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The little blue pill known as Viagra (generic name sildenafil) was first developed in 1989 as a treatment for high blood pressure and angina. After discovering the drug’s benefits for increasing erections in the early 1990s, scientists rebranded the drug as a treatment for erectile dysfunction. Once the drug was approved by the FDA in 1998, prescriptions for Viagra exceeded five million over the next six months, and that number continues to climb. In 2012, 8 million prescriptions were written for Viagra alone – that doesn’t account for the other ED drugs on the market.
Unfortunately, ED drugs don’t work for everyone who takes them. If you suffer from erectile dysfunction and your ED drugs aren’t working as well as you’d like them to, don’t immediately abandon them or switch to another drug. Take the time to learn how ED drugs work and what might be causing your issues. From there, you can consult with your doctor and decide whether to give the drugs another shot or move on to an alternative treatment.
How Are ED Drugs Supposed to Work?
The risk factors for erectile dysfunction are vast and varied but, for the most part, the underlying issue comes down one thing: circulation. Like any other organ in the body, the penis requires a supply of oxygenated blood in order to perform basic functions. When it comes to sexual function, circulation is key to achieving and maintaining an erection – the penis fills with blood, and the resulting pressure traps it inside, allowing the penis to expand in size and to become very firm.
Erectile dysfunction is a condition which, among other symptoms, makes it difficult for a man to achieve and maintain an erection - underlying vascular issues play an important role. The primary function of ED drugs is to resolve those vascular issues, restoring blood flow to the penis to facilitate an erection. More specifically, ED drugs belong to a class of drugs known as phosphodiesterase type 5 (PDE5) inhibitors, and they increase the amount of nitric oxide in the body which works with other substances to open the blood vessels, increasing blood flow to the penis.
What Are the Risks and Downfalls of ED Drugs?
Though many men experience an improvement in ED symptoms after they start taking prescription medications, many men do not. In fact, one study revealed that nearly 70% of men taking PDE5 inhibitors like Viagra (sildenafil) and Cialis (tadalafil) continued to experience erectile issues. There is some evidence to suggest that this number is high because many men fail to take ED drugs properly which can inhibit a favorable response. Even so, an article published by Harvard Health Publishing suggests that ED drugs fail to work for 30% of the men who take them.
Not only is there a risk that erectile dysfunction drugs might not work, but they could trigger some unpleasant side effects. Using Viagra as an example, some of the most common side effects are:
- Flushing of the skin
- Upset stomach
- Changes in vision
- Runny or stuffy nose
- Back pain
- Muscle aches
- Dizziness or fainting
If you are taking prescription drugs for erectile dysfunction but you don't see the results you want, there are several options available to you. Before you consider an alternative course of treatment, ask yourself whether you are using the drug correctly. Many men fail to read the instructions or follow their doctor’s advice when it comes to ED drugs.
Here are the top six mistakes men make when taking drugs for erectile dysfunction:
- Expecting a miracle – Drugs for ED are designed to improve blood flow to the penis, but they won’t enhance your arousal – you still need to become aroused to achieve an erection. You should also know that these drugs may not work immediately.
- Taking the wrong dose – Many men don’t like the idea of taking medication, so they take the lowest dose possible. Unfortunately, if you don’t take the right dose, your ED drugs aren’t going to work, so talk to your doctor about dosage and try a higher dose if it still doesn’t work.
- Eating a large meal – Most ED drugs are designed to be taken on an empty stomach – having food in your stomach when you take the drug can inhibit absorption and uptake. Wait at least 2 to 3 hours after eating to take ED drugs.
- Not waiting long enough – Again, ED drugs are not a magical pill that will immediately give you an erection – you need to give the drug some time to work. Doctors recommend waiting at least 1 hour, but some drugs (like Cialis) work best after 2 to 3 hours.
- Giving up too soon – It is impossible to tell how your body is going to respond to a drug – any drug – so don’t be discouraged if your ED drug doesn’t work the first time. Give it a few tries then try a higher dose. If all else fails, talk to your doctor about other options.
