What to do if your erectile dysfunction medication isn’t working
Viagra and other ED medicines are not always guaranteed to work
Cialis not working anymore? Possible next moves
If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.
You’ve done the hard part—you’ve opened up to your healthcare provider about your erectile dysfunction (ED), and they’ve prescribed you Cialis (tadalafil; see Important Safety Information) to treat it. But now, Cialis isn’t working the way it did initially, or maybe it never worked well for you in the first place. What can you do?
The good news is there are many treatment options for ED, even if Cialis doesn’t do the trick for you. Read on to learn about your options.
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What to do if Cialis isn’t working anymore
Sometimes, people find that tadalafil is not working as well as in the past for treating their erectile dysfunction (difficulty getting or maintaining an erection). Here are some steps you can take to troubleshoot (Huang, 2013):
- Be sure to wait at least 30 minutes after taking the medication before trying to have an erection.
- While studies have not shown that food affects tadalafil, other PDE5 inhibitors may not work as well if taken after a large meal, especially a high-fat meal. So you may want to try taking your Cialis without a high-fat meal.
- If you’re taking any new medications, these might affect how well Cialis works for you. Talk to your healthcare provider about any changes.
Your healthcare provider might also recommend upping your dose. The usual dose of tadalafil can range from 2.5 mg to 20 mg and can vary by person depending on individual dosing patterns (daily vs. as needed) and how well you respond to it (Dhaliwal, 2021). Don’t change your dose without consulting with your healthcare provider, but a dose adjustment may be all you need for Cialis to become effective again.
What is Cialis? How long does it last?
Other ED treatments
If tadalafil and other drugs like it are not working for you, your healthcare provider may suggest other treatment options, including (Sooriyamoorthy, 2021):
Emotional issues can also affect ED. Things like relationship conflicts, stress, depression, or anxiety can contribute to ED, and there’s often a vicious cycle with ED creating performance anxiety. Help from a mental health professional can be an essential part of overcoming ED.
ED can also signify an underlying medical condition, such as heart disease, high blood pressure, and diabetes, so it’s important to speak with your healthcare provider early.
How does Cialis work?
Cialis is a type of drug called a PDE-5 inhibitor, which works by relaxing the blood vessels, leading to more blood flowing into the penis. During arousal, the increased blood flow allows you to get and maintain an erection during arousal. It’s important to note that tadalafil will not give you an erection without sexual stimulation (Huang, 2013).
You can take tadalafil either as needed (at least 30 minutes before sexual activity) or once a day regardless of sexual activity (and at a lower dose). Tadalafil works up to 36 hours after taking it.
Is erectile dysfunction reversible? In most cases, it’s treatable
Cialis side effects
Tadalafil and other ED medications can interact with other drugs and cause side effects. Be sure to tell your healthcare provider about any medical issues you may have or any other medicines you may be taking.
Common side effects of tadalafil include (Dhaliwal, 2021):
Avoid taking tadalafil if you take nitrates, are on dialysis for kidney disease, or have severe liver disease.
Several treatment options exist for improving erectile dysfunction. Talk to your healthcare provider about your options. Don’t give up or feel frustrated if one treatment doesn’t work—there are other choices, and your provider can help you find the one that is right for you.
References
- Capogrosso, P., Colicchia, M., Ventimiglia, E., et al. (2013). One patient out of four with newly diagnosed erectile dysfunction is a young man—worrisome picture from the everyday clinical practice. The Journal of Sexual Medicine, 10(7), 1833-1841. doi:10.1111/jsm.12179. Retrieved from https://pubmed.ncbi.nlm.nih.gov/23651423/
- Dhaliwal, A. & Gupta, M. (2021). PDE5 inhibitors. [Updated Jun 25, 2021]. In: StatPearls [Internet]. Retrieved on Mar. 15, 2022 from https://www.ncbi.nlm.nih.gov/books/NBK549843/
- Huang, S. & Lie, J. (2013). Phosphodiesterase-5 (PDE5) inhibitors in the management of erectile dysfunction. Pharmacy and Therapeutics, 38(7), 407, 414-41. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3776492/
- Kessler, A., Sollie, S., Challacombe, B., et al. (2019). The global prevalence of erectile dysfunction: a review. BJU International, 124(4), 587–599. doi:10.1111/bju.14813. Retrieved from https://pubmed.ncbi.nlm.nih.gov/31267639/
- Sooriyamoorthy, T. & Leslie S. W. (2021). Erectile dysfunction. [Updated Feb 14, 2022]. In: StatPearls [Internet]. Retrieved on Mar. 15, 2022 from https://www.ncbi.nlm.nih.gov/books/NBK562253/.
