaufman, Board Certified Urologist and Director of Urology at Maiden Lane Medical in NYC.

Why urologists recommend it?

Although experimental, there is good anecdotal evidence that this can help.

Anika Ackerman, Board Certified Urologist Specializing in Sexual Health in Morristown, NJ.

Emerging treatment for some situations where other treatments may not be effective.

Shiv Kumar Pandian, Consultant Urologist and Lead Clinician for Urological Cancer at North Middlesex University Hospital NHS Trust in London.

New treatment worth trying as initial reports suggest good efficacy.

Syed Rahman, Consultant Urologist at Spire Leeds Hospital and St James’ University Hospital, and an honorary senior lecturer at the University of Leeds.

Platelet rich plasma therapy (PRP)

Chart showing how many urologists recommend PRP therapy for erectile dysfunction

Platelet Rich Plasma Therapy, or PRP, involves extracting blood, separating its components, and reinjecting the plasma portion into the targeted area.

The theory behind it is to aid in tissue healing. However, many urologists find the data on its effectiveness conflicting or dubious, lacking sufficient robust studies.

The Sexual Medicine Society of North America has taken a firm stance, asserting that restorative therapies for ED, such as platelet-rich plasma and stem cell therapy, should be reserved for clinical trials and not standard practice.

Despite this, opinions vary among experts, with some urologists cautiously optimistic about the potential of these therapies in certain cases.

Why urologists advise against it?

There is currently no evidence that platelet-rich plasma therapy helps at all. This treatment is very expensive, and without evidence of results, it is not recommended.

Edward Gheiler, Board Certified Urologist in Hialeah, FL.

Currently, the evaluation of platelet-rich plasma (PRP) therapy for erectile dysfunction lacks robust backing from peer-reviewed research, with no conclusive benefits demonstrated in human subjects.

Prudent consideration of its efficacy as a viable treatment option necessitates awaiting additional evidence to emerge from further studies.

Amy Pearlman, Board Certified Urologist Specializing in Male Sexual and Hormonal Health and Genital Reconstruction.

There are very few good studies and one of the best randomized control trials published last year (2023) by the University of Miami showed no difference in efficacy between PRP and placebo.

Ased Ali, Consultant Urological Surgeon, and Founder of Yorkshire Urology.

Why urologists say “it depends”?

I consider this a “poor man’s” stem cell treatment. It theoretically provides similar benefits as stem cell therapy but can be done at much less expense and in your urologist’s office. 

Its benefits are anecdotal, but believers are convinced of improvements with treatment.

David Kaufman, Board Certified Urologist and Director of Urology at Maiden Lane Medical in NYC.

Current clinical research and evidence has shown that platelet rich plasma (PRP) therapy may improve erectile dysfunction in men, as it can help enhance healthy blood flow throughout the genital region and stimulate tissue regeneration.

That said, current research shows limited scientific evidence to support these claims and the use of PRP for ED is still deemed as “experimental.”

Most of the current evidence is anecdotal and additional research is needed to fully understand the benefits of PRP treatments for ED.

Jason Kovac, Board Certified Urologist Specialized in Men’s Health and Sexual Medicine, Editor of American Journal of Men’s Health.

The evidence is conflicting but some studies have shown that it maybe effective. Still early days and a lot of research is going into this so watch the space.

Shafi Wardak, Consultant Urological Surgeon and Andrologist, Treats Patients Privately in Reading, Maidenhead and London

Why urologists recommend it?

Data is mixed, but it is a safe procedure and worth a shot if money is not an issue.

Anika Ackerman, Board Certified Urologist Specializing in Sexual Health in Morristown, NJ.

Done for other organs. low risk of side effects. 

Alexander Lipyansky, Board Certified Urologist Affiliated With SUNY Downstate University Hospital and The Brooklyn Hospital Center.

Testosterone replacement therapy

Chart showing how many urologists recommend testosterone replacement therapy for erectile dysfunction

Now, let’s dive into testosterone and testosterone replacement therapy. Here’s the truth – despite the hype you may have encountered, testosterone isn’t a cure-all for erectile dysfunction or sexual issues.

Surprisingly, many men with low testosterone levels still experience normal erections, while some with high levels struggle with erectile dysfunction.

This raises the question: should testosterone replacement therapy be the go-to solution for all cases of ED?

Most urologists argue against it, but there’s a subset who advocate for its consideration. Here’s what a few of them had to say.

