How science is moving beyond Viagra

Erectile disorder (ED) refers to a persistent difficulty achieving or maintaining an erection sufficient for satisfying sexual activity. It affects millions of men worldwide, including up to 1 in 4 in the United States. Beyond physical functioning, erectile difficulties can impact sexual confidence, self-esteem, relationship satisfaction, and quality of life.

Although prevalence increases with age, age alone does not explain ED. Medical conditions such as diabetes, cardiovascular disease, and the after-effects of surgery (prostate surgery particularly) can disrupt erectile functioning.

Psychological contributors are also common. Performance anxiety, stress, and relational concerns frequently cause ED or interact with biological factors, making ED a complex condition, not a single, isolated problem.

Treatment for erectile dysfunction

Currently, most treatment approaches include medication, sex therapy, or a combination of both. Phosphodiesterase type 5 inhibitors, such as Viagra and Cialis, are widely prescribed and increase blood flow to the penis in response to sexual stimulation.

Their on-demand dosing and ease of oral use make them appealing. However, they are not appropriate for everyone. Certain medical conditions, side-effects, concerns about reduced spontaneity, lack of efficacy, or cost can limit their usefulness.

Sex therapy offers another well-established treatment option. It can help individuals and couples reduce performance anxiety, improve communication and sexual satisfaction, and rebuild sexual confidence. Yet access is uneven. Cost, waitlists, geographic limitations, and stigma prevent many people from receiving timely care.

At the same time, technology is transforming how ED is assessed and treated. From app-connected devices to immersive virtual-reality environments, new tools are expanding both research and clinical possibilities.

At the EROS Research Chair, we study how innovations can be integrated into ED treatment. Several promising directions are already emerging.

Monitoring erectile health: Anytime, anywhere

Smart penile rings are transforming assessment. These wearable devices are placed around the penis during sleep or sexual activity and collect continuous data on erection strength and duration. The data are stored online, accessible through the user’s app, and can be shared with specialists.

The data are more objective than patient recall and offer more information than a clinic visit can provide, making it possible to assess whether difficulties are consistent or situational, or if they are improving with treatment.

Devices such as the Techring connect to a smartphone app and can be used independently at home, providing greater privacy, convenience, and patient engagement.

Virtual reality

Virtual reality (VR) creates immersive, computer-generated environments that simulate real-life experiences. In sexual health research, VR allows arousal and erectile responses to be examined in controlled, yet realistic contexts.

Recent studies show men with ED display different responses to VR sexual scenarios compared to men without the condition. In 2024, our team found reduced arousal levels, while other researchers observed weaker and shorter-lasting erections during scenarios such as masturbation, oral sex, and penetrative intercourse.

Beyond diagnosis, VR may help identify which situations are most challenging for a given individual: specific activities, partner contexts, or environmental factors. This information can guide more personalized treatment planning rather than relying solely on generalized recommendations.

The promise of regenerative medicine

Most existing treatments manage symptoms rather than address underlying tissue damage. Regenerative approaches, including platelet-rich plasma, stem cell therapies, and low intensity shock-wave therapy aim to stimulate blood vessel and tissue growth and repair.

Pre-clinical studies, largely in animal models, suggest potential improvements in erectile function and acceptable short-term safety. Early human findings for shock-wave therapy indicate possible benefits for penile blood flow.

However, these interventions remain experimental. Protocols are not standardized and long-term effectiveness and safety are still unclear. Larger, high-quality human trials are needed.

Vacuum devices: A low-tech option, reimagined

Vacuum erection devices have existed for decades. They create negative pressure around the penis to draw blood in, then a constriction ring helps maintain the erection.

Older models use a physical pump to create that negative pressure. Newer models are battery-operated, quieter, and can be app-connected, reducing awkwardness and required physical effort of older models.

Although not new, vacuum devices remain a valuable option, particularly for people who cannot use medications or prefer non-pharmacologic approaches. They may also be combined with medication for additive effect.

A new era for erectile health

For decades, ED treatment relied heavily on self-reporting and a narrow set of treatment options. Now, wearable technologies offer objective, real-time data, VR provides insight into situational and contextual factors, and regenerative therapies seek to rectify damaged tissue. Even established tools like vacuum devices continue to evolve.

Together, these advances support an increasingly personalized, data-driven, and patient-centered care model. Although many technologies are still emerging, they promise a future in which ED is understood and treated with greater precision, nuance, and compassion.

This article is republished from The Conversation under a Creative Commons license. Read the original article.