Erectile dysfunction exercises: do they work?
Do penis enlargement pills really work?
Drugs that cause erectile dysfunction: what to do when your medication has sexual side effects
Can you take Cialis in the morning, Viagra at night?
Important Safety Information for Tadalafil (Cialis)
What Is The Most Important Information I Should Know About CIALIS® (tadalafil) and generic CIALIS®?
- CIALIS® and generic CIALIS® can cause serious side effects. Serious, but rare, side effects include:
- An erection that won’t go away (priapism). If you get an erection that lasts more than 4 hours, get medical help right away. Priapism must be treated as soon as possible or lasting damage can happen to your penis, including the inability to have erections.
- Changes in vision. Color vision changes, such as seeing a blue tinge (shade) to objects or having difficulty telling the difference between the colors blue and green.
- Sudden decrease or loss of vision. In rare instances, men taking PDE5 inhibitors (oral erectile dysfunction medicines, including CIALIS® and generic CIALIS®) reported a sudden decrease or loss of vision in one or both eyes. It is uncertain whether PDE5 inhibitors directly cause the vision loss. If you experience sudden decrease or loss of vision, stop taking PDE5 inhibitors, including CIALIS® and generic CIALIS®, and call a healthcare provider right away.
- Sudden loss or decrease in hearing. Sudden loss or decrease in hearing, sometimes with ringing in the ears and dizziness, has been rarely reported in people taking PDE5 inhibitors, including CIALIS® and generic CIALIS®. It is not possible to determine whether these events are related directly to the PDE5 inhibitors, to other diseases or medications, to other factors, or to a combination of factors. If you experience these symptoms, stop taking CIALIS® and generic CIALIS® and contact a healthcare provider right away.
- ED is a condition where the penis does not fill with enough blood to harden and expand when a man is sexually excited, or when he cannot keep an erection. A man who has trouble getting or keeping an erection should see his healthcare provider for help if the condition bothers him.
- CIALIS® and generic CIALIS® help increase blood flow to the penis and may help men with ED get and keep an erection satisfactory for sexual activity. Once a man has completed sexual activity, blood flow to his penis decreases, and his erection goes away. Some form of sexual stimulation is needed for an erection to happen with CIALIS® or generic CIALIS®.
- CIALIS® and generic CIALIS® do not:
- Cure ED
- Increase a man’s sexual desire
- Protect a man or his partner from sexually transmitted diseases, including HIV. Speak to your healthcare provider about ways to guard against sexually transmitted diseases.
- Serve as a male form of birth control
- Take CIALIS® or generic CIALIS® exactly as your healthcare provider prescribes it. Your healthcare provider will prescribe the dose that is right for you. Do not change your dose or the way you take CIALIS® or generic CIALIS® without talking to your healthcare provider.
Who Should Not Take CIALIS® or generic CIALIS®?
Do not take CIALIS® or generic CIALIS® if you:
- Have severe liver disease. Tell your doctor if you have mild to moderate liver disease as you may need dosage reductions.
- Have severe kidney disease. Tell your doctor if you have mild to moderate kidney disease as you may need dosage reductions
- Take any medicines called “nitrates”
- Use recreational drugs called “poppers” like amyl nitrite and butyl nitrite
- Take any medicines called guanylate cyclase stimulators, such as riociguat
- Are allergic to CIALIS®, tadalafil or ADCIRCA®, or any of its ingredients
When should I call my primary provider?