Why urologists advise against it?

Though testosterone therapy is recommended for people with low testosterone, it has no effect on erectile dysfunction.

Testosterone replacement therapy can be used to help if a person has a lowered sexual desire than previously if someone is having issues remembering or concentrating, or if they are experiencing depression.

Edward Gheiler, Board Certified Urologist in Hialeah, FL.

There is consistent data showing that in eugonadal men (men with normal testosterone levels), testosterone does not improve erectile function.

Virtually all credible urological guidelines suggest that testosterone should not be used in men with isolated erectile function for ED.

Joshua T. White, Board Certified Urologist Affiliated With University of Miami Hospital and Clinics-Uhealth Tower.

Why urologists say “it depends”?

It can improve erectile function in men with mild ED, but not moderate and severe ED.

In men with low testosterone, it can help with libido and if they are unresponsive to PDE5 inhibitor drugs (such as Viagra) then normalization of testosterone levels can improve the response to these drugs.

Ased Ali, Consultant Urological Surgeon, and Founder of Yorkshire Urology.

Men with erectile dysfunction and low testosterone can benefit from using testosterone therapy.

Young men can see significant improvement in their erections by improving their testosterone level however older men with other medical issues are unlikely to see improvement in their erections without using medication specifically for erectile dysfunction such as Cialis or Viagra or Levitra along with their testosterone replacement therapy.

In addition men with multiple medical problems and low testosterone are unlikely to get good quality reactions using Cialis, Viagra or Levitra alone.

I do recommend testosterone in the appropriate patient, as long as they understand the purpose for the testosterone.

Eric C. Darby, Board Certified Urologist and Former Chief of Staff at Mary Immaculate Hospital in Newport News, VA.

Well, it’s definitely worth considering. TRT is a medical treatment that aims to restore testosterone levels in men who have an abnormally low amount of this hormone.

As we age, our testosterone levels naturally decline, and this can lead to a range of issues like fatigue, decreased libido, and even depression.

TRT can help address these problems by providing the body with the necessary doses of testosterone. Not only can it improve your energy levels and sex drive, but it could also boost muscle mass and bone density.

However, before diving into TRT, make sure you consult with a healthcare professional who will assess whether you truly need this therapy.

It’s essential to weigh the potential benefits against possible risks such as acne or sleep apnea.

Ultimately, the decision should be made on an individual basis in consultation with experts in the field. So why not explore the realm of TRT – it might just give you that much-needed vitality boost!

David Shusterman, Board Certified Urologist and Founder of New York Urology.

Normal levels of testosterone are important for good health. Testosterone deficiency can result in increased cardiovascular disease, bone weakness, mental health problems and sexual dysfunction.

Replacing testosterone if low can help to restore good health and prevent these problems.

Adding testosterone if levels are normal, however, can be harmful.

Ben Lamb, Consultant Urological and Robotic Surgeon at Barts Health and UCLH NHS Trusts, Clinical Senior Lecturer at Barts Cancer Institute.

Men with symptoms of low testosterone should consider testosterone replacement therapy. If a man has a low testosterone but no symptoms and a normal bone density then there is no reason to treat.

If the man has significant symptoms consistent with a low testosterone and even a low normal testosterone as opposed to just low then testosterone replacement therapy would be indicated.

The major symptoms of a low testosterone are decreased energy, decreased libido, difficulty taking off fat and putting on muscle, erectile dysfunction, and brain fog.

The dosage of testosterone should be based on how the man responds and not on the absolute testosterone level.

Michael A. Werner , Board Certified Urologist, Medical Director, and Founder of Maze Men’s Sexual & Reproductive Health.

Why urologists recommend it?

Yes – when indicated. Testosterone replacement therapy (TRT) with the Biote method is an important part of the treatment plan for ED.

ED generally has multiple underlying causes.

TRT can stimulate the central nervous system to increase the release of nitric oxide, improve libido, and optimize efficacy of medications used to treat ED.

Michael Murray, Urologist and Co-medical Director at Canyon View Wellness and Spa.

Medical literature and my clinical data/results/responses are encouraging.

Ian Walsh, Consultant Urologist and Clinical Academic at Queen’s University Belfast, Institute of Psychosexual Medicine, and Kingsbridge Private Hospital.

Natural supplements

Chart showing how many urologists recommend supplements for erectile dysfunction

It’s not uncommon to come across online websites or ads touting miracle cures for erectile dysfunction in the form of natural supplements and medications.

