Larry Bans: There are other options for erectile dysfunction beyond pills or pharmacologic medications. One could use a vacuum erection device, and one could use injectable therapy. The other option would be a penile implant or a penile prosthesis. The vacuum pump is a simple device which is safe to use for most people. It is usually covered by insurance and can be purchased without a prescription, and injectable therapy needs to be maintained and monitored by a physician or someone who does injectable therapy. There’s slight risk to injectable therapy, where you actually take a needle with a syringe and you inject vasoactive drugs into the penis itself, and the risk are priapism (a prolonged erection), or scarring or fibrosis. So most people I would recommend that they start with the vacuum erection device. If that’s not acceptable or satisfactory, the possibility of moving on to injections or an implant, a penile prosthesis, should be considered.