
Erectile dysfunction (ED), formerly called impotence, is a common type of sexual dysfunction where men lack the ability to get or keep an erection. The treatment for ED largely depends on its cause or any other underlying conditions. Thus, what may work for some men may not be the best medication or treatment for you.
Typically, sildenafil (Viagra) is the first drug that doctors prescribe for erectile dysfunction. However, other effective medications may include Stendra (avanafil), Cialis (tadalafil) and Levitra (vardenafil).
Vardenafil is also available in a sublingual formulation (the pill is put under the tongue and is absorbed in the blood) called Staxyn. Sublingual formulations generally act faster than the pills taken orally.
Medications for ED may cause an erection sufficient to start intercourse in about 70 percent of otherwise healthy men. Which medication you choose may depend on your budget and lifestyle. For example, if you have sex more often, Cialis (tadalafil) may be best because it has a long-acting effect.
Apart from the aforementioned medications, your doctor may recommend the following for ED:
- Lifestyle changes such as
- Maintaining a healthy weight.
- Staying physically active.
- Quitting smoking, excessive alcohol consumption and any drug abuse.
- Stress management through various activities such as meditation, sports, music or yoga.
- Getting adequate sleep and rest.
- Counseling to manage stress, anxiety, relationship problems or any emotional issue.
- Testosterone supplements if low testosterone levels are causing the dysfunction.
- Alprostadil (a type of medication resembling a class of naturally occurring substances in our body called prostaglandins) is an injectable drug or a suppository.
- Medication to manage any underlying health conditions, such as diabetes, high blood cholesterol or kidney diseases.
- Vacuum devices can cause an erection by pooling blood into the penis.
- Surgery that mainly includes penile implants or surgeries to repair the damaged blood vessels (revascularization surgery).
What are the side effects of erectile dysfunction medications?
Medications such as Viagra (sildenafil), Stendra (avanafil), Cialis (tadalafil) and Levitra and Staxyn (vardenafil) may cause the following side effects:
- Headache
- Dizziness
- Flushing
- Nasal congestion
- Stomach upset
- Diarrhea
- Muscle pain
- Skin rash
- Vision problems or reversible type of color blindness
These medications may also interfere with any other drug you are already on. Hence, you must inform your doctor if you are already taking any medication.
ED Medication May Interfere with These Drugs
ED medication cannot be taken if you are using a nitrate drug for chest pain or heart problems including:
- Nitroglycerin
- Isosorbide dinitrate
- Isosorbide mononitrate
- Some recreational drugs such as “poppers”
Taking erectile dysfunction pills with a nitrate medicine can cause a sudden and serious decrease in blood pressure. Other medications that lower blood pressure, such as alpha-blockers prescribed for urinary symptoms, must be taken at least four hours apart from ED medications.
Seek immediate medical attention if you are on ED medication and develop:
- A painful erection.
- An erection lasting longer than four hours (persistent penile erection can permanently damage the penis).
- Nausea, chest pain or dizziness during sex.
- Sudden vision loss.
What are the symptoms of erectile dysfunction?
Erectile dysfunction causes a persistent inability to achieve an erection firm enough for sexual intercourse at least 25 percent of the time. An occasional failure to get or maintain an erection is common with most men and may be caused by stress, fatigue, alcohol or relationship issues.
A man with ED may experience the following symptoms:
- Inability to get an erection at any time
- Inability to get an erection sometimes but not every time they want to have sex
- An erection that does not last long enough for sex
Although ED is commonly seen in older men, it is not a natural part of aging. Older men may need more sexual stimulation, such as through touching or stroking, to achieve an erection. They may even need longer periods between two erections. If an older man cannot get an erection sufficient for intercourse, consulting a physician is necessary to rule out any underlying health conditions, such as an enlarged prostate or diabetes.

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