But do any of these supplements actually deliver, or are they simply a waste of time and money? And could some of them even be dangerous?

Here, we discovered that urologists are divided on the matter. Here’s what a few of them had to say.

Why urologists recommend it?

Oh, absolutely! Men should definitely consider trying natural supplements like Ginseng, Arginine, and Yohimbine.

These supplements have shown immense potential in addressing various male health concerns.

Ginseng is known for its ability to boost energy levels, improve concentration, and enhance sexual performance.

Arginine, on the other hand, promotes healthy blood flow and supports cardiovascular health, which can positively impact erectile dysfunction.

Lastly, Yohimbine is believed to help with boosting libido and treating certain forms of sexual dysfunction.

However, it’s important to note that the effectiveness of these supplements may vary across individuals, so consulting a healthcare professional before adding them to your regimen is crucial.

Nonetheless, incorporating natural supplements into your lifestyle can be a great way to support overall well-being and address specific concerns that men often face.

David Shusterman, Board Certified Urologist and Founder of New York Urology.

Some men benefit from supplements. Yohimbine was our go-to option before we had the newer meds like Viagra and Cialis.

Elizabeth Kavaler , MD, Board Certified Urologist and Urogynecologist and Medical Director of Total Urology Care of NY.

Reasonable evidence, well tolerated.

Nigel Borley, Consultant Urological Surgeon at Practice Plus Group Hospital Southampton.

Reports suggest good efficacy in some cases and worth a trial.

Syed Rahman, Consultant Urologist at Spire Leeds Hospital and St James’ University Hospital, and an honorary senior lecturer at the University of Leeds.

No downsides.

Tod J. Fusia, Board Certified Urologist Practicing in Tampa, FL.

Arginine works to raise nitric oxide.

Anthony Saracino, Urologist With Over 39 Years of Experience, Affiliated With Holmes Regional Medical Center in Melbourne.

Why urologists advise against it?

There is no convincing evidence to support the use of natural supplements in the management of ED.

Herbal supplements are often not regulated and their therapeutic benefit for ED should be scrutinized.

Joshua T. White, Board Certified Urologist Affiliated With University of Miami Hospital and Clinics-Uhealth Tower.

So far no particular supplements have been proven to be useful. Yohimbine can improve libido. Tribulus can actually act like testosterone and improved testosterone levels.

However I prefer to use testosterone which is studied way more and who his manufacturer is regulated.

Michael A. Werner , Board Certified Urologist, Medical Director, and Founder of Maze Men’s Sexual & Reproductive Health.

People use dietary supplements for all kinds of purposes these days from optimizing physical fitness to improving nutrient deficiencies and more.

These supplements can be great for many people, but they are not a permanent solution for health conditions like erectile dysfunction.

These types of ED supplements lack FDA approval for treating erectile dysfunction and, even if they do help improve symptoms, supplements are not a long-term solution to health issues.

Supplements only mask the symptoms temporarily; they do not address the root causes of the issues.

Jason Kovac, Board Certified Urologist Specialized in Men’s Health and Sexual Medicine, Editor of American Journal of Men’s Health.

Why urologists say “it depends”?

There is no level 1 data to support these supplements. If it helps you anecdotally and does not interfere with your daily medications, it is usually not harmful to try but if it interferes with your necessary medications then they are not worth it as the data behind them is lacking.

Ankur A. Shah, Board Eligible Urologist Practicing in St. Petersburg and the Greater Tampa Bay Area.

While several natural supplements have been studied with positive results in men with ED, they also have been associated with side effects that range anywhere from acne to headaches, insomnia, vertigo, nausea and diarrhea.

L-arginine, in particular, should not be used in combination with Viagra.

Generally, I recommend patients consult with a physician before using supplements to protect from any unnecessary side effects or interactions with any other drugs the patient may be taking.

Jonathan Beilan , MD, Adviser for Marius Pharmaceuticals, and Assistant Professor at USF Department of Urology.

Recent research suggests that supplements like L-arginine, when combined with oral phosphodiesterase inhibitors like tadalafil, improve erectile function more than either one alone.

In my men’s health practice at Prime Institute, I discuss supplements with patients interested in optimizing non-invasive treatment options, particularly those who don’t mind taking pills.

Amy Pearlman, Board Certified Urologist Specializing in Male Sexual and Hormonal Health and Genital Reconstruction.

