Cialis Doesn’t Work For Me: What to Do

Dr. Patrick Carroll, MD
Medically reviewed by Patrick Carroll, MD Written by Our Editorial Team Last updated 9/21/2020

Cialis® is one of several medications used to treat erectile dysfunction (ED). Thanks to its long half-life, it can provide relief from erectile dysfunction that lasts for 36 hours.

Like Viagra®, Stendra® and Levitra®, Cialis is highly effective as a treatment for ED. Studies of tadalafil, the active ingredient in Cialis, show that it improves erections and enhances sexual performance even at a relatively low dose. 

However, no medication has a 100 percent success rate, and Cialis is no exception. Even after you take Cialis, you could still experience some symptoms of ED. Below, we’ve explained some reasons why this can happen, as well as some things you can do if Cialis doesn’t work for you. 

Why Cialis Doesn’t Always Work

Tadalafil, the active ingredient in Cialis, works the same way as the sildenafil used in Viagra, the avanafil used in Stendra or the vardenafil used in Levitra. They’re all categorized as PDE5 inhibitors.

After you take Cialis, your body absorbs the tadalafil inside the tablet. Tadalafil increases blood flow to the erectile tissue of your penis by inhibiting the PDE5 enzyme. This makes it easier for blood to flow into your penis when you’re aroused, giving you an erection.

However, this doesn’t always happen. 

According to Harvard Men's Health Watch, the active ingredients used in Cialis, Viagra, Stendra and Levitra are only fully effective around 70 percent of the time in the healthy men that take them, meaning that many men still have erection issues even with the use of medication.

Sometimes, this is because the medication wasn’t used properly. In other cases, other health issues can affect the effectiveness of Cialis. Below, we’ve listed several of the most common reasons why Cialis might not work for you:

You’re Not Using Cialis Correctly

Cialis is designed to be used under specific conditions for maximum effectiveness. While you should always take Cialis exactly as your healthcare provider tells you to, it is generally recommended that for optimal results, you should:

  • Take Cialis at least one hour before sex. Cialis can take up to one hour to start fully working inside your body. Try to take your Cialis tablet at least one hour before sex for the optimal results.

    Since Cialis is a long-lasting medication, you can take it several hours before sex without having to worry about its effects wearing off. Unlike Viagra®, there’s no need for you to take Cialis on an empty stomach.
  • Avoid drinking alcohol. Not only can alcohol make Cialis and other medications less effective, but it can also affect your blood flow. This makes it harder to get an erection even with the help of medication.

You’re Not Using the Right Dose of Cialis

Cialis comes in several dosages: 2.5mg, 5mg, 10mg and 20mg. Most of the time, the 10mg and 20mg dosages are used to treat erectile dysfunction, although the lower 5mg dosage is also occasionally used to treat cases of mild to moderate ED. 

The 2.5mg and 5mg doses of Cialis tend to be used to treat mild ED and conditions such as benign prostatic hyperplasia (BPH).

Studies of tadalafil tend to show that the higher the dose, the more effective the medication is at treating erectile dysfunction. For example, in a 2007 study from Japan, men with severe ED who used the 20mg dosage of Cialis reported greater benefits than those given the 10mg dosage. 

If you’re prescribed a lower dosage of Cialis and you find that it’s not fully effective (for example, you notice some improvements but still have difficulty maintaining an erection), it’s a good idea to discuss this with your healthcare provider to see if switching you to a higher dose is appropriate.

You’re Experiencing Performance Anxiety

ED can be caused by sexual performance anxiety — a feeling of nervousness and anxiety before and during sex. If you’re affected by sexual performance anxiety, it’s quite normal to feel worried about Cialis’ effectiveness the first few times you use it.

This nervousness can result in worse ED than normal, meaning that Cialis might not be totally effective as a treatment. 

If you find that Cialis doesn’t work the first time you use it at a normal dosage, you may want to stick with it before you throw in the towel on this specific medication. Wait until you feel relaxed, confident and in the right mood so that you can judge Cialis’s performance fairly. 

Your ED is Caused by a Psychological Condition

Cialis is designed to treat the physical causes of erectile dysfunction, such as poor blood flow to the erectile tissue of your penis. However, it’s not a psychiatric medication and isn’t designed to be a treatment for some psychological causes of ED.

Erectile dysfunction can be associated with anxiety, stress and depression. If you have a mental illness or other condition that affects your sexual performance, Cialis (as well as other ED drugs like Viagra, Stendra or Levitra) might not be a completely effective treatment. 

If you think this is the cause of your ED, it’s important to talk to your healthcare provider. Sexual performance issues caused by mental illnesses can often be treated through therapy, medications and other treatment options. 

Your ED is Caused by a Physical Health Condition

Erectile dysfunction is often caused by a physical health condition, such as hypertension (high blood pressure), diabetes or nerve damage

Tadalafil, the active ingredient in Cialis, works by increasing blood flow to the erectile tissue of your penis. This makes it effective for most cases of ED. However, certain physical conditions can cause ED that isn’t completely treated by Cialis.

Beyond the cardiovascular causes of ED, issues such as low testosterone can affect both your sexual performance and your general level of interest in sex. Because Cialis isn’t a hormonal medication, it might not be completely effective at treating ED if this is the underlying cause. 

If you’re concerned that your sexual performance issues are caused by an underlying physical health condition, talk to your healthcare provider. By treating the underlying condition, you can often improve your sexual performance with or without the use of medications such as Cialis. 

Porn is Affecting Your Sexual Performance

If you frequently watch porn, it could negatively affect your sexual performance, causing you to face difficulties getting and maintaining an erection. 

Porn-induced ED, as it’s commonly referred to, occurs when your porn habits affect your sexual tastes, expectations and perceptions. Porn consumption can potentially result in anxiety around sex, which can contribute to erectile dysfunction.

Since this is a psychological cause of ED, it often isn’t fully treated with medications like Cialis, Viagra, Stendra or Levitra. Our guide to porn-induced ED explains this phenomenon in more detail and shares techniques that you can use to avoid letting porn affect your sex life. 

Another ED Medication is More Suitable for You

Cialis is one of several medications used to treat erectile dysfunction. Because Cialis has a longer half-life than other ED medications, it’s typically prescribed to men affected by ED who need a long-lasting treatment option.

Although all PDE5 inhibitors work similar, some men seem to prefer the effects of one drug over those of others. If you’re not satisfied with Cialis, talk to your healthcare provider about the possibility of using a different ED medication that’s more suitable for your needs.

Learn More About Treating Erectile Dysfunction

Dealing with erectile dysfunction can be a frustrating experience, especially if you don’t get the results you anticipated from medications like Cialis. However, it’s worth remembering that there are real, proven, science-backed treatment options available that can help you.

In our guide to the most effective ED treatments, we list a wide range of treatment options that can help you get and maintain an erection during sex, improve your overall sexual performance and enjoy a better sex life.

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.