Scroll past those dodgy ads and you’ll get to the legit stuff: a class of medications called phosphodiesterase 5 (PDE5) inhibitors. These are FDA approved male enhancement pills that help men suffering from ED. PDE5 inhibitors improve blood flow, including to the penis. Since erectile dysfunction (1) is largely a blood flow problem PDE5 inhibitors can help most men who experience ED.
| Drug | Mechanism of Action | Receptor Target | Effect Duration | Additional Effects |
|---|---|---|---|---|
| Sildenafil | PDE5 inhibitor, increases blood flow to the penis | PDE5 | 4-6 hours | Vasodilation, slight hypotension |
| Tadalafil | PDE5 inhibitor, longer half-life | PDE5 | Up to 36 hours | Smooth muscle relaxation |
| Vardenafil | PDE5 inhibitor, similar to sildenafil | PDE5 | 4-5 hours | Minimal effects on blood pressure |
| Avanafil | PDE5 inhibitor, fast-acting | PDE5 | 6 hours | Fewer visual side effects |
There are four different PDE5 inhibitors: tadalafil (sold under the brand name Cialis), sildenafil (Viagra), vardenafil (Levitra), and avanafil (Stendra).Let’s look at these meds more closely, explain the differences, and figure out if they can help with any erection woes you’re experiencing. PDE5 inhibitors were initially developed to treat chest pain, high blood pressure and heart problems by—you guessed it—improving blood flow.
In clinical trails researchers noticed another benefit: Patients who were taking the medication reported better erections. ED affects at least 12 million men in the U.S. and the older you are, the more likely you are to experience it. About 40 percent of men in their 40s and nearly 70 percent of men in their 70s suffer from ED.
Younger men aren’t immune, though: about a quarter of men under 40 have erectile dysfunction.
We encourage you to discuss any questions or concerns you may have with your provider. PDE5 inhibitors are medications that are used to treat erectile dysfunction. The drugs attach to vigora spray an enzyme in the bloodstream and block it from breaking down a chemical compound that enables the blood vessels in the penis to dilate. PDE5 inhibitors are also used to treat conditions including pulmonary hypertension and premature ejaculation. Google searches for erectile dysfunction meds turn up plenty of sketchy over the counter ed pills and sham sexual enhancement boosters. PDE5 inhibitors are the front line treatment for erectile dysfunction.
| Product | Dosage | Quantity + Bonus | Price | |
|---|---|---|---|---|
| Cialis Original | 20mg | 64 + 4 Pills | 274.18€ 261.12€ | |
| Cialis Black | 80mg | 360 + 20 Pills | 639.78€ 609.31€ | |
| Viagra Professional | 100mg | 10 Pills | 44.09€ 41.99€ | |
| Kamagra Gold | 100 mg | 60 + 4 Pills | 201.34€ 191.75€ | |
| Cialis Generic | 20mg | 180 + 10 Pills | 254.09€ 241.99€ | |
| Viagra Generic | 150mg | 60 + 4 Pills | 111.25€ 105.95€ | |
| Super Kamagra | 160 mg | 92 + 6 Pills | 478.75€ 455.95€ | |
| Viagra Soft Tabs | 100mg | 20 Pills | 62.99€ 59.99€ | |
| Cialis Generic | 2.5mg | 180 + 10 Pills | 154.86€ 147.49€ | |
| Kamagra | 100mg | 360 + 6 Pills | 839.95€ 799.95€ |
Unlike over the super p force 160mg counter (OTC) meds that claim to boost erections, you can only get them through a pharmacy using a prescription from your doctor.
