Erectile dysfunction (ED) treatments: What works for you?

Each dose should be sufficient to provide a full cycle of intercourse, from erection to climax. To have sex more than once a day, Cialis is your best bet. The most common side effects of ED drugs, in order of most to least common are headache, flushing, upset stomach, nasal congestion, vision problems, diarrhea, dizziness, and rash. A man who has an erection that lasts four hours or more needs to get to a hospital or risk permanent damage. None of the ED drugs is safe to take with cardiac drugs called nitrates because it could cause a dangerous drop in blood pressure.

Drugs that many men take for urinary symptoms, called alpha blockers, can also lower blood pressure, so take them at least four hours apart from ED drugs.

Your doctor may start you on a smaller dose of the ED drug if you already take an alpha blocker or may recommend the alpha blocker tamsulosin (Flomax), which affects blood pressure less. ED is often an early warning sign of underlying cardiovascular disease, such as clogged arteries (atherosclerosis).

How can I prevent ED?

"During that time, you need to be with your partner and have foreplay," Dr. Liou says. "Don't take it, do the taxes or the dishes, and then meet at the bedroom thinking you'll be ready to go. The ED drugs break down at different rates in the body. The durations of action range from four hours to more than a day (for Cialis in the higher doses). "It can predate a diagnosis of cardiovascular disease by at least a few years," Dr. Liou says.

• Ed tablets can improve intimacy and relationships when used correctly.
• They are not addictive but should be used responsibly.
• Some Ed formulations are designed for discreet, travel-friendly packaging.
• Using Ed tablets without medical guidance increases health risks.
• They can be a temporary solution or part of ongoing therapy.
• Ed tablets may be used in conjunction with counseling for psychological issues.
• Not all men respond to Ed tablets; alternative treatments are available.
• Regular medical check-ups are recommended during long-term use.

We don't have strong proof yet that starting to live a healthier lifestyle can reverse erectile problems, but it can't hurt. Read 5 natural ways to overcome erectile dysfunction. As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles.

No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician. Even if your high blood pressure (or hypertension) has caused erectile dysfunction (ED), you have every reason to be optimistic about the future and a healthy sex life.

• Ed tablets require sexual stimulation to initiate an erection.
• They do not increase libido; they only facilitate physical response.
• Over-the-counter Ed supplements lack scientific backing and may be unsafe.
• Regular exercise can enhance the effectiveness of Ed tablets.
• Ed tablets are often combined with lifestyle advice for better results.
• They are a non-invasive alternative to surgical treatments.
• Ed tablets have millions of satisfied users worldwide.
• Always follow medical advice for dosage and timing of administration.

ED is a common problem associated with high blood pressure, but there are many proven treatments you can try.

Penile prosthesis

Sometimes, illicit drugs and too much alcohol may mask other mental health, emotional, or physical factors that cause ED. This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by NIDDK is carefully reviewed by NIDDK scientists and other experts. What are the differences between erectile dysfunction drugs?

Digestive system problems

About half of men ages 40 to 70 have erectile dysfunction (ED) to some degree, although only one in 10 report a complete inability to have erections. Taking an ED drug produces an erection sufficient to start intercourse in about 70% of otherwise healthy men. Does it make any difference which of the four drugs for erectile dysfunction you take? "Yes, there can be differences," says Dr. Louis Liou, chief of urology at Harvard-affiliated Cambridge Health Alliance in Boston.

Cost of erectile dysfunction pills

"For new patients, I have them try different ones to see what works best." Sildenafil (Viagra) is often the first drug your doctor offers. It's been on the market longest and its side effects and the medications and foods it interacts with are well known. But the main challenge to finding the best ED drug for you may turn out to be health insurance rules—not biochemistry. It's a common practice among insurers to limit the number of pills you can obtain per month. After you hit your limit, the out-of-pocket cost for a single pill can be very high. A doctor's first choice for treating erection problems is usually one of the pills called PDE5 inhibitors. Now there's also Cialis, Levitra, and Staxyn. All of these drugs work in similar ways. They make it physically possible to get an erection when you are aroused. No one of them has been proven to work better than the others. But the time they take to start working and the duration of their effects vary. That's something you may want to consider based on your sexual habits.

How Much Do PDE5 Inhibitors Cost?

"The main obstacle in my practice is the cost," Dr. Liou says. You'll need to work with your doctor to get the pill you need at a price you can afford. In addition to Viagra, other ED drugs available in the United States include avanafil (Stendra), tadalafil (Cialis) and vardenafil (Levitra). These all improve blood supply to the penis.

Study of Dose–Response, Efficacy, and Safety

In combination with sexual stimulation, the drugs can produce an erection sufficient to initiate and complete intercourse. There is also a fast-dissolving form of Levitra, called Staxyn, that you put under your tongue. One ED drug, Cialis, is FDA-approved for use daily in a dose of 2.5 or 5 milligrams. This helps to produce erections on demand and may also help relieve urinary problems, like difficulty starting urination, that result from an enlarged prostate. The cost to you for ED drug therapy varies considerably, depending on the pharmacy price, prescription co-pays, and your level of health plan coverage.