While some natural supplements like ginseng, L-arginine, and yohimbine have been studied for their potential benefits in ED, the evidence supporting their effectiveness is mixed and often limited.

Furthermore, supplements are not regulated as strictly as medications, leading to concerns about purity, dosage, and potential side effects.

Men considering natural supplements should consult with a healthcare provider to discuss their safety and potential interactions with other medications.

Justin Houman, Board Certified Urologist, Men’s Sexual Health Specialist, and Medical Director at Bastion Health.

Natural supplements are not effective. Most of the supplements that can currently be found on the market contain low doses of Viagra or Cialis. That’s the reason why people find them effective.

On top of this, many of these substanceshaven’t been evaluated by the Food & Drug Administration (FDA), which means that you can’t really know what you are ingesting.

It’s better to see a doctor to get the proper medical advice and, if necessary, medicine.

Edward Gheiler, Board Certified Urologist in Hialeah, FL.

Pelvic floor exercises

Chart showing how many urologists recommend pelvic floor exercises for erectile dysfunction

Now, let’s delve into the treatments favored by most urologists. Pelvic floor exercises were recommended by 58% of urologists, with another 27% saying ‘it depends,’ while 15% advised against them.

Some experts argue that pelvic floor exercises are crucial for strengthening the muscles responsible for maintaining blood flow to the penis, thus supporting erectile function.

They believe these exercises can also enhance overall pelvic health, indirectly benefiting erectile function.

However, not all urologists are convinced of their efficacy for treating erectile dysfunction. Some have observed limited success with pelvic floor exercises, suggesting they may be more suitable for addressing urinary incontinence.

Let’s hear what some of these experts had to say:

Why urologists recommend it?

Pelvic floor exercises, commonly referred to as Kegels, should be one of the first things that men with ED do to address their condition.

The goal is to strengthen the muscles at the bottom of the pelvis that help maintain blood flow to the penis by putting pressure on penile veins.

This blood flow, in turn, allows men to develop and sustain erections for intercourse.

Keep in mind that true pelvic floor physical therapy, as directed by a trained professional, is much more involved and beneficial than at-home exercises, but it’s always worthwhile to practice these techniques at home.

Jonathan Beilan , MD, Adviser for Marius Pharmaceuticals, and Assistant Professor at USF Department of Urology.

Believe it or not, pelvic floor exercises can help those with erectile dysfunction because the exercises help strengthen muscles that are essential for maintaining the correct blood flow to the penis, which helps sustain erections. In addition, stronger pelvic muscles will help enhance your overall sexual function, which can enhance sexual sensations and intensify orgasms.

Just keep in mind that the best solution to ED issues is a combination of therapies and treatments rather than just one exercise on its own.

Jason Kovac, Board Certified Urologist Specialized in Men’s Health and Sexual Medicine, Editor of American Journal of Men’s Health.

Pelvic floor exercises, also known as Kegel exercises, can be beneficial for some men with ED, especially those with a venous leak component.

These exercises strengthen the pelvic floor muscles, which can help in maintaining an erection by improving blood flow to the penis and supporting venous occlusion.

Pelvic floor exercises are a non-invasive treatment option and are generally recommended as part of a comprehensive approach to managing ED.

Justin Houman, Board Certified Urologist, Men’s Sexual Health Specialist, and Medical Director at Bastion Health.

For men presenting with erectile dysfunction, particularly those inclined towards non-invasive therapies, recommending pelvic floor physical therapy is prudent.

This becomes even more essential if they exhibit additional signs or symptoms of pelvic floor dysfunction, such as penile, scrotal, or perineal pain, pain during ejaculation, urinary urgency/frequency, as well as issues like constipation or diarrhea.

Pelvic floor physical therapy offers a targeted approach to address these concerns and can be a valuable component of a comprehensive treatment plan for ED.

In my men’s health practice at Prime Institute, I often refer my patients for personalized evaluation and treatment by specialized pelvic physical therapists in the community as the pelvic floor is particularly complex and often requires a nuanced assessment.

Amy Pearlman, Board Certified Urologist Specializing in Male Sexual and Hormonal Health and Genital Reconstruction.

Why urologists advise against it?

I have seen not much success with this for ED.

Anika Ackerman, Board Certified Urologist Specializing in Sexual Health in Morristown, NJ.

It may help with ejaculatory dysfunction but there is no data to support this. It does not help with erectile dysfunction.