Prostate Cancer Foundation: funds high-impact research aimed at finding better treatments and a cure. Zero Cancer: a large nonprofit prostate cancer education and support network. Men's Health Network: an educational nonprofit comprised of doctors, researchers, public health workers and other health professionals who focus on health awareness and disease prevention. American Association for Marriage and Family Therapy: 112 South Alfred St., Alexandria, VA 22314-3061; phone: (703) 838-9808, fax: (703) 838-9805 American Association of Sexuality Educators, Counselors and Therapists: P.O. Box 5488, Richmond, VA 23220-0488; phone: (804) 752-0026 American Cancer Society: phone: (800) 227-2345 CancerCare: phone: (800) 813-HOPE, (213) 712-8400 #1 in NIH funding for urology research Erectile Dysfunction CausesSome conditions are risk factors for erectile dysfunction (ED), including diabetes and heart disease.
See a list of conditions and medicines that can cause ED. Oral Medications for Erectile DysfunctionFind a list of oral medications for Erectile Dysfunction (ED) including, viagra, levitra, and cialis and possible side effects and important things to remember. Penile Injections: A Patient GuideLearn how to administer a penile injection and get answers to common questions, including how the injected medication produces an erection. Treatments Testosterone Replacement Therapy Cognitive Behavioral Therapy Psychotherapy Lifestyle Modification Vascular Ultrasound UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. To better understand how these FDA approved male enhancement pills work and how they can help treat ED, let’s quickly review how your body gets and keeps an erection.
However, that response tends to restrict blood flow into the penis and can make erections difficult or impossible. Careful attention to both mental and physical health is important in preserving erectile function. A normal erection requires the penis to have intact nerves and blood vessel systems. Nerves that travel to the penis include fibers from the autonomic nervous system – the part of the nervous system that functions independently of conscious thought – as well as the somatic nervous system – the part responsible for sensation and contraction of muscles attached to the penis. The autonomic nervous system controls the smooth muscle in the penis, prostate and urinary sphincter – muscle that is important for initiating erections and facilitating ejaculation.
The autonomic nervous system has two parts. The sympathetic division tends to restrict penile blood flow and is important for closing the bladder neck to prevent urine leakage during sex. The parasympathetic division increases penile blood flow and stimulates erection. Coordination of these two components of the autonomic nervous system is critical to sexual response. Sensory nerves travel to the head and shaft of the penis; these nerves are responsible for conveying sensations (such as touch, temperature and pain) to the brain and may be important for stimulating sexual response. When you’re sexually stimulated, nerve impulses in your body release neurotransmitters, or chemical messengers, into two spongy cylinders of tissue in your penis called the corpora cavernosa.
Going the Distance: Finding and Keeping Lifelong Love, by Lonnie Barbach and David L. Geisinger, Plume, 1993. Hold Me Tight: Seven Conversations for a Lifetime of Love, by Sue Johnson, Little Brown, Spark, 2008. Stellar book on communication and intimacy for couples. Intimacy With Impotence: The Couple's Guide to Better Sex After Prostate Disease, by Ralph Alterowitz and Barbara Alterowitz, De Capo Lifelong Books, 2004.
Written in an honest, compassionate style by a patient with prostate cancer and his wife. Discusses ED in nonmedical terms, with information on treatments. Gives practical advice about sex, covering everything from getting into the mood to common-sense suggestions for achieving sexual satisfaction and intimacy when erections are not possible. The Lovin' Ain't Over: The Couple's Guide to Better Sex after Prostate Disease, by Ralph and Barbara Alterowitz, Health Education Literary Publisher, 1999. Men, Women and Prostate Cancer: A Medical and Psychological Guide for Women and the Men They Love, by Barbara Rubin Wainrib, Jack Maguire and Sandra Haber, New Harbinger Publications, 2000. These chemical messengers tell the blood vessels in your penis to dilate, so that more blood can enter.
