Will I need tablets forever?

Can the underlying cause be fixed?

Sometimes. Smoking cessation, cardiometabolic improvement, changing a contributing medication, treating genuine testosterone deficiency, addressing performance anxiety or treating a specific anatomical problem may improve erections. In other men—particularly after nerve injury, advanced diabetes or established vascular disease—the biological change may not be fully reversible.

Does using a tablet make me dependent?

PDE5 inhibitors do not create chemical dependence in the addiction sense. A man may become practically reliant on them because the underlying erectile problem remains. That is different from the medicine causing the problem.

What about shockwave therapy as a “cure”?

The most recent Cochrane synthesis included 21 randomised trials and 1,357 men. Low-intensity shockwave therapy improved short-term IIEF erectile-function scores by 3.89 points versus sham, while a commonly used clinically important threshold is around four points; long-term estimates were somewhat larger, but certainty was low and studies were heterogeneous.² It may help selected men, but “regeneration” or “permanent cure” claims go beyond the evidence.

What about PRP or the “P-shot”?

A 2024 systematic review found 17 human studies (1,099 patients) across ED and Peyronie’s disease. Reported benefits were small to moderate, but protocols varied, sample sizes were small, follow-up was short and many studies lacked controls.³ PRP remains investigational rather than an established replacement for standard ED treatment.

Can treatment be reviewed rather than simply repeated?

Yes. If erections improve substantially after risk-factor modification or psychological treatment, medication need may fall. If tablets remain the safest and most effective way to have reliable erections, continued use can be a perfectly reasonable long-term strategy.

A word about what you will be sold

The MHRA seized 3.5 million counterfeit erectile dysfunction pills in the UK in a single year, and states that more than half of all medicines bought online are fake. It links this directly to the 44% of men with ED who never seek professional help: the less willing a man is to have the conversation, the more likely he is to buy from someone who will not ask questions.

The same logic applies further up the price range. A clinic offering an unregulated regenerative treatment has no incentive to tell you that the guideline body reviewed it and declined to recommend it. That is precisely the sentence you should be looking for.

Bottom line

Wanting the cause addressed is reasonable. But “cause treatment” and “symptom treatment” are not opposites. You can improve cardiovascular, hormonal or psychological contributors while also using a proven treatment that makes sex reliable. Be particularly cautious of expensive regenerative treatments marketed as permanent cures before the evidence supports that promise.

Wanting the cause fixed is entirely reasonable and I will look for one. But be careful about what is sold to you in the meantime: the shockwave evidence sits just below the threshold at which men can feel a difference, and platelet-rich plasma has no recommendation from the European guideline at all. I will tell you which is which before you spend anything.