Ankur A. Shah, Board Eligible Urologist Practicing in St. Petersburg and the Greater Tampa Bay Area.

Why urologists say “it depends”?

Very good for mild cases of ED and PE.

Ramon Perez-Marrero, Board Certified Urologist, Affiliated With Morton Plant Hospital and Hca Florida Trinity Hospital in New Port Richey, FL.

Some men have erectile dysfunction because of chronic pelvic pain syndrome.

These men would benefit from pelvic floor therapy and the pelvic floor therapist may recommend pelvic floor exercises.

Michael A. Werner , Board Certified Urologist, Medical Director, and Founder of Maze Men’s Sexual & Reproductive Health.

There are two phases of an erection. The first phase is vascular (related to blood flow), having very little relation to the pelvic floor muscles.

The second phase does involve pelvic floor muscle contraction that helps “close the gates.”

Therefore, pelvic floor exercises may both improve firmness and help maintain an erection.

Unfortunately, these exercises will have no effect on the initiation of an erection.

Scott D. Miller , Board Certified Urologist, and Medical Director of Wellstar Urology.

pelvic floor exercises such as kegel exercises can potentially help by improving help inform muscle strength and increasing blood circulation to the area. 

Pelvic floor exercises are very helpful for men especially after prostate cancer surgery to decrease incontinence however this is unlikely to improve your erections without any other treatment.

Eric C. Darby, Board Certified Urologist and Former Chief of Staff at Mary Immaculate Hospital in Newport News, VA.

This wouldn’t cause harm but would be unlikely to cause a significant benefit in erectile function.

Joshua T. White, Board Certified Urologist Affiliated With University of Miami Hospital and Clinics-Uhealth Tower.

There is some weak evidence suggesting a role of pelvic floor exercises in regards to erectile function. Literature is stronger in regards to men with premature ejaculation and the role of pelvic floor therapy.

Zamip Patel , Urologist and Andrology Expert, and Medical Director of Cryos International

Mindfulness meditation

Chart showing how many urologists recommend mindfulness meditation for erectile dysfunction

Since we know that a man’s mental well-being is closely linked to his erectile health, we surveyed urologists on the effectiveness of mindfulness meditation-based therapy in addressing a range of mental health issues, from performance anxiety to chronic stress and depression, to aid men in overcoming erectile dysfunction.

Unsurprisingly, an overwhelming 88% of urologists recommended integrating mindfulness meditation into treatment plans, particularly when psychological factors are involved. Let’s delve into some of their insights:

Why urologists recommend it?

Yes (not just for psychological ED). Stress reduction will lower blood cortisol levels. Cortisol is an essential hormone that allows our body to tolerate acute stress.

However, chronically elevated levels of cortisol can wreak havoc on erectile function. Of course, since 90% of the sexual response is above the neck, a clear head can only have a beneficial effect.

Scott D. Miller , Board Certified Urologist, and Medical Director of Wellstar Urology.

Yes, absolutely. I have, myself, been performing classic TM for years and it has had a massive positive impact on my life.

Tod J. Fusia, Board Certified Urologist Practicing in Tampa, FL.

Mindfulness meditation is great for all men – and especially those with ED.

ED can be linked to high levels of sexual performance anxiety that include, fear about living up to your partner’s expectations, insecurities about your body, and even simply the fear of not being able to maintain an erection.

The goal with meditation is to relax the brain – to let go of all the of the pressures, stress, worries, concerns and distractions – and allow the body to enjoy the pleasures being experienced in the present moment.

While it can take some practice to master meditation as a form of therapy, the results can be extremely powerful for those with anxiety in the bedroom.

Jonathan Beilan , MD, Adviser for Marius Pharmaceuticals, and Assistant Professor at USF Department of Urology.

My own growing clinical series with this intervention indicates significant therapeutic response; especially in combination with additional pharmacological intervention, such as PDE5 inhibition

Ian Walsh, Consultant Urologist and Clinical Academic at Queen’s University Belfast, Institute of Psychosexual Medicine, and Kingsbridge Private Hospital.

normal sexual function requires a meeting of mind and body working in synchrony. A disturbance of either can impair sexual function and fulfillment.

Stress and anxiety can affect sexual performance, which can become a vicious cycle. psychological strategies such as mindfulness, meditation, relaxation or even talking to a counsellor can help with psychological problems and improve sexual function.

Ben Lamb, Consultant Urological and Robotic Surgeon at Barts Health and UCLH NHS Trusts, Clinical Senior Lecturer at Barts Cancer Institute.

