Phosphodiasterase type 5 inhibitors (sildenafil, vardenafil, tadalafil) are the 
first line symptomatic therapy for patients with erectile dysfunction. The 
patient should receive a meticolous information on the use of these drugs and 
their possible side effects. These drugs are safe and can be used even in 
patients with stable cardiovascular disease. Patients not responding to oral 
drugs may be offered intraurethral or intracavernous alprostadil. Vacuum 
constriction devices are a second line option more acceptable to older patients. 
Penile prosthesis are very seldom used in Switzerland and vascular surgery is a 
vanishing option. Testosterone substitution is seldom needed in this setting. 
Treatment of premature ejaculation subdivides into behavioural therapy 
("stop-start" or "squeeze" technique) and drug therapy as well. Topical therapy 
with lidocaine/prilocaine-containing medications to be applied before sexual 
intercourse and a oral daily off label use therapy with selective serotonin 
re-uptake inhibitors (paroxetine, fluoxetine, sertraline) can be offered. 
Dapoxetine, a potent selective serotonin reuptake inhibitor with short half life 
time, is the first officially approved medication for the treatment of premature 
ejaculation and should be available soon in Switzerland.