Call your primary provider right away if you:
- Have an erection that lasts longer than 4 hours
- Experience a sudden loss of vision in one or both of your eyes
- Experience a sudden decrease or loss hearing
- Take too much CIALIS® or generic CIALIS®
- Have an allergic reaction to CIALIS® or generic CIALIS®
- Symptoms of an allergic reaction may include:
- Rash
- Hives
- Swelling of the lips, tongue, or throat
- Difficulty breathing or swallowing
Call your healthcare provider or get help right away if you have any of the symptoms of an allergic reaction listed above.
If you are experiencing a medical emergency, call 911 or seek immediate medical attention.
What Should I Tell My Roman-affiliated Provider Before Taking CIALIS® and generic CIALIS®?
Tell your Roman-affiliated provider about all your medical problems, including if you:
- Have heart problems such as angina, heart failure, irregular heartbeats, or have had a heart attack. Ask your healthcare provider if it is safe for you to have sexual activity. You should not take CIALIS® and generic CIALIS® if your healthcare provider has told you not to have sexual activity because of your health problems.
- Have pulmonary hypertension
- Have low blood pressure or have high blood pressure that is not controlled
- Have had a stroke
- Have liver problems
- Have kidney problems or require dialysis
- Have retinitis pigmentosa, a rare genetic (runs in families) eye disease
- Have ever had severe vision loss, including a condition called NAION
- Have stomach or intestinal ulcers
- Have a bleeding problem
- Have a deformed penis shape or Peyronie’s disease
- Have had an erection that lasted more than 4 hours
- Have blood cell problems such as sickle cell anemia, multiple myeloma, or leukemia
Tell your healthcare provider about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.
Especially tell your healthcare provider if you take any of the following:
- Medicines called nitrates
- Medicines called guanylate cyclase stimulators, such as riociguat (Adempas®), used to treat pulmonary hypertension
- Medicines called alpha blockers. These include Hytrin® (terazosin HCl), Flomax® (tamsulosin HCl), Cardura® (doxazosin mesylate), Minipress® (prazosin HCl), Uroxatral® (alfuzosin HCl), 4 Jalyn® (dutasteride and tamsulosin HCl) or Rapaflo® (silodosin). Alpha-blockers are sometimes prescribed for prostate problems or high blood pressure. If CIALIS® or generic CIALIS® is taken with certain alpha blockers, your blood pressure could suddenly drop. You could get dizzy or faint.
- Other medicines to treat high blood pressure (hypertension)
- Medicines called HIV protease inhibitors, such as ritonavir (Norvir® , Kaletra® )
- Oral antifungals such as ketoconazole (Nizoral® ), itraconazole (Sporanox® )
- Antibiotics such as clarithromycin (Biaxin® ), telithromycin (Ketek® ), erythromycin (several brand names exist. Please consult your healthcare provider to determine if you are taking this medicine).
- Other medicines or treatments for ED.
- Tadalafil is also marketed as ADCIRCA® for the treatment of pulmonary arterial hypertension. Do not take both CIALIS® or generic CIALIS® and ADCIRCA®. Do not take sildenafil citrate (Revatio®, Viagra®) with CIALIS® or generic CIALIS®.
Withholding or providing inaccurate information about your health and medical history in order to obtain treatment may result in harm, including, in some cases, death.
What are the most common side effects of CIALIS® or generic CIALIS®?
The most common side effects with CIALIS® and generic CIALIS® are:
What is the FDA-approved Use of CIALIS® and generic CIALIS®?
CIALIS® and generic CIALIS® are prescription medicines used to treat erectile dysfunction (ED), symptoms of benign prostatic hyperplasia (BPH), or both.
Roman-affiliated doctors may prescribe CIALIS® for the treatment of premature ejaculation (PE), if they believe in their medical judgment that it is an appropriate course of treatment.
You are encouraged to report negative side effects of prescription products to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Please see the full Prescribing Information for complete safety information.
What to do if your erectile dysfunction medication isn’t working
Posted on 1 September 2015 15 February 2022 by Dr Tony Steele – Dr Fox pharmacy is CQC & GPhC regulated.
Viagra and other ED medicines are not always guaranteed to work
As with any medication, Viagra and other erectile dysfunction medications aren’t guaranteed to work for everyone.
