The number of erectile dysfunction (ED) treatments and medications approved for use in the UK has increased significantly in the years since Sildenafil (the active ingredient in Viagra) was first tested in Pfizer’s UK laboratories back in 1989.
Today, the prevalence of a wide range of ED medications is why questions regarding which erectile dysfunction treatment is best to relieve the associated symptoms are common.
Therefore, our resident expert Pharmacist Naeem Seth has prepared this comprehensive guide to erectile dysfunction treatments based on the latest available medical research to assist with deciding on which ED treatment may be best for you.
How do ED treatments work?
ED treatments that are classified as PDE-5 inhibitors work by preventing an enzyme called phosphodiesterase type 5 (PDE-5) from stimulating the smooth muscle to constrict blood vessels in the penis. This extends the duration of blood flow to the genital area following arousal, resulting in an erection that can be sustained for longer.
Topical treatments that can be applied to the penis also work by dilating of blood vessels in the erectile tissues of the penis causing penile rigidity.
It is important to note that ED treatments only work properly if the individual taking them is sexually stimulated or aroused.
Comparing Different Erectile Dysfunction Treatments
Oral ED medication Sildenafil (Generic Viagra)
Sildenafil is the active ingredient in Viagra and Viagra Connect. It works by inhibiting the PDE-5 enzyme which is responsible for breaking down cyclic guanosine monophosphate (cGMP), a substance that plays a crucial role in achieving an erection.[4] The scientific mechanism behind how Sildenafil works can be explained in four steps:
Arousal – When a man becomes sexually aroused, nitric oxide (NO) is released in the spongy tissue within the penis.
Guanylate activation – The release of NO activates the guanylate cyclase enzyme, resulting in increased levels of cGMP.
Increased blood flow – cGMP relaxes smooth muscle cells, increasing blood flow to the penis and leading to an erection. PDE-5 inhibition – Normally, PDE-5 is released in the body once arousal subsides to break down cGMP and relax the muscles, ending the erection. Sildenafil inhibits PDE-5, preventing the mechanism mentioned earlier and prolonging the erection.
Tadalafil (Generic Cialis)
Tadalafil is the active ingredient in Cialis and Cialis Together. The scientific mechanism behind how Tadalafil works is identical to that of Sildenafil, however, the duration of action differs with each of these ED medicines. The main difference between Tadalafil and Sildenafil is how long it takes for effects to be produced in the body. Tadalafil can remain effective for up to 36 hours because it has a half-life of 17.5 hours.[5] In other words, it takes 17.5 hours for the levels of Tadalafil in the body to halve in volume. In comparison, Sildenafil has a half-life of 4 hours.
Viagra
Viagra is the branded version of Sildenafil. It works in the same way as Sildenafil but is generally priced higher as it is a branded ED pill.
Viagra Connect
Viagra Connect contains 50 mg of Sildenafil per tablet. The scientific mechanism behind how Viagra Connect works is identical to Cialis and Tadalafil, however, Viagra Connect does not require a prescription. The decision to allow the sale of Viagra Connect without a prescription in the UK was based on several factors, including the safety profile of the drug at that dosage, the risk of potential side effects, and the need to complete a medical assessment to determine whether the medication is suitable.
Cialis
Cialis is the branded version of Tadalafil. It works in the same way as Tadalafil but is generally priced higher as it is a branded ED medication.
Cialis Together
Cialis Together contains 10 mg of Tadalafil, which is why the scientific mechanism regarding how it works is identical to that of Tadalafil. The main difference between these ED treatments is that Cialis Together can be obtained without a prescription, while Tadalafil is a prescription ED medication.
Vardenafil (Generic Levitra)
Vardenafil is a PDE-5 inhibitor and works in the same way as other PDE-5 inhibitors such as Sildenafil and Tadalafil. Vardenafil is the generic version of Levitra and is recommended for diabetics because it has a slightly different molecular structure compared to Sildenafil (Viagra) and Tadalafil (Cialis), which can mean that for some men with diabetes, it may work better or have fewer side effects. Like other PDE-5 inhibitors, Vardenafil does not cause sexual arousal. It simply facilitates the physiological processes that allow an erection to occur and be maintained following sexual stimulation.
Spedra (Avanafil)
Spedra is another type of PDE-5 inhibitor similar to Sildenafil, Tadalafil, and Vardenafil. According to research,[6] Spedra produces a quicker onset of action (approximately 15 to 30 minutes) because it is formulated to be absorbed by the body quicker than other PDE-5 inhibitors. In comparison to Spedra, Sildenafil, Vardenafil, and Tadalafil all take at least 30 minutes to produce effects.
Topical Treatments
Vitaros Cream
Vitaros cream (Alprostadil) shares a chemical identity with prostaglandin E1, a substance known for its role in widening blood vessels within the erectile tissues of the corpora cavernosa. This process leads to an increased blood flow in the cavernosal artery, resulting in penile rigidity.
VaxAid Deluxe
VaxAid Deluxe is a non-invasive, vacuum pump treatment for erectile dysfunction. It creates a seal on the pelvic seat to improve blood flow along the full length of the penis and prevents excessive negative pressure due to the elastic recoil strength of its pump. The pump also features a cycling action that allows the user to achieve an erection gradually.
Branded vs Generic
When it comes to erectile dysfunction (ED) medications, both branded and generic options share the same active ingredient. For instance, Viagra, a well-known branded ED medication, and its generic counterpart, Sildenafil, both contain sildenafil as their active component. This similarity means that generic ED treatments are medically equivalent to their branded versions, offering the same effectiveness. Generally, individuals find generic versions are much cheaper than their branded counterpart.
Other Considerations for Erectile Dysfunction Treatments
In considering erectile dysfunction (ED) treatments, it’s essential to thoughtfully evaluate several key aspects. It is worth noting that the advice of a healthcare professional is key in determining some factors:
Dosage Strength: The dosage strength is a critical element in ED treatment selection. An excessively high dosage might lead to an increase in side effects, whereas a dosage that’s too low may not be effective. We advise starting with a medium-strength treatment and potentially progressing to a stronger variant, always in consultation with a healthcare professional such as a pharmacist or GP.
Onset Duration: Understanding how quickly ED treatments begin to work and the duration of their effectiveness is important for effective planning of sexual activity. This onset duration can vary significantly based on individual factors, so a discussion with a healthcare provider for personalised advice is recommended.
Side Effects: While most ED treatments function as PDE-5 inhibitors and thus share similar potential side effects, individual reactions may differ. Prior to starting any treatment, it’s advisable to consult with a healthcare professional and thoroughly review the Patient Information Leaflet provided with the medication.
Duration of Effectiveness: The length of time ED treatments remain active in the body can vary, influenced by the specific medication used and individual physiological factors. This information is vital for understanding how the treatment aligns with your needs and lifestyle.
Each of these considerations plays a significant role in determining the most suitable ED treatment for an individual, underlining the importance of informed decision-making guided by professional medical advice.
Pharmacare offers a wide range of treatment for erectile dysfunction and our consultation form will provide solutions. If you have any questions beforehand then please contact our medical team.
