Guide to Erectile Dysfunction Medications: Understanding Causes, Effective Treatments, and Combination Therapies

Erectile dysfunction is a male sexual condition in which they cannot gain a harder erection when aroused. It’s a common issue and can impact a person’s self-esteem, relationships, and overall quality of life. Moreover, a person also notices decreased libido and sexual satisfaction levels because of the issue.

But the good news is that medications are available in the market that help men regain their confidence in the bedroom. It happens by getting a harder erection, increased libido, and satisfaction levels.

In this guide, we’ll dive into these medications, how they function, potential side effects, and factors to consider when selecting the right treatment.

Understanding Erectile Dysfunction

Before we dive into the details of specific ED medications, it’s essential to have a basic understanding of what causes this condition. ED occurs when there is a problem in the process that induces an erection in the body.

These can be due to various reasons, which might involve the interplay of physical, psychological, and emotional factors. When a man becomes sexually aroused, the brain sends signals to the nerves and blood vessels in the pelvic region.

It causes blood to flow into the spongy tissue of the penis, resulting in an erection. But due to the following common reasons, there is a disruption in the process of erection-

  • Aging
  • Heart problems
  • High blood pressure
  • Diabetes
  • Metabolic syndrome
  • Hormone changes
  • Medication side effects
  • Depression
  • Performance anxiety
  • Other sexual disorders
  • Neurological disorders, such as multiple sclerosis
  • Traumatic injuries
  • Stroke
  • Sleep apnea
  • Chronic obstructive pulmonary disease
  • Glaucoma
  • Priapism
  • Prostatic hyperplasia

The erectile dysfunction medicines we are about to discuss addresses the physical aspect of erectile function by enhancing blood flow to the penis. In some cases, the medicine might even promote the relaxation of specific muscles and blood vessels.

Note- These medications do not directly address psychological or emotional factors contributing to ED.

Now, let’s explore the most effective pills for treating erectile dysfunction:

Sildenafil (Viagra)

Sildenafil, first sold under the brand name Viagra, is a well-known and widely used medication for ED. It belongs to a class of drugs called phosphodiesterase type 5 (PDE5) inhibitors, which are prescription-based.

Viagra works by inhibiting the enzyme PDE5, which can constrict blood vessels in the penis by blocking cGMP, causing poor blood flow. By inhibiting PDE5, Sildenafil promotes dilation of blood vessels. It means better blood flow to the penis, making it easier for a man to achieve an erection when sexually aroused.

Effectiveness: Sildenafil has been proven effective in providing temporary relief from ED symptoms. Studies show that it helps a significant percentage of men achieve erections sufficient for satisfactory intercourse.

Onset of Action: Sildenafil typically starts working within 20-25 minutes after consumption on average. It completely depends on the level of issues that a person has. The physician suggests that a person should use it around half an hour before intercourse.

Dosage: The standard dose of Sildenafil is decided by the physician based on the individual level of issues, response, and tolerability. It should be taken about 30 minutes before sexual activity, in a dose prescribed by the physician.

Side Effects

  • Painful erections lasting several hours
  • Chest pains
  • Headaches
  • Vision problems
  • Hot flashes
  • A fever
  • Nausea
  • Dizziness
  • A stuffy or runny nose
  • Indigestion

2. Tadalafil (Cialis)

Tadalafil, first marketed under the brand name Cialis, is another popular PDE5 inhibitor used to help ED patients. Tadalafil is known for its long-lasting effects, which is why it is commonly known as a “weekend pill.”

Effectiveness: Tadalafil is highly effective in treating ED, with a similar success rate to Sildenafil.

Onset of Action: Unlike Sildenafil, Tadalafil has a longer onset of action. The tablet takes 40-45 minutes to act in a person’s body on average. The effects generated typically last for up to 36 hours. This means you can be more spontaneous during sex.

Dosage: Tadalafil is available in different strengths (2.5mg, 5mg, 10mg, and 20mg), and the appropriate dose is decided by the physician. Like Sildenafil, the dosage depends on an individual’s levels of issues, needs, and tolerability. It can be taken once daily or on an as-needed basis.

Side Effects

  • Hot flashes
  • Headaches
  • Muscle pain
  • Back pain
  • Pain in the limbs
  • Indigestion
  • A stuffy or runny nose

3. Vardenafil (Levitra) and Avanafil (Stendra)

Vardenafil, sold as Levitra, and Avanafil, marketed as Stendra, are two other PDE5 inhibitors used to help ED temporarily. They work in a similar way as the other two.

Effectiveness: Both Vardenafil and Avanafil are effective treatments for ED, and they have different times of action and active duration listed below.


  • Onset of Action:The medicine usually starts working within 40-45 minutes like Tadalafil. But this depends on various factors like levels of the issue and the digestive system of a person.
  • Duration:Once active, the medicine will last for about 4-5 hours on average. In some entry-level cases, the medicine might even last for 8-9 hours.


