Erectile dysfunction (ED) is a common condition where you fail to get or keep an erection. Tablets to treat erectile dysfunction are called PDE-5 inhibitors.
You’ve probably heard of Viagra and Viagra Connect but there are many others available as well such as Levitra, Tadalafil, Cialis, Spedra. They all work in a similar way but their side effects and who they are most suitable for varies depending on the active ingredient in the tablet. Fill in our brief questionnaire and our experienced doctors can recommend the ED treatment that will work best for you.
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About erectile dysfunction treatment
Erectile dysfunction (ED) is when you have difficulty either getting or maintaining an erection that is firm enough to have sex. Many men experience ED, and it is more common if you are over 40. ED is also called impotence and is different from premature ejaculation, where you ejaculate sooner than you or your partner would like.
While it is common to experience ED, if it happens frequently you should talk to your doctor or visit your local sexual health clinic where you can get help and advice.
Erectile dysfunction (ED) is diagnosed by a doctor or nurse after they have asked you several questions and carried out some basic health checks.
You will be asked about your lifestyle, relationships, and anything causing you stress or anxiety. The doctor or nurse will also examine your genitals in case there is an obvious physical cause, take your blood pressure and measure your height and weight, and ask you about any other symptoms such as needing to pee more often.
Erectile dysfunction tablets are called PDE-5 inhibitors. They work by relaxing your blood vessels so that the blood flow to your penis increases and this helps you get and keep an erection. It is important to note that ED tablets will not work if you are not sexually aroused.
Viagra and Sildenafil
Sildenafil usually works within 30 to 60 minutes and lasts about 4 hours. It is considered the most effective treatment for ED (74% effective), but people also report the most side effects.
Viagra Connect is the same medication as Viagra and generic sildenafil. It works in the same way as these two treatments. The difference is that it is the only treatment for ED that you can buy over the counter without a doctor’s prescription. It is also only available in the standard dose of 50mg, whereas Viagra and generic sildenafil are available in lower (25mg) and higher (100mg) doses.
Cialis and tadalafil
Cialis is the brand name for a PDE-5 inhibitor called tadalafil. Tadalafil is 60-70% effective and is considered to be a fastest-acting ED treatment as it usually works in 15 to 30 minutes and lasts up to 36 hours. In consultation with your doctor, you can also repeat the dosage the next day.
You can request both Cialis and generic tadalafil from ZAVA.
Levitra contains the PDE-5 inhibitor called vardenafil.
It usually works within 30 minutes and lasts 5 to 8 hours. Vardenafil has the fewest reported side effects and is considered the most suitable ED treatment if you have diabetes.
Spedra contains the PDE-5 inhibitor called avanafil.
It usually works within 15 to 30 minutes and lasts up to 4 hours. Avanafil interacts with grapefruit, so you must not drink or eat grapefruit in the 24 hours before taking Spedra.
As with all medication, it is possible to experience side effects when taking treatment for ED. The side effects can vary depending on which PDE-5 inhibitor you take.
If you experience any of the following serious side effects, seek immediate medical help:
- signs of an allergic reaction: difficulty breathing, a raised itchy rash, swollen lips, tongue or face
- chest pains
- prolonged and painful erections
- loss of or change in vision
- severe skin reaction including blistering of the mouth, genitals and around the eyes and severe peeling and swelling of the skin
People have reported the following milder side effects:
- pain in your head, muscles or back
- going red or getting flushed
- feeling or being sick
- blocked or runny nose
- vision disturbances
If the side effects you experience do not go away or affect your life, talk to your doctor about trying a different treatment for ED.
If you do not want to take medication, you can try using a penis pump or a penis ring to stop your erectile dysfunction. Make sure you read the information leaflet for both the pump and the rings carefully.
Lifestyle changes that improve your overall health and fitness can also reduce your likelihood of experiencing ED:
- stop smoking
- drink less alcohol
- take regular exercise
- maintaining a healthy weight
- pelvic floor exercises
Some people use supplements or herbal products such as horny goat weed, arginine, maca, red ginseng and Vitamin E. The evidence to prove that these work is limited.
Different factors can cause erectile dysfunction (ED). In some cases, it is your mental and emotional (psychological) state; in others it can be physical factors such as smoking, being overweight or a health condition; or it can be a combination of both. Certain medications can also cause ED.
