Modern Management of Erectile Dysfunction: An Integrative and Regenerative Therapeutic Framework

Erectile dysfunction is a prevalent and multifactorial condition affecting men worldwide, often serving as an early indicator of systemic vascular, metabolic, and endocrine disorders. Traditionally approached as a localized urogenital disorder, erectile dysfunction is now recognized as a complex, multisystem disease with significant implications for cardiovascular health, psychosocial well-being, and quality of life. Contemporary management requires a comprehensive, patient-centered approach that integrates conventional therapies, including phosphodiesterase type 5 inhibitors and vacuum erection devices, with hormonal optimization, regenerative interventions, and emerging functional medicine strategies. This review provides an up-to-date synthesis of the epidemiology, pathophysiology, and etiological factors underlying erectile dysfunction, emphasizing the interplay between vascular, neurogenic, and hormonal mechanisms. Special attention is given to advanced therapeutic modalities, including low-intensity shockwave therapy, intracavernosal injections, peptides, and stem cell–based interventions, highlighting their potential to restore erectile function beyond symptom management. By framing erectile dysfunction as a multidimensional disease, this article underscores the importance of individualized, multimodal treatment strategies that address both the underlying pathophysiology and the holistic health of the patient.