It’s estimated that prostate cancer affects 1 in 9 men, with the average age of diagnosis around 66. If caught early, it’s a very treatable cancer. Though treatment can save lives, it also comes with serious side effects, one of which is erectile dysfunction (ED).

Depending on the type of surgery required and your recovery, ED can range from the mild to severe. If you or your partner is having trouble getting or maintaining an erection post-surgery, there are several treatments you can explore to return to a satisfying sex life.

1. Penis pump

The penis pump is a non-invasive, drug-free method of achieving an erection post-surgery. A penis pump consists of a plastic tube that fits over the penis, a hand or battery-powered pump attached to the tube, and a constriction band that fits around the base of the penis once it is erect. While a penis pump will not cure ED, it can create an erection that will last long enough for intercourse. It can also be used in combination with erectile medications.

2. The “Little Blue Pill”

One of the first treatments to be considered for post-op ED is a prescription for Viagra or Cialis. Rather than taking pills every day, it is advised that the patient should take pills as needed.

Arousal is complicated by the fact that it often requires a combination of mental and physical stimulation. Therefore the act of taking the pill can add a psychosomatic confidence boost along with the physical affect it offers, especially when taken thoughtfully rather the daily.

Popping a pill is not a quick fix, however. As urologist Trinity Bivalacqua, M.D., Ph.D explained to, “I tell men that it often takes three or four attempts with Viagra to have a true response that will allow penetrative sex. Usually men see the most meaningful recovery around 9 to 12 months after surgery.”

Bivalacqua stresses that you not get discouraged if you don’t see results immediately. “Recovery and allowing a new drug to work in your system takes time.”

3. Injection therapy 

Don’t be scared. Injection therapy may sound terrifying, but in fact the drugs are administered by a tiny needle that your doctor shows you how to use.

Erections from this method of injection can last for up to 90 minutes and may not disappear immediately after orgasm.

The drug used in the injection is actually a mix of three drugs: papaverine, phentolamine and prostaglandin E-1. This medication is shot into the base of the penis using a small hypodermic syringe and works quickly, usually within 20 minutes. The drug allows the main arteries to dilate, which causes blood to fill the penis.

Erections from this method of injection can last for up to 90 minutes and may not disappear immediately after orgasm.

Side effects are rare, but one possible outcome is the development of curvature in the erect penis, which can be painful and interfere with intercourse. This is called “Peyronie’s Disease” and is caused by a buildup of plaque or scar tissue inside the penis.

You can minimize the risk of getting Peyronie’s by learning to inject correctly. If an erection lasts longer than 2 hours after injection, you may be suffering from priapism. To reduce the erection you can apply a cold press or take a cold shower. If it still won’t soften, a trip to the emergency room is recommended. 

4. Implant

Often considered a last resort on the ED checklist, the penile implant has a high success rate for those running out of options. According to the Mayo Clinic, most men and their partners report satisfaction with the devices.

This is not a one-size-fits-all treatment, however. Several factors have to be considered before the right implant can be chosen. Things such as overall health, whether a penis is circumcised, and penis size can all play a role.

If you aren’t ready to talk out loud yet, there are online forums for those who are dealing with the same situation.

There are also three types of implants currently in use; the three-piece inflatable pump, the two-piece inflatable pump and semi-rigid or malleable rods. You will need to speak to your doctor to determine which implant may work for you. Penile implant is highly invasive but it is effective. Implants can last for up to 10 years. 

Erectile dysfunction does not have to mean the end to an active sex life. Think of it like having a car that won’t start on cold winter mornings. It will run, it just needs a little jump start.

Don’t despair, don’t suffer alone and don’t worry — anxiety can exacerbate the problem. Talk to your doctor, or talk to your partner. And if you aren’t ready to talk out loud yet, there are online forums for those who are dealing with the same situation. One in four men under 40 suffer with ED and by the time they reach 70 that number is up to 70 percent, so it’s safe to say that you are in good company.