Erection Pills – How Do They Really Work?

Dr Kathryn Basford

Medically reviewed by

Dr Kathryn Basford

Last reviewed: 15 Nov 2018

There are erection medications available, but you need an assessment to buy them. Still, they are much more reliable than erection pills that can be bought without an assessment.

Man looking on his phone for erection pills as he walks down a concrete street

Medications like PDE5-inhibitors work to make your erections better. To buy them, you need to fill out an assessment online or in a pharmacy.

There are some erection pills that don’t need an assessment, but they aren’t going to do the same job as ones that do.

What erection pills are there?

If you're having problems with erections, the first line of treatment are medications called PDE5-inhibitors.

These pills don't cause erections. What they do is make it easier for you to get erections naturally, when you’re sexually aroused. They require an assessment before you can buy them.

Below are the erection pills normally used to treat erectile dysfunction:


Viagra was the first PDE5-inhibitor erection pill to be invented. It’s taken one hour before sexual activity.

Works for: 4 to 6 hours.


Sildenafil is actually the same medicine as Viagra, but doesn’t have the brand name. One advantage of Sildenafil is that it is cheaper than Viagra, because other drugs manufacturers can produce it.

Works for: 4 to 6 hours.

Viagra Connect

Viagra Connect is an over-the-counter version of Viagra. This means it doesn't require a prescription.

Works for: 4 to 6 hours.


Cialis lasts much longer than the other medicines in this list. But, it is also more expensive.

Works for: 24 to 36 hours.

Cialis daily

Cialis daily is a tablet that you take once every day instead of before sexual activity. Cialis daily comes in a lower dosage than Cialis, so it’s taken more often.

Works for: 24 hours.

Tadalafil (and Tadalafil daily)

Tadalafil and Tadalafil daily are just like Cialis and Cialis Daily, but they’re the non-branded versions. Like with Viagra and Sildenafil, this means they’re made and sold more cheaply.

Tadalafil works for: 24 to 36 hours

Tadalafil daily works for: 24 hours


Levitra is very similar to Viagra and Sildenafil. But, some men find that Levitra starts working a little faster compared with Viagra and Sildenafil.

Works for: 4 to 6 hours


Spedra is a lot newer than the other drugs in this list. It also works a lot faster, with some men finding that it only takes 15 to 30 minutes for the medicine to start working. This may be a good option for you if you don’t want to plan sexual activity a long time in advance.

Works for: 4 to 6 hours

Herbal erection pills

Herbal erection pills aren’t proven to help with better erections. Although you can buy them without an assessment, you're not likely to get the results you want. They also may not be safe, because they’re not regulated properly.

DHEA extract

  • Adds to the natural sex hormones made by the body
  • Can cause acne


  • Increases blood flow to the penis
  • May cause nausea, cramps, and diarrhoea
  • Canit be taken with Viagra or Sildenafil


  • Researchers are currently unsure of how it works
  • May cause insomnia
  • Little research on the effects of long term use

Niacin (vitamin B3)

  • Reduces cholesterol levels, which is thought to improve erection problems
  • Do not take niacin if you suffer from type II diabetes
  • May cause serious side effects including stomach ulcers and liver damage

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.

Which ones work best?

Different medications work best for different people

It’s important to remember that everyone reacts to medicines differently. It can be really helpful to compare things like the time they take to work, and the potential side effects, to try and decide which might be best for you. Your online doctor or GP can also help by making a recommendation.

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 seems 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.

Medication works better than herbal pills

Remember that medications for treating erectile dysfunction have been proven to work, and are safe if you've been assessed before buying them. Herbal pills have been researched, but that research hasn’t proved they work. The ingredients in herbal pills also may not be regulated, so you couldn’t be sure how strong they are, or what else they might have in them.

Making the most of your erection pills

There are some lifestyle changes that you can make, which have been proven to improve erections naturally. These include:

  • quitting smoking
  • not drinking alcohol, especially just before sexual activity
  • eating a low-cholesterol diet
  • exercising regularly. The government recommends 30 minutes of moderate exercise, like jogging or cycling, 5 times a week

Tips for taking erection pills

When you first take a new erection pill, 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 make the most of erection pills:

  • 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

To request pills or other treatments we offer for erectile dysfunction, complete our short online medical questionnaire. Our doctors can prescribe treatment within a few hours once they’ve checked this is suitable for you. If you have any questions, send them a private message through your account, free of charge.

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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. Only buy these medicines from a trusted source, and get a doctor’s advice before starting to use any of these supplements.

How do erection pills work?

Effective erection pills all work in a similar way. PDE5-inhibitors relax your muscles and improve blood flow throughout the body. In the penis, better blood flow means an improved erection.

Pills shouldn't cause erections on their own. PDE5-inhibitors make it easier to get an erection for a certain period of time. If they cause an erection that is painful or won't go away (priapism), this is a serious side effect and you should get medical help as soon as possible.

Erection pills can cause a drop in blood pressure, which isn’t an issue for most people. But if you’re taking other prescription medicines which also lower your blood pressure (like beta blockers, ACE inhibitors, or nitrates), it may not be recommended for you to take erection pills too. Your online doctor or GP will be able to give you advice on this.

Medically reviewed by:
Dr Kathryn Basford

Dr Kathryn Basford is a qualified GP who works as a GP in London, as well as with ZAVA. She graduated from the University of Manchester and completed her GP training through Whipps Cross Hospital in London.

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Last reviewed: 15 Nov 2018

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