Your doctor should explain carefully how to use them, and what to expect, but even under the best of circumstances you may find that you need a number of attempts, or possibly an adjusted dose or different type of medication in order to see results.
If you aren’t able to achieve an erection soon after you start treatment, don’t despair. Check to ensure you are taking the medication exactly as directed according to the patient information leaflet supplied with the tablets, and be sure to let your doctor know what happens (or doesn’t happen) when you do. Always consult a doctor if treatment doesn’t work. Studies show an improved response rate after receiving appropriate dose and instructions on administration. You may require further tests and assessment, and possibly alternative treatments.
What is the ‘success rate’ of sildenafil (Viagra)?
From clinical trials the following percentages of men responded to the three different doses of sildenafil as follows:
Proportions of patients reporting improved erections in clinical trials of sildenafil
Sildenafil 25mg dose 62% reported improved erections Sildenafil 50mg dose 74% reported improved erections Sildenafil 100mg dose 82% reported improved erections The results show sildenafil (Viagra, Viagra Connect) is not effective for all men, but the reasons can be complex and varied. Read on to learn a few different things you can try in order to help your medication have the desired effect. These points will help you develop a realistic expectation for your treatment.
Adopt the right mindset
Before all else, try to keep in mind that no erectile dysfunction medicine is a miracle cure. The PDE5 inhibitors (sildenafil, tadalafil, vardenafil, and avanafil) work by facilitating blood flow to the penis, but they all require sexual arousal. Your body sends the necessary chemical to the blood vessels of the penis and the medication helps you to get an erection.
Without proper arousal the medication will simply not take effect. Try to make sure you are receiving stimulation that works for you; whether it’s visual or from touch, scent or taste, you need to feel naturally turned on.
Patient expectations
Psychological factors can make a big difference with regard to treatment and outcome, and should not be underestimated (the placebo effect is a good example). Brand, size, shape, and colour of a pill can all have a psychological impact on a patient’s confidence in the treatment. There is also documented evidence that a higher dosage can have a positive psychological effect, however side effects are more likely. Studies also suggest men’s mood improves after taking sildenafil.
Don’t eat before taking Viagra, Levitra, or Spedra
Many men make the mistake of taking Viagra, Levitra, or Spedra after a meal. This can impede the absorption of the drugs, making them only marginally effective. You should wait at least 2 hours after eating before taking the tablets so you can experience their full effect. Avoid eating fatty foods or drinking sour fruits, particularly grapefruit, as these may affect efficacy.
Cialis (tadalafil) is the exception, which can be taken with food.
When you have ED, having sex may take more planning than before. For couples concerned about the loss of spontaneity, low dose (2.5mg or 5mg) Cialis/tadalafil taken daily provides continuous treatment and requires less planning.
But if sex is a night-time activity for you, it may not be much of an issue. Simply have your evening meal, take your medication a few hours later, and then just wait the required time before you plan to have sex. This leads us to our next point:
Give yourself an hour
The medication takes a while to enter your system and reach its peak effect, and the time varies from Viagra to Spedra, Levitra, and Cialis. By waiting at least the required amount of time you will be giving yourself the best chance of achieving a full erection.
This also gives you and your partner time to get into the mood. Why not ease into the interlude by touching and kissing, lying down together, or even watching a sexy film. As the medication takes effect you can focus on foreplay leading up to sex, and this can make the experience less rushed and more enjoyable overall.
Keep trying
If your medication doesn’t work the first time, or even the first few times, don’t lose hope. It is recommended that you try the prescribed dosage at least 8 times to gauge its effectiveness. Your doctor can guide you as to how long you should continue with this initial dosage before considering any change to your medication.
Increased dosage or different ED medicine
The normal starting dose of Viagra (sildenafil) is a 50mg tablet, but if this dosage isn’t effective it may be increased to one 100mg tablet. Doses of other ED medications can also be increased. Increasing dosage also increases the potential for side effects.
Conditions like high blood pressure, diabetes, or cholesterol will affect whether you are prescribed the higher dose, but if your ED medication isn’t working, a higher dosage may well be the correct course of action.
