Most experts will tell you that every man
will deal with some level of erectile dysfunction (ED) at some point in
his life. Many men, especially as they get older, will have it seriously
enough that they'll consider seeking some help. The upside is that
the vast majority of ED cases can be treated with great effectiveness.
For many, it's a simple as taking a pill. Here's what you need to know
before you do.
1. How to Talk to Your Doctor
ED is such a common problem, don't be too daunted about talking to your
doctor about it. However, don't expect them to throw you a bunch of
free samples right away. First, they are going to want to make sure your
erectile issues require medication. They will likely ask about your
diet, weight, stress-levels, and sleep. "Making sure the dysfunction is
from a medical problem and not necessarily related to anxiety or a
psychogenic cause is also important to tease out before to running to
give them medicine," says Dr. Benjamin Breyer, Chief of Urology at San Francisco General Hospital.
Medical history can also be an important factor, especially
for men who have had surgery or radiation that could affect functioning.
Age and baseline erectile functioning are also important determinants
of how various ED treatments will work.
2. How the Pills Work
already know the names of the most popular pills — Viagra, Levitra,
Cialis — but how do they work? First of all, all increase the
effects of nitrous oxide in the body, which relaxes muscles around your
penis and allows for increased blood flow. Although they are
referred to interchangeably in the common lexicon, there are some
differences between these pills. The biggest is how long they last.
Cialis is the standout here, as a man can take it well before he thinks
he will need it and, if he takes it daily, there is no time delay in
terms of when it will work. Viagra and Levitra, on the other hand, have
to be taken at least 30 to 60 minutes prior to sex and can last four to
five hours. A new pill, Avanafil (Stendra), has cut this time down to 15
to 30 minutes and lasts six to 12 hours. Cialis is also the only ED
pill that is also FDA-approved to treat benign prostatic hyperplasia
(BPH), an enlarged prostate condition which can affect urination. So,
some men may take Cialis for this reason as well.
Overall, these pills are quite safe for most men. Common
side effects that exist are pretty mild and Breyer says they often
improve over time. "By and large, they are safe. There are common side
effects, like headaches, dizziness, flushing, back pain, some guys get
runny noses, feeling congested," says Breyer. This is particularly good
to know, considering men using these treatments will likely use them for
the rest of their lives. Erectile dysfunction medications may be
ineffective or dangerous for men who take nitrates or blood thinners,
and those who have had heart problems, stroke, or issues with their
3. Non-Oral Medications
work for most men with ED but some may require more potent options. The
first of these is a suppository pellet, Alprostadil (Muse), which is
inserted directly into the urethra (the tube that carries urine and
semen out of the penis). In order to use this, a man urinates to
lubricate the urethra and then inserts the pellet. This a strong
medication and the delivery is much more direct than in oral pills. It
is still fairly safe. "Guys tend to tolerate it well, but some men will
complain of penile pain or burning afterwards when they urinate," says
The other non-pill medication treatment for ED is direct
injection. This entails using a needle to deliver medication — usually a
mix of two to three meds — into the penis prior to sex. This mix is
usually created in special pharmacies and is the strongest ED medication
available. Due to its potency, doctors will put their patients on the
lowest possible doses and increase the dose only if necessary.
4. Over-the-Counter Supplements
Different experts have different opinions
on the effectiveness of supplements. Most agree, however, that using
them is a gamble. Supplements, unlike medications, are not regulated by
the U.S. Food and Drug Administration (FDA) and this can be problematic.
"Because of how it's regulated or the lack of regulation, really you
don't know what you're getting," says Breyer. This lack of certainty
means supplements could be potentially dangerous. More often, it seems
that they simply don't work.
5. Recreational Use and Sketchy Retailers
no secret that many men use ED drugs without getting the go-ahead from
their doctor. "We know that people use it recreationally and I wouldn't
advise them to do it medically," says Breyer. "If they're going to do
it, they should obviously be careful." This warning is even more
important for people trying to use the injectable medications without
medical guidance. Because these are so strong, there is an increase
chance that they will cause priapism — that erection lasting longer than
four hours that you've heard so much about. This condition is a medical
emergency, which, if not addressed immediately, could result in very
severe ED that cannot be treated with medications.
Recreational users tend to get these medications from
nonconventional places, like the Internet or foreign pharmacies, without
talking with their doctor. Some of the people buying ED drugs from
these places truly have erectile problems but cannot afford to purchase
the proper medications from their pharmacy. These medications are
prohibitively expensive for many people and there are innumerable
unapproved retailers offering what they say are the same drugs at a much
lower price. It's an understandable risk for men to take but a risk all
the same. "The truth is, it's really hard to tell whether it's reliable
or not, whether it's counterfeit or not when you're not obtaining it
through a well-established, known source," says Breyer. Often, the
problem with these drugs is that they are diluted and, therefore, less
6. The Big Picture
may be challenging, frustrating, and embarrassing but it is impressively
treatable. The pills that are available do wonders for many men and
there are enough other options out there that almost all cases of ED can
be successfully addressed. While, there are many avenues that men use
to try and fix ED themselves but the best way is through consulting with
a medical professional.