As blood flows into the corpora cavernosa, they expand—and so does your penis. Fibrous tissue called the tunica albuginea traps the blood in the corpora cavernosa, keeping your erection long enough for sex. The important link to all of this is cyclic guanosine monophosphate (cGMP). Cyclic GMP relaxes the muscles inside the blood vessels of your penis to increase blood flow. PDE5 is an enzyme that binds to and breaks down cGMP, decreasing its effect.
| Drug Name | Active Ingredient | Typical Dose | Onset Time | Duration of Action | Common Uses | Side Effects |
|---|---|---|---|---|---|---|
| Viagra | Sildenafil | 50 mg | 30-60 min | 4-6 hours | Erectile dysfunction | Headache, flushing |
| Cialis | Tadalafil | 20 mg | 30 min | Up to 36 hours | ED, BPH | Muscle pain, nausea |
| Levitra | Vardenafil | 10 mg | 25-60 min | 4-5 hours | ED | Nasal congestion |
| Stendra (Avanafil) | Avanafil | 100 mg | 15 min | Up to 6 hours | Rapid onset ED | Dizziness |
PDE5 inhibitors attach to PDE5 in the bloodstream and prevent it from blunting the effects of cGMP. As cGMP levels increase, more blood can reach your penis, and you have firmer erections that last longer. They can’t boost your libido or cause you to get random erections.
You need to be sexually stimulated for the drugs to work. A host of medical conditions can cause erectile dysfunction. Big culprits include diabetes, high blood pressure, high cholesterol, heart disease, and vascular disease—all of which can decrease blood flow to the extremities, including your penis But other factors are also to blame. Certain medications (prescription and non-Rx), smoking, drinking to excess, and not getting enough sleep or exercise are all linked to ED. Depression, stress, performance anxiety, and relationship issues can also play a role. When you talk to your doctor about ED, they should do a full workup to find out what’s preventing you from getting and keeping an erection. One of the things they should test for is low testosterone since ED is a common symptom in men with low T.
Motor nerves control contraction of the ischiocavernosus and bulbocavernosus muscles, which are necessary to producing a fully rigid erection and to ejecting semen during ejaculation. With sexual stimulation, parasympathetic cavernous nerves release chemicals (primarily nitric oxide) that significantly increase blood flow to the penis. The erectile tissue of the penis rapidly fills with blood and expands, becoming firm and erect. With increasing sexual arousal, the somatic nervous system causes the bulbocavernosus and ischiocavernosus muscles of the penis to contract, forcing additional blood into the penis and making it very rigid. At peak sexual arousal, the sympathetic nervous system causes contraction of the prostate and seminal vesicles, leading to emission, which is the deposition of seminal fluid into the urethra.
The sympathetic nervous system also pills for womens libido makes the bladder sphincter close, preventing the semen from leaking into the bladder. As the amount of fluid builds in the urethra, pressure increases and the sensation of the inevitability of ejaculation is experienced. The bulbocavernosus muscle, which is under control of the somatic nervous system, then contracts and expels the semen forcibly from the urethra. Detumescence, or loss of erection, occurs shortly thereafter, as the nerves that trigger penile erection stop sending those signals. Saving Your Sex Life: A Guide for Men with Prostate Cancer, by John Mulhall, Hilton Publishing, 2010. Testosterone replacement therapy (TRT) can help boost your sex drive, and studies show it can improve erectile function in males with mild ED.
| Drug | Contraindications | Precautions | Interactions | Special Notes |
|---|---|---|---|---|
| Sildenafil | Nitrate use, certain cardiac conditions | Hypotension risk | Nitrates, alpha-blockers | Use with caution in heart disease |
| Tadalafil | Nitrate use, eye disorders | Long duration may cause priapism | Same as sildenafil, antihypertensives | Dose adjustment needed |
| Vardenafil | Nitrate use | Allergies to PDE5 inhibitors | Similar to sildenafil | Avoid high-fat meals |
| Avanafil | Nitrate use | Liver impairment | CYP3A4 inhibitors | Fast onset, fewer side effects |
If you’re concerned that you could have low testosterone, Hone’s test can tell you if your levels are in the normal range. If the test shows that your T level is low and ED is one of your symptoms, a Hone physician can help you determine the best treatment, which may include testosterone replacement therapy (TRT) and PDE5 inhibitors.