However, if your body still doesn’t respond to your treatment, it could be a question of trying a different medicine. Don’t think that just because one medication doesn’t work that another can’t be successful.
Some brands of sildenafil (generic Viagra) come as scored tablets, meaning they can be broken in half or quarters if required to save money (eg: a 100mg tablet broken in half provides 2 x 50mg doses). Drug manufacturers do not recommend splitting tablets but it is often common practice by nurses. If you choose to split tablets break the tablet only at the time required, and store the remaining part of the tablet in a sealed container or cling-film, to limit any dehydration of the tablet. Generally, it is advised to use the correct dosage tablet.
It can be frustrating trying to determine why you aren’t experiencing the desired results but there is usually a reason, so consider the preceding factors and arm yourself with this knowledge as you speak with your GP. There are different things you can do to help bring about the results you’re hoping for, just remember that success with ED isn’t always instantaneous.
Cialis Stopped Working? What To Do Next
Cialis (brand name for tadalafil) is one of the major ED medications. Even though it works for most people, sometimes it may not work or stop working altogether.
How Cialis Works
Phosphodiesterase 5 (PDE5) is an enzyme present on the walls of blood vessels that affects blood flow. Cialis (and the other medications) are referred to as PDE5 inhibitors.
They block the enzyme thus, preventing it from working. As a result, blood flows to the penis, making it erect.
Vardenafil (Levitra), sildenafil (Viagra), and avanafil (Stendra) are other common PDE5 inhibitors for treating erectile dysfunction.
Cialis starts working 30 min to 1 hour after taking and can last for up to 36 hours. Unlike other drugs, you need to be sexually aroused for it to work.
Possible Reasons Why It’s Not Working
You’re Using Cialis Incorrectly
Cialis may not work if you take it a few minutes before sex. It can take up to an hour before it works. So, ensure you take your dose at least an hour before engaging in sex.
Wrong Dosage
You should take the dosage prescribed by your doctor. If it’s not working or is less effective, talk to your healthcare provider to see if a higher dosage will be appropriate.
ED Caused by Psychological Conditions
If your ED is caused by mental health issues such as anxiety and depression, Cialis might not work. It treats physical issues affecting blood flow and not psychological causes.
Physical Conditions are Causing ED
Diabetes, obesity, and high blood pressure can cause ED. Sometimes, ED caused by some physical conditions might not improve with Cialis.
What To Do If Cialis Stopped Working
It can be frustrating if a treatment like Cialis doesn’t work for you. However, you can opt for other options such as:
- Change your lifestyle: Exercise, reduce stress, eat healthy diets, and avoid alcohol.
- Testosterone therapy: For ED caused by low testosterone levels.
- Penile implants: Devices placed surgically in the penis to allow you to get and maintain an erection.
- Penile vascular reconstructive surgery for ED caused by penis trauma in young males.
- Intraurethral therapy: You place medication through the opening on the penis into the urethra.
- Other PDE5 inhibitor medications: Viagra, Levitra, and Stendra.
Take Charge. Rise Again!
All is not lost if Cialis is not working. You can explore other treatment options. Need to talk to a professional physician? Connect with one at Phoenix, an online men’s clinic in Canada.
Talk to a licenced physician, no waiting time, no visiting the pharmacy, and your medication is delivered discreetly and free of charge. Talk to us to take control of your erections and rise again.This blog post is for educational purposes only and does not constitute medical or other professional advice. Your specific circumstances should be discussed with a healthcare provider. All statements of opinion represent the writers’ judgement at the time of publication and are subject to change. Phoenix and its affiliates provide no express or implied endorsements of third parties or their advice, opinions, information, products, or services.
Viagra Not Working? What To Do Next
Reaching and maintaining an erection is a complex chain of events that involves specific chemicals, hormones, and multiple systems in the body—and potentially an erotic internet search or two. This is complicated enough without the symptoms of erectile dysfunction .
If you have erectile dysfunction (ED) and don’t believe your prescribed medications are working as they should, you may want to explore other options with your doctor for enhanced sexual function.