- Trying only one drug – If you don’t see the results you want on one ED drug, try another before you give up entirely. You can’t expect your body to have the same reaction to a drug as someone else’s, so find the drug that works best for you as an individual.
After reviewing the mistakes from the list above, ask yourself honestly whether you are using your ED drugs correctly. If you are and you still aren’t experiencing any relief from your symptoms, it may be time to consider an alternative treatment. Keep reading to learn more.
Alternative Treatments for ED
When erectile function drugs don’t provide the results you want, you may need to consider other options. Some of the most common alternative treatments for ED include the following:
- Vacuum restriction devices
- Penile implants
When oral medications don’t work, another option is to inject the drug directly into the penis. Alprostadil (brand names Cavarject and Edex) is the most common injectable ED drug, and it can create an erection within 5 to 20 minutes that lasts up to an hour. This drug is effective in between 70% and 90% of cases, though it comes with a risk for mild side effects such as pain at the injection site.
If you don’t like the idea of sticking yourself with a needle, a urethral pellet or suppository is another option. Known as the medicated urethral system for erection (MUSE), this treatment involves inserting a pellet of Alprostadil into the urethral opening in the tip of the penis. The drugs are absorbed through the urethral wall and can trigger an erection within 10 minutes that lasts up to an hour. This treatment is a little less effective than injections and slightly more likely to cause pain or irritation.
A completely non-medical treatment alternative for erectile dysfunction comes in the form of vacuum restriction devices. These devices consist of a cylinder that is placed over the penis and then you use a pump to create pressure inside the tube, drawing blood into the penis. Once the penis is erect, a rubber ring is placed around the base to prevent the blood from escaping. Though this treatment may produce an erection that can last up to 30 minutes, it is not a natural erection.
In particularly stubborn cases of erectile dysfunction, surgical treatment may be worth considering – the most common option is penile implants. Penile implants are small, hollow tubes that are surgically implanted in the penis. These tubes can be hooked up to a small pump that is implanted in the scrotum and then inflated to produce an erection. Though this treatment may produce an erection, the procedure disrupts normal penile anatomy which may render the future use of oral medications or injectables ineffective.
In addition to considering these alternative treatments, you may also want to think about psychotherapy as a supportive treatment if the cause of your ED is primarily psychological. Research suggests that as many as 10% to 20% of impotence cases have an underlying psychological trigger such as anxiety, depression, or stress. Relationship troubles, fear of failure, and low self-confidence can also contribute to psychological ED. Talking to a therapist can help you resolve any underlying issues that might be affecting your libido and inhibiting healthy sexual function.
Could Diet and Lifestyle Changes Help?
While erectile dysfunction drugs and other treatments may help to reduce symptoms or facilitate an erection, they don’t always address the underlying issues that caused the ED in the first place. Some of the most common risk factors for ED include obesity, smoking, diabetes, high cholesterol, stress, alcohol intake, poor diet, and an inactive lifestyle. All of these are things that can theoretically be changed which could improve your erectile dysfunction.
The two biggest things you can do to natural resolve ED is to improve your diet and exercise habits. Generally speaking, a healthy diet is made up of lean proteins, whole grains, fresh fruits, vegetables, and healthy fats. This type of diet is good for your heart which means that it is also good for circulation – circulation is a key factor in your ability to achieve and maintain an erection, so you can see the link. You may also want to reduce your intake of saturated fats and sugars as well as fried food, processed foods, and alcoholic beverages.
In addition to making improvements to your diet, getting more regular exercise can benefit your sexual health. The more you exercise, the stronger your heart becomes and that increases its ability to pump oxygenated blood throughout the body to the parts that need it – including your penis. Aim for 30 minutes of moderate-intensity exercise five days a week for the best results. If you haven’t exercised for a while, you can start slow and build up your stamina over time.
Erectile dysfunction is a condition that affects as many as 52% of men over the course of their lifetime. As common as ED issues are, many men feel the stigma and fail to seek treatment which only makes matters worse. Unfortunately, a fairly high percentage of people who do seek treatment don’t get the results they want.
If you’ve been taking prescription drugs to manage your erectile dysfunction, take the time to think about whether they are really working for you. If they aren’t, talk to your doctor about dosage or switch to another product. When you’ve exhausted your options, consider whether an alternative treatment like those discussed here might be your next best choice.