Why urologists say “it depends”?

Well, the answer here is a solid “It Depends.” See, mindfulness meditation can be incredibly helpful for some individuals dealing with ED.

By practicing mindfulness techniques like deep breathing and being fully present in the moment, you may experience reduced anxiety and stress levels that often contribute to ED.

Plus, focusing on sensations in your body during meditation can improve body awareness and enhance intimacy between partners.

However, it’s important to note that psychological ED has various underlying causes which might require different treatments.

So while mindfulness meditation could be one tool in your toolbox, consulting with a healthcare professional who specializes in sexual health is crucial for personalized advice.

Overall, guys, don’t hesitate to explore alternative practices like this – just keep an open mind and work closely with experts to find what truly works for you.

David Shusterman, Board Certified Urologist and Founder of New York Urology.

Meditation can provide a wealth of benefits for your mental health and, in some cases, it can be very beneficial for addressing the psychological factors that contribute to ED.

Mindfulness meditation gives you the opportunity to calm yourself, reflect on your emotional wellness, and process events in your life in a healthy way. This activity has been shown to aid in stress and anxiety management, which are commonly associated with sexual health.

If you suffer from ED, it’s a good idea to embrace mindful meditation, but remember: everyone is different.

Meditation may not prove effective for everyone and you will still likely need to seek additional treatments/therapies to improve your condition.

Jason Kovac, Board Certified Urologist Specialized in Men’s Health and Sexual Medicine, Editor of American Journal of Men’s Health.

Diet and exercise

Chart showing how many urologists recommend diet and exercise for erectile dysfunction

Our survey revealed a clear winner: diet and exercise, recommended by a remarkable 97% of urologists.

This overwhelming support isn’t surprising, considering that diet and exercise can prevent, reverse, or improve many of the medical issues underlying erectile dysfunction.

In fact, a recent study has shown that exercising can be as effective as taking ED medications like Viagra and Cialis.

Why urologists recommend it?

Diet and exercise can ABSOLUTELY help erectile function. A recent article likened exercise as equivalent to a PDE5 inhibitor like Viagra.

Zamip Patel , Urologist and Andrology Expert, and Medical Director of Cryos International

All patients can benefit from healthy diet and lifestyle choices. Weight loss can also help with libido, erectile dysfunction and male factor infertility.

Francis Petrella MD, Andrology Fellow at the University of Miami.

Absolutely. Anything related to heart health can improve (and prevent) ED. In addition, increased blood sugar and insulin levels have a direct harmful effect to the nerves in erectile tissue.

Scott D. Miller , Board Certified Urologist, and Medical Director of Wellstar Urology.

Nutrition and exercise are the foundations of medicine (and optimizing erectile function). I actually co-founded Prime Institute with my twin sister, a gastroenterologist and physician nutrition specialist with this very concept in mind.

Amy Pearlman, Board Certified Urologist Specializing in Male Sexual and Hormonal Health and Genital Reconstruction.

A healthy diet and regular exercise can significantly improve erectile function, especially in men whose ED is linked to lifestyle factors such as obesity, metabolic syndrome, or cardiovascular disease.

Improvements in diet and physical activity can lead to better blood flow, reduced inflammation, and improved endothelial function, all of which are beneficial for erectile health.

Therefore, diet and exercise are universally recommended for men with ED.

Justin Houman, Board Certified Urologist, Men’s Sexual Health Specialist, and Medical Director at Bastion Health.

Metabolic syndrome, HTN, diabetes, etc. are all associated with erectile dysfunction.

There is data supporting lifestyle modifications and these should be first line in patients with ED.

Joshua T. White, Board Certified Urologist Affiliated With University of Miami Hospital and Clinics-Uhealth Tower.

Diet and exercise is always helpful for a healthier lifestyle.

Losing weight can help control your blood pressure and your hemoglobin A1C so by improving your blood pressure by losing weight can decrease the amount of medications that you may need for your high blood pressure.

Since high blood pressure is the second most common cause of erectile dysfunction along with antihypertensive medications if the better you control your blood pressure the more likely you are to improve the quality of your erections especially early on in life.

Improving your weight and monitoring your diet and doing exercise will decrease your chances of diabetes related to being overweight.

By decreasing your chances of diabetes will significantly decrease your chances of erectile dysfunction. Diabetes is the most common cause of erectile dysfunction.