Emotional and mental factors causing erectile dysfunction include:
- relationship difficulties
- sexual issues in your past, including experiencing sexual abuse
The following conditions in your body can cause erectile dysfunction:
- side effects of specific medicines
- changes in hormone levels
- high blood pressure
- high cholesterol
- heart disease
A number of studies are available that indicate erectile dysfunction (ED) is a very common condition. According to the Cleveland Clinic, 1 in 10 men will have ED at some point in their lifetime. Research from the American Journal of Urology has shown that the incidence of ED increases the older you get.
You cannot cure your erectile dysfunction (ED) so it never comes back, but most men find they can stop their erectile dysfunction (ED) by understanding its cause and then getting the proper treatment.
Frequently asked questions
What non-prescription erection pills are there?
Viagra Connect is the only prescription-free erection pill that works. But you still need an assessment to get it, either online or in a pharmacy.
Other prescription-free pills don’t work. There are some dietary and herbal supplements which people use to try to improve their erections. However, there isn’t a lot of research into how well they work, or even how safe they are to take.
Tips for taking erection pills
When you first take an erectile dysfunction tablet, you may find that it doesn’t have the effect that you’re looking for. This is perfectly normal – there are a few simple things that you can do to get the best results:
- Make sure you get enough sexual stimulation as well as taking the pill. It’s common to get frustrated if you don’t get an erection straight away after taking an erection pill. But, it’s important to remember that these pills work by enhancing your natural response to sexual stimulation and so will not give an erection without stimulation
- Don’t eat just before taking some medicines. Viagra, Sildenafil, and Levitra work better if you eat two or three hours before taking them. Cialis works just as well on an empty or full stomach
- Make sure you wait long enough before trying to get an erection. Viagra, Sildenafil and Levitra need around 1 hour after being taken to work best. Cialis may need as long as 3 hours
- Try a few times, even if it doesn’t work the first time. If you can, try out a new medicine at least six times before changing the dose or even switching to another medication. Not getting results straight away can be discouraging, but often your body simply needs to get used to the medicine
Which erection pill works best?
Most tried and tested
Viagra, Sildenafil and Levitra all work in a similar way. They’re normally taken 1 hour before sexual activity, and work for 4 to 6 hours.
Viagra and Sildenafil seem to be effective for the highest percentage of men, with up to 80% saying that it works for them in some studies.
Cialis has the advantage that it works for a much longer time than the other medicines. Some people find that they still experience the effects a day and a half after taking it. This means Cialis can be a great option for people who don’t always want to plan sexual activity a long time in advance.
Spedra is the newest medicine of the five that are commonly prescribed for erection problems. It works much more quickly than the other medicines, with some people reporting that it takes just 15 minutes to work. This makes it another option for people who don’t want to plan sexual activity very far in advance.
Where can I get erection pills?
The most convenient way to get erection pills is through an online doctor service.
At ZAVA, for example, you’ll complete a short assessment, with a few questions about you and your health. One of our doctors will then review your answers, and prescribe medication if there’s no medical reason not to.
You should only buy medications online from a source that you trust. It can be tempting to buy from another source, especially if you already know which medicines work best for you. But if a seller isn’t regulated, there is no way of knowing that what you’re buying is safe, or that it’s going to work.
You can also buy erection pills in person. Your doctor or GP may give you a prescription, which you can take to any pharmacy. But, if you’re short of time or you’d rather avoid a face-to-face consultation, an online doctor service could work well for you.
Supplements that aren’t medication can be bought online or in specialist shops. Again, you should make sure that these online sellers or shops are trustworthy and fully regulated.
Dr Babak Ashrafi Clinical Lead for Service Expansion
Babak studied medicine at King’s College London and graduated in 2003, having also gained a bachelor’s degree in Physiology during his time there. He completed his general practice (GP) training in East London, where he worked for a number of years as a partner at a large inner-city GP practice. He completed the Royal College of GPs membership exam in 2007.Meet our doctors
Last reviewed: 28 Jan 2022
Erectile dysfunction NHS [accessed 6th December 2021]
Erectile dysfunction (ED) Urology Health [accessed 6th December 2021]
Erectile dysfunction Cleveland Clinic [accessed 6th December 2021]
Long-term safety and effectiveness of sildenafil citrate in men with erectile dysfunction NCBI [accessed 6th December 2021]
Sildenafil-Viagra NHS 2019 [accessed 6th December 2021]