Keep reading to learn more about improving your erectile function.
In this article, we’ll talk about the following:
- How Do ED Medications Work?
- Why Is Your Viagra Not Working?
- How to Troubleshoot ED Drugs Not Working
- ED Medication Alternatives
- Key Takeaway
How Do ED Medications Work?
Before genuinely understanding how ED medications work and seeking treatment, you must know more about erectile dysfunction .
Erectile dysfunction is when you can’t achieve an erection adequate enough for satisfying sex life. If you can get an erection, they may not last as long as you want or become as hard as you’d like them to be.
Regardless of the stigma surrounding erectile dysfunction, it is one of the most common sexual issues. ED affects the sexual health of many men around the world—the worldwide prevalence is expected to increase to 322 million individuals by 2025 .
An erection begins with stimulation, which can be psychological (thinking of something that sexually excites you) or sensory (like sight, touch, or smell).
Erectile dysfunction medications like Viagra (sildenafil), Cialis (tadalafil), and Levitra (vardenafil) are in a medication class called phosphodiesterase type 5 (PDE5) inhibitors. When you are sexually aroused, nerve messages trigger the production of cyclic guanosine monophosphate (cGMP). Along with nitric oxide , this chemical relaxes smooth muscles in your penis’s arteries.
When you are more relaxed, you can get an erection because your blood flows freely. ED medications work by blocking the PDE5 enzyme. After you ejaculate, PDE5 breaks down cGMP, which signals your penis to release blood and turns off your erection.
While PDE5 inhibitors are highly effective at treating erectile dysfunction, you still need sexual stimulation for them to perform.
Possible Side Effects
While most men aren’t bothered by side effects when taking ED medication, some experience the following:
- Headache
- Skin flushing
- Indigestion
- Runny or stuffy nose
- Changes in vision (such as blurred vision or sensitivity to light)
- Back pain
In extreme cases, an erection produced with the help of ED meds may not go away on its own. This condition, called priapism , is rare, but it’s painful and requires medical treatment.
If you experience an erection lasting longer than four hours, promptly seek medical attention.
Why Is Your Viagra Not Working?
If you struggle with erectile dysfunction , you may have been prescribed an ED medication such as sildenafil (Viagra), vardenafil (Levitra), or tadalafil (Cialis). While these medications are effective for most individuals with ED, they don’t always work as expected.
Here are some factors to consider if you’re in this frustrating situation.
Talk to your doctor if your ED medication is not working. Do not double up the dosage or take another ED medication on top of that.
You’re Not Patient
Erectile dysfunction medications are more effective once you’ve used them more than once. Anxiety surrounding taking the drug can play a role, but so can familiarity with the effects.
Your healthcare provider may suggest masturbating after taking the medication first, so you know what to expect. If you take the meds for the first time before engaging in sexual activity with a partner, anxiety may compromise the results .
Also, be sure to take ED pills 30 to 60 minutes before you plan to have sex. It usually takes an hour before the medication starts working, but it can take up to four hours in some cases. You may need to give the medication longer to kick in to notice the results.
Your Expectations Are Too High
It’s essential to manage your expectations when taking an ED medication. Many men wrongly believe that erectile dysfunction pills will increase the size of their erections, improve their sex drive, or make them last all night.
Despite what you may have heard, ED medications don’t affect the size of your penis or turn you into a sex fiend. They can help you get and maintain an erection. If you expect anything more, you’ll be disappointed.
You Need a Higher Dose
If you’ve tried your current dose of ED medication a couple of times and aren’t happy with the effects, you may need to talk with your doctor about a higher dose .
Never adjust your dosage on your own. Schedule an appointment with a practitioner to discuss your options.
This article is written for informational purposes only and does not constitute medical advice. The information provided in the articles cannot and should not replace advice from a healthcare professional. Talk to your healthcare provider about any physical or mental health concerns or the risks and benefits of any treatment or medication.
You’re Drinking Too Much Alcohol
Alcohol is the enemy of all erectile dysfunction medications.
While ED meds increase the blood flow to your penis, alcohol reduces it , which makes it harder to get an erection.
