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If tadalafil does not work, a doctor might recommend sildenafil, which works in a similar way.

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“If someone really wants an herbal supplement, I’ll recommend ginseng,” Laborde says. “At least it’s not going to hurt you.”
https://www.sciencedirect.com/science/article/abs/pii/S0302283802001756?via%3Dihub Preliminary observations on the use of propionyl-L-carnitine in combination with sildenafil in patients with erectile dysfunction and diabetes. (2004). .

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More than two drinks a day is considered a risk factor for ED. Alcohol can lower testosterone levels, decrease flowing blood to the penis, and cause nerve and hormonal imbalances. Low testosterone from alcohol or drug abuse can also affect your libido and performance, potentially leading to further psychological ED complications.
Before you embark on an ED treatment, it’s good to talk with your healthcare provider. If you hope to use any of the prescription ED treatments, you’ll have to get the prescription from a doctor who will review your medical history and current health to determine if one of these medicines is suitable for you.

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Wave therapy is a non-invasive procedure that has been shown to improve certain types of erectile dysfunction. However, not all wave therapy machines are equal. Urologist Dr. John Smith explains how the use of waves can ...
Sildenafil is a solid treatment option, as well. It works reliably, and many doctors recommend it and prescribe it with great efficacy. Vardenafil is nearly identical to sildenafil and makes a good choice for the few men who don’t have success with the latter.

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Having erectile dysfunction isn't something you just have to live with. Almost all cases of erectile dysfunction are treatable, and treatment can lead to better overall physical and emotional health for nearly every patient as well as improve intimacy for couples.

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GAINSWave®, the clinically proven, non-invasive therapy, was specifically developed for men seeking an erectile dysfunction treatment that would improve their sexual performance.

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    Urethral alprostadil is a synthetic hormone that stimulates blood flow to the penis. A small pellet can be inserted into the urethra.

    If stress, anxiety, or other emotional issues are causing the condition, counseling may help. Some men experience erectile dysfunction because of past experiences that cause a lack of self-esteem, fear, or guilt, and counseling can help you overcome those negative feelings. Couple counseling can also help improve mutual understanding and acceptance in a relationship, allowing you to feel more comfortable during intimacy.
    “The downside is: It just doesn’t work,” Laborde says. Meanwhile the possible side effects can include increased bleeding, convulsions, diarrhea, and upset stomach.

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    It may not be safe to breast-feed while using this medicine. Ask your doctor about any risk.

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    If Viagra doesn’t work for you, it may be due to a variety of factors, including the following:
    https://www.ouh.nhs.uk/patiena-guide/leaflets/files/29164Ppelvic.pdf Penile Blood Change After Oral Medication of Korean Red Ginseng in Erectile Dysfunction Patients. (2003).

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    8. Viagra (sildenafil citrate) [Prescribing Information]. New York, NY: Pfizer Labs; December 2017.

    Local treatment pathways tend to vary and it might be that many of the treatments listed above are co-ordinated by the urologists or a dedicated ED nurse. Vacuum-assist devices can be used at any stage. After using a vacuum pump, 9 out of 10 men are usually able to have sex, irrespective of the cause of the ED.29
    Erectile dysfunction can often be improved if you make changes to your lifestyle, such as:

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Benign Prostatic Hyperplasia/BPH, Erectile Dysfunction, Kidney Stones, Robotic surgery, Urinary Incontinence, UroLift, Vasectomy

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Urethral alprostadil is a synthetic hormone that stimulates blood flow to the penis. A small pellet can be inserted into the urethra.

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Having erectile dysfunction isn't something you just have to live with. Almost all cases of erectile dysfunction are treatable, and treatment can lead to better overall physical and emotional health for nearly every patient as well as improve intimacy for couples.

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https://pubmed.ncbi.nlm.nih.gov/15383186/ Pharmaceutical quantities of yohimbine found in dietary supplements in the USA. (2016).

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