  • Onset of Action:The Avanafil API is known for its fast action. Once consumed, the API shows results within 15 minutes. In some serious cases, it might take 20 minutes.
  • Duration: The effects of the medicine typically last for 6-12 hours in a male’s body.

Dosage: The dose of the medicine is decided by the physician. They will consider levels of issues and a person’s response to prescribe the dose.

Side Effects

  • Headache
  • Flushing
  • Dizziness
  • Nasal congestion
  • Backache
  • Muscle pain
  • Stomach upset
  • Diarrhea
  • Vision changes
  • Rash
  • Priapism
  • Allergic reactions

Combination Therapies

In some cases, erectile dysfunction (ED) may require a multiple approach that combines the use of medication with lifestyle modifications and stress-reduction techniques. It is required because sometimes ED can happen because of more than one reason.

This strategy aims to tackle both the physical and psychological factors leading to erectile dysfunction. Here are a few examples of the combination therapies that one might adopt.

PDE5 Inhibitors with Lifestyle Modifications

A combination of PDE5 inhibitors with lifestyle modifications can enhance the effectiveness of ED treatment. Here are a few examples of lifestyle modifications-

  • Weight Management: Obesity is a known risk factor for ED because it leads to conditions like diabetes, high blood pressure, and high cholesterol. Using PDE5 inhibitors with a weight management plan that includes a balanced diet and regular exercise can address the underlying health issues that can cause ED.
  • Smoking Cessation:Smoking can damage blood vessels and reduce blood flow, which is essential for achieving and maintaining an erection. Quitting smoking is crucial for preserving the sexual health of a male. That is why medication with smoking cessation programs can permanently improve ED symptoms.
  • Stress-Reduction Techniques: Stress and anxiety can lead to ED or worsen the situation. Combining PDE5 inhibitors with stress-reduction techniques, such as meditation, deep breathing exercises, or yoga, can help resolve the psychological factors contributing to ED.

Psychotherapy with Medication

When ED is primarily caused by psychological factors such as anxiety, depression, or unresolved relationship issues, combining psychotherapy with medication can be highly effective. Here are the examples-

Cognitive-Behavioral Therapy (CBT): CBT is a common form of psychotherapy used to address the psychological aspects of ED. It helps individuals identify and modify negative thought patterns and behaviors that contribute to stress and anxiety related to sexual performance. Combining CBT with PDE5 inhibitors can lead to improved sexual function.

Couples Counseling: In cases where relationship issues contribute to ED, couples counseling can be highly effective. A therapist can facilitate open communication and help both partners work together to address relationship challenges. Combining couples counseling with medication can lead to better sexual intimacy and satisfaction.

Hormone Replacement Therapy (HRT)

In some cases, ED may be linked to hormonal imbalances, particularly low testosterone levels. Combining hormone replacement therapy with PDE5 inhibitors can address the underlying hormonal factors contributing to ED. However, hormone replacement therapy should only be considered under the guidance of a healthcare provider, as it carries potential risks and side effects.

Herbal and Alternative Remedies

Some individuals explore herbal supplements and alternative remedies as a more natural approach to treating ED. These remedies include herbs, amino acids, and dietary changes believed to potentially benefit sexual health.

  • Ginseng: Ginseng is a popular herbal remedy believed to improve sexual function. Some studies suggest that ginseng may help increase blood flow and enhance sexual desire. However, more research is needed to confirm its efficacy in treating ED.
  • L-Arginine: L-arginine is an amino acid that plays a role in the production of nitric oxide, a compound that relaxes blood vessels and promotes increased blood flow. Some people take L-arginine supplements with the hope of improving their erectile function.
  • While some evidence supports its potential benefits, it’s essential to consult with a healthcare professional before using L-arginine, as it can interact with certain medications and have side effects.
  • Pomegranate Juice: Pomegranate juice is rich in antioxidants and has been explored for its potential cardiovascular benefits, which can indirectly support sexual health. Some studies have suggested that pomegranate juice may enhance blood flow, potentially benefiting ED. However, more research is needed to establish its effectiveness in treating this condition.

Note- It’s important to remember that the FDA does not regulate herbal and alternative remedies for ED. Therefore, the safety and efficacy of these treatments can vary widely.



MedzPills is dedicated to providing consumers with accurate and reliable health information. This article has been carefully reviewed by an expert, Parry Stone. However, it’s important to understand that this information is not a substitute for advice from a qualified medical professional. Our information is meant to be a helpful resource, but it might not cover every aspect of health conditions, lab tests, medications, potential side effects, drug interactions, warnings, or alerts. It’s strongly recommended that you consult your doctor for any specific questions or concerns about a particular illness or medication. At MedzPills, our goal is to complement, rather than replace, the important doctor-patient relationship.

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