Erectile dysfunction is a treatable issue, and a variety of medications can help.

Phosphodiesterase type 5 (PDE5) inhibitors can be effective ED treatments, and drugs in other classes can work, as well. This article will focus on PDE5 inhibitors.

These drugs impede the functioning of PDE5, an enzyme in blood vessel walls that helps control blood flow.

Following arousal, the body releases enzymes that cause smooth muscle in blood vessels to relax, allowing for more blood to flow through. PDE5 inhibitors block the degradation of these enzymes, increasing blood flow and resulting in an erection.

It is important to note that a person needs to be aroused for a PDE5 inhibitor to help with ED.

PDE5 inhibitor drugs for treating ED include:

a pile of pills for ed where it is unknown what is the most effectiveShare on Pinterest
A range of medications can help treat erectile dysfunction.

Sildenafil (Viagra) can be an effective way of treating ED, and it can also treat conditions such as high blood pressure. The pills come in doses of 25 milligrams (mg), 50 mg, or 100 mg.

Some advantages of taking Viagra for ED include:

  • Viagra is fast-acting, it starts working around 30 minutes after taking the pill.
  • The effects have been well-established in many clinical trials.
  • The effects can last for up to 4 hours.
  • Serious side effects are rare — though they can include allergic reactions and heart problems.

Some disadvantages include:

  • It may only be a short-term option, as 20–50% of people who take Viagra do so temporarily.
  • It may not be suitable for people with some chronic conditions, such as multiple sclerosis, a 2012 review reports.
  • Viagra can interact with other drugs, including some heart disease and blood pressure medications.
  • People seem to prefer an alternative, Cialis, though the two drugs are equally effective, according to 2017 research.

Also, some possible side effects include:

  • a stuffy or runny nose
  • hot flashes
  • headaches
  • a fever
  • nausea
  • chest pains
  • painful erections lasting several hours
  • dizziness
  • vision problems

Tadalafil (Cialis) also works by increasing blood flow to the penis.

Doctors also use Cialis to treat high blood pressure in the lungs and enlargement of the prostate. For ED, people take it as an oral tablet.

Some advantages of Cialis include:

  • Cialis is the longest-lasting PDE5 drug for ED, typically lasting up to 36 hours, though some reports suggest that it can last up to 72 hours.
  • It is possible to take a low dose of Cialis — 2.5 mg to 5 mg — once a day, so it can be a longer-term solution.
  • People who regularly engage in sexual activities may prefer taking a daily pill.
  • Research suggests that people who take Cialis experience more sexual confidence than those who take Viagra.

Disadvantages include:

  • Taking Cialis daily can be expensive.
  • Taking it in the long term may prevent or delay treatment for the underlying cause of ED, which can be psychological.
  • Cialis can interact with several types of medication, including common blood pressure drugs.

Also, some possible side effects include:

  • a stuffy or runny nose
  • a cough
  • hot flashes
  • indigestion
  • headaches
  • pain in the arms and legs
  • muscle pain
  • back pain

Avanafil (Stendra) is another PDE5 drug. Unlike Cialis and Viagra, Stendra is not available in generic form. It works like other drugs in its class by increasing blood flow to the penis.

Some advantages of Stendra include:

  • Stendra can start working 15 minutes after taking the drug.
  • Research has found that Stendra is a safe and effective ED treatment.
  • The effects can last for up to 6 hours.
  • A 2014 review found that older and younger adults both preferred taking Stendra to other PDE5 drugs, due to its quick effects.

Disadvantages include:

  • Because Stendra is not available in generic form, it can be more expensive than other PDE5 drugs.

Also, some possible side effects include:

  • a stuffy or runny nose
  • hot flashes
  • headaches
  • muscle aches
  • back pain
  • nausea
  • vision problems

Vardenafil (Levitra), like other PDE5 medications for ED, works by increasing blood flow to the penis.

Some advantages of Levitra include:

  • Clinical trials have found it to be effective.
  • Unlike Stendra, Levitra is available in a cheaper generic form.

Disadvantages include:

  • The drug can take comparatively longer to start working — a person takes it 1 hour before sexual activity.
  • Compared with Viagra and Cialis, Levitra does not have any unique advantages.

Also, some possible side effects include:

  • a stuffy or runny nose
  • facial flushing
  • headaches
  • stomach problems
  • back pain
  • vision problems

While ED medications are effective, there are other ways of addressing ED, including:

  • Following a healthy lifestyle: This involves staying active, having a healthful diet, and avoiding smoking.
  • Psychotherapy: Dealing with any underlying emotional or psychological issues may help treat ED.
  • Vacuum devices: These devices use suction to bring blood into the penis and cause an erection.
  • ED rings: These may also be effective for some people.
  • Surgery: When all other treatments are ineffective, a doctor may recommend a surgical implant to support erections.

Read about some of the best available ED rings here.

Several medications can treat ED, and many — including those above — work by blocking the PDE5 enzyme, increasing blood flow to the penis.

The best choice of ED medication will depend on various factors. For example, people who have regular sex may prefer taking Cialis, which is available as a daily pill.

It is important to speak with a doctor before taking ED medication.