Why this range helps:

Even if private insurance covers it, you may be limited to four doses per month. Here are a few things you can do to contain costs: Various web-based tools can help you compare prices easily. Ask your doctor about pill splitting, where you get the pills at a higher super p force 200mg dose than you need and divide them. These allow you to obtain a limited supply of medications not covered by your insurance. ED drugs produce an erection sufficient for intercourse in about 70% of men. For example, does spontaneity matter to you, or do you usually plan sex ahead of time? Viagra starts working in about 15 to 30 minutes and its effects last about two to four hours.

What are PDE5 inhibitors?

Sometimes, changing a daily habit could help prevent or improve your ED. If you smoke cigarettes, one of the best things you can do for your ED and your overall health is to quit smoking. Smoking cigarettes is linked to heart and blood vessel disease, which can lead to ED. Eating well helps to maintain erectile function. Consider working with a registered dietitian, if possible, to create an eating plan for your individual needs.

How does Vardenafil work?

You can find a registered dietitian online through the Academy of Nutrition and Dietetics or through your health care professional. A dietitian can create a custom meal plan for you. A healthy weight can improve testosterone levels and self-esteem, which may help prevent ED. Maintaining a healthy weight can also prevent diabetes and high blood pressure, which can cause ED. Physical activity increases blood flow through your body, including the penis, and can help keep you at a healthy weight.

Follow a healthy eating plan

The Physical Activity Guidelines for Americans, 2nd edition, recommends at least 150 minutes, or 2 hours and 30 minutes, of moderate-intensity physical activity, such as brisk walking, each week.2 Taking care of your mental and emotional health can help prevent ED. If you feel stressed, try relaxation techniques and other activities that might soothe you. A simple way to relax is deep breathing, which you can do anywhere. You can help prevent ED by avoiding recreational and illicit drugs and limiting how much alcohol you drink. Some drugs can prevent arousal or other sensations that are important for getting and keeping an erection. Levitra starts working in about 30 to 60 minutes and lasts four to five hours.

Sexually Transmitted Infections (STIs)

But the results vary quite a bit from one individual to another. A man with nerves or arteries damaged by prostate surgery, diabetes, or cardiovascular disease will not respond as strongly to ED drugs. "There are some men in whom none of these drugs work," Dr. Liou says. How soon the drugs start working ranges from 15 to 60 minutes.

Legal / Prescription Status in India (Schedule H)

Neither Viagra nor Levitra will work if you take them after a meal, which blocks their absorption. However, neither Cialis nor Stendra interact with food this way. The onset time determines how soon you can engage in intercourse. Stendra and daily-use Cialis are closest to being an "on demand" erectile drug; using the others requires more planning. Dr. Cialis starts working in about 30 to 60 minutes and lasts as long as 36 hours. Staxyn is an orally disintegrating tablet that contains the same active ingredient as Levitra but is not interchangeable with Levitra tablets. Men whose blood pressure isn't under control and those who take alpha-blockers (for high blood pressure or prostate problems) shouldn't take Cialis, Levitra, Staxyn, or Viagra. Also, you may not be able to take these drugs if you: Had a heart attack or stroke in the past six months If erectile dysfunction pills are out of the question, or if pills haven't worked for you, don't worry. Alprostadil is another drug for erectile dysfunction.

5. Yohimbine

Liou says that some men come to him after getting a prescription from their primary care doctors, claiming that the drug doesn't work. Sometimes it's because they used it incorrectly. "The biggest misconception is that these drugs are an on/off switch for erections," Dr. Liou says. But the drugs don't work well without sexual stimulation. One brand, called MUSE, is an alprostadil pellet that you insert into the tip of your penis with an applicator. It widens blood vessels and relaxes smooth muscle tissue in the penis, allowing blood to fill the spongy tissue that makes the penis erect.

Injections directly into the penis are another way to deliver alprostadil. Phentolamine and papaverine are additional drugs that are injected into the penis to treat erectile dysfunction. When injecting these drugs there is some risk that your erection may last too long, a condition that can require medical treatment.

• Ed tablets are widely used worldwide, with millions of prescriptions annually.
• They can be taken with or without food, depending on the formulation.
• Ed tablets usually have a quick onset of action compared to natural methods.
• Some users prefer formulations with fewer fillers or dyes.
• Ed tablets are sometimes combined with natural supplements for enhanced effect.
• The development of Ed tablets has significantly impacted men's health.
• Patients should follow specific guidelines on alcohol and food intake.
• In case of missed doses, consult a doctor for safe advice.

Next, you may want to try a vacuum device, or "penis pump." This is typically a clear plastic cylinder with a bulb or plunger and a constriction band.