Erectile dysfunction in 45 year old men who do not have a hard erection can be improved by general treatment, medication, physical therapy and surgery. 1. General treatment: including lifestyle modification, stop smoking and alcohol, increase physical activity in moderation, weight control, reasonable diet, moderate supplementation of Omega-3 fatty acids, antioxidants, calcium, etc. can improve vascular endothelial function and erectile function. 2. Medication: the most common method is oral medication, including sildenafil, androgens, apomorphine, yohimbine, trazodone and so on. 3. Physical therapy: If the effect is not good, it can also be combined with physical therapy, including vacuum erection device, low-energy extracorporeal shock wave therapy, cavernous vasoactive drug injection therapy (poppycine, phentolamine, prostaglandin, etc.). 4. Surgery: If general treatment and medication are ineffective, surgery can be chosen to improve impotence completely with penile support implantation. The above drugs should be used under the guidance of a doctor, and it is recommended that patients go to a regular hospital in time for treatment and strive for early recovery.