In addition diabetes and obesity is also linked to low testosterone. So I do encourage patients to improve their lifestyle through diet and exercise which can lead to improvement in their sexual function.

Eric C. Darby, Board Certified Urologist and Former Chief of Staff at Mary Immaculate Hospital in Newport News, VA.

A Special Thank You to the Survey Participants

Urologist State City
Jonathan BeilanFloridaLargo
Michael A. WernerNew YordNew York
Scott D. MillerGeorgiaRosewell
Anika AckermanNew JerseyNew Jersey
Amy PearlmanFloridaSouth Florida
David ShustermanNew YorkNew York
Jason KovacIndianaCarmel
Justin HoumanCaliforniaLos Angeles
Michael MurrayColorado Grand Junction
Edward GheilerFloridaHialeah
Shiv Kumar PandianUnited KingdomLondon
Eric DarbyVirginiaNewport News
Wissam Abou ChedidUnited KingdomGuildford
Alexander LipyanskyNew YorkNew York
Ased AliUnited KingdomYorkshire
Ankur A. ShahFloridaSt. Petersburg
Shafi WardakUnited KingdomReading
John BoltAustraliaAdelaide
Nigel BorleyUnited KingdomReading
Jeudy JacquesHaitiHaiti
Ramasamy JaganathanUnited KingdomSolihull
Joshua WhiteCanadaCalgary
David KaufmanNew YorkNew York
Ben LambUnited KingdomLondon
Syed RahmanUnited KingdomLeeds
Ramon PerezCaliforniaNew Port Richey
Shenelle WilsonGeorgiaAtlanta
Tod J FusiaFloridaTampa
Ian WalshIrelandBelfast
Zamip PatelFloridaOrlando
Francis PetrellaFloridaMiami
Anthony SaracinoFloridaMelbourne
Elizabeth KavalerNew YorkNew York
Urologist State City
Jonathan BeilanFloridaLargo
Michael A. WernerNew YordNew York
Scott D. MillerGeorgiaRosewell
Anika AckermanNew JerseyNew Jersey
Amy PearlmanFloridaSouth Florida
David ShustermanNew YorkNew York
Jason KovacIndianaCarmel
Justin HoumanCaliforniaLos Angeles
Michael MurrayColorado Grand Junction
Edward GheilerFloridaHialeah
Shiv Kumar PandianUnited KingdomLondon
Eric DarbyVirginiaNewport News
Wissam Abou ChedidUnited KingdomGuildford
Alexander LipyanskyNew YorkNew York
Ased AliUnited KingdomYorkshire
Ankur A. ShahFloridaSt. Petersburg
Shafi WardakUnited KingdomReading
John BoltAustraliaAdelaide
Nigel BorleyUnited KingdomReading
Jeudy JacquesHaitiHaiti
Ramasamy JaganathanUnited KingdomSolihull
Joshua WhiteCanadaCalgary
David KaufmanNew YorkNew York
Ben LambUnited KingdomLondon
Syed RahmanUnited KingdomLeeds
Ramon PerezCaliforniaNew Port Richey
Shenelle WilsonGeorgiaAtlanta
Tod J FusiaFloridaTampa
Ian WalshIrelandBelfast
Zamip PatelFloridaOrlando
Francis PetrellaFloridaMiami
Anthony SaracinoFloridaMelbourne
Elizabeth KavalerNew YorkNew York

Methodology

Our survey included 33 urologists. For this survey, the urologists we consulted were given an option to vote to recommend for or against the 7 alternative ED treatments we included in the survey. Each vote was counted only once.

Experts were not required to vote for treatments if they did not feel their knowledge was relevant.

It should be noted that there are several possible limitations to the data provided here:

  1. This survey data was captured at a specific point in time within a specific culture and may not be true across times and places.
  2. Statistical analyses were not performed on this data, meaning that our findings are not necessarily statistically significant. 

Despite all of this, we believe that our data provide an important insight into the use of alternative ED treatments for the enhancement of sexual enjoyment.

Fair use statement

We permit the free use of all images and information provided on this page. However, we ask that you kindly acknowledge the creators by mentioning Between Us Clinic and linking back to this page.

About The Between Us Clinic

Sex Therapy Online Programs

The Between Us Clinic is an online sex therapy clinic that aims to help both men and women overcome a variety of sexual disorders by bringing the proven and trusted methods used in traditional, in-person sex therapy to a wide audience via the Internet.