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As a result, there are many possible treatments, including lifestyle changes, therapy, prescription medication, and natural remedies that are used to help this disorder. In the smooth muscle, testosterone modulates the activity of phosphodiesterase type 5, the kinase that regulates Ca2 and K levels, and adrenergic receptor sensitivity. A penile injection can create an erection within five to 10 minutes and last for up to one hour. Only after the cause of ED is determined can it be effectively treated. Patients with depression are almost 40 more likely to have ED than normal men without depression.