Important Safety Information
IMPORTANT SAFETY INFORMATION
Do not take Sildenafil (sildenafil citrate) if you:
- take any medicines called nitrates, often prescribed for chest pain, or guanylate cyclase stimulators like Adempas (riociguat) for pulmonary hypertension. Your blood pressure could drop to an unsafe level
are allergic to sildenafil, as contained in Sildenafil and REVATIO, or any of the ingredients in Sildenafil
Discuss your health with your doctor to ensure that you are healthy enough for sex. If you experience chest pain, dizziness, or nausea during sex, seek immediate medical help
Sildenafil can cause serious side effects. Rarely reported side effects include:
- an erection that will not go away (priapism). If you have an erection that lasts more than 4 hours, get medical help right away. If it is not treated right away, priapism can permanently damage your penis
- sudden vision loss in one or both eyes. Sudden vision loss in one or both eyes can be a sign of a serious eye problem called non-arteritic anterior ischemic optic neuropathy (NAION). Stop taking Sildenafil and call your healthcare provider right away if you have any sudden vision loss
sudden hearing decrease or hearing loss. Some people may also have ringing in their ears (tinnitus) or dizziness. If you have these symptoms, stop taking Sildenafil and contact a doctor right away
Before you take Sildenafil, tell your healthcare provider if you:
- have or have had heart problems such as a heart attack, irregular heartbeat, angina, chest pain, narrowing of the aortic valve, or heart failure
- have had heart surgery within the last 6 months
- have pulmonary hypertension
- have had a stroke
- have low blood pressure, or high blood pressure that is not controlled
- have a deformed penis shape
- have had an erection that lasted for more than 4 hours
- have problems with your blood cells such as sickle cell anemia, multiple myeloma, or leukemia
- have retinitis pigmentosa, a rare genetic (runs in families) eye disease
- have ever had severe vision loss, including an eye problem called NAION
- have bleeding problems
- have or have had stomach ulcers
- have liver problems
have kidney problems or are having kidney dialysis have any other medical conditions
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
Sildenafil may affect the way other medicines work, and other medicines may affect the way Sildenafil works, causing side effects. Especially tell your healthcare provider if you take any of the following:
- medicines called nitrates
- medicines called guanylate cyclase stimulators such as Adempas (riociguat)
- medicines called alpha-blockers such as Hytrin (terazosin HCl), Flomax (tamsulosin HCl), Cardura (doxazosin mesylate), Minipress (prazosin HCl), Uroxatral (alfuzosin HCl), Jalyn (dutasteride and tamsulosin HCl), or Rapaflo (silodosin). Alpha-blockers are sometimes prescribed for prostate problems or high blood pressure. In some patients, the use of Sildenafil with alpha-blockers can lead to a drop in blood pressure or to fainting
- medicines called HIV protease inhibitors, such as ritonavir (Norvir), indinavir sulfate (Crixivan), saquinavir (Fortovase or Invirase), or atazanavir sulfate (Reyataz)
- some types of oral antifungal medicines, such as ketoconazole (Nizoral) and itraconazole (Sporanox)
- some types of antibiotics, such as clarithromycin (Biaxin), telithromycin (Ketek), or erythromycin
- other medicines that treat high blood pressure
- other medicines or treatments for ED
Sildenafil contains sildenafil, which is the same medicine found in another drug called REVATIO. REVATIO is used to treat a rare disease called pulmonary arterial hypertension (PAH). Sildenafil should not be used with REVATIO or with other PAH treatments containing sildenafil or any other PDE5 inhibitors (such as Adcirca tadalafil)
Sildenafil does not protect against sexually transmitted diseases, including HIV.
The most common side effects of Sildenafil: headache; flushing; upset stomach; abnormal vision, such as changes in color vision (such as having a blue color tinge) and blurred vision; stuffy or runny nose; back pain; muscle pain; nausea; dizziness; rash.
Sildenafil (sildenafil citrate) is prescription medicine used to treat erectile dysfunction (ED).
Sildenafil is not for women or children.