Drinking alcohol will also decrease nerve sensitivity, which prevents adequate stimulation. If you’re taking ED medication, you should drink alcohol sparingly (or avoid it entirely). Failure to do so may increase the likelihood of medication side effects and impact your ability to get and stay hard.
You Have Underlying Medical Issues
If you have tried all of the above and nothing works, your issue may go beyond erectile dysfunction.
Several underlying health conditions can cause symptoms of ED , including issues related to your hormones, nerves, and blood vessels.
Talk to a practitioner about evaluating your overall health for other conditions that could be contributing to your ED symptoms.
How To Troubleshoot ED Drugs Not Working
If you’re unhappy with your current medication approach to erectile dysfunction, don’t give up on it entirely. There are a few things you can do to increase your chances of ED medication working for you.
Check Your Testosterone Levels
Viagra and similar medications are not as effective if your testosterone levels are too low. Some studies declare that as many as one in three men discussing erectile dysfunction with their doctor have low testosterone.
Combined with other factors, low testosterone levels can strongly contribute to erectile dysfunction, making a challenging situation even worse. If you suspect that low testosterone is the culprit, schedule an appointment with your healthcare provider, who can evaluate this with you.
Try Taking Your ED Medication in Different Scenarios
Before deciding that ED medication isn’t for you, take it at least five times in the most optimal situation. You should also try it combined with masturbation to make sure you’re not suffering from a relationship issue.
Some people have to take ED meds up to ten times before becoming comfortable with it. You’ll be more comfortable once you understand how the medication makes you feel and how it works.
If you’re still in the trial-and-error phase, speak with your practitioner about your treatment so they can make suggestions and help you find a solution.
Rule Out STDs
Finally, while STDs are an uncomfortable subject to discuss, we cannot rule them out when talking about erectile dysfunction medication efficacy.
Erectile dysfunction medications do not provide a barrier to STDs. Some STDs , including gonorrhea, HIV, viral hepatitis, and chlamydia, can lead to erectile dysfunction, which hinders the performance of ED medication.
For example, if you contract chlamydia and don’t seek proper medical attention, your prostate gland can become infected. This infection may lead to prostatitis , an inflamed prostate.
Try Something New
Even if you’ve had luck with ED medication in the past, sometimes your body can get used to a particular drug, and it stops working over time. In this case, you may need to change your dose or try an entirely new medication.
If you’re currently taking Viagra, you may have better luck with Levitra or Cialis. Always discuss your options with a practitioner before adjusting your dose.
ED Medication Alternatives
If ED medications aren’t working for you, the good news is that some of the things you can do to alleviate ED symptoms don’t require a prescription. Other remedies for ED include non-oral drugs, lifestyle changes, penile devices, and natural therapies.
Lifestyle Changes
While using ED medication, it is vital to address the lifestyle factors contributing to erectile dysfunction. Some common lifestyle factors that contribute to poor blood circulation include:
To improve your overall health, consider making the following changes:
Making these changes and managing any existing health conditions is the most effective way to prevent erectile dysfunction.
Vacuum Devices
Another straightforward treatment for erectile dysfunction is using a penis vacuum device, also called a penis pump .
A penis pump is a simple device that creates suction around your penis. The suction of blood causes it to swell. Placing a ring at the base of your penis prevents blood from draining out. This is how you maintain the erection.
To avoid damage to your penis, never leave a penis pump on for longer than thirty minutes. Your blood will circulate as usual once you remove it.
Some men find that using a ring by itself helps them maintain an erection. It’s important to note that using a penis pump can cause damage to your penis’s blood vessels, which may contribute to any existing ED symptoms.
Injectable ED Medications
If oral ED meds aren’t working for you, consider injectable versions.
Injectable ED medications are injected directly into your penis. This sounds scary, but many men who do not respond well to oral ED medications find injectable ones effective.
On average, it takes five to 20 minutes to see results from an injection. The medication’s effects typically last 30 minutes to one hour, and you administer it up to three times per week.
Urethral Suppositories
Don’t love the idea of injecting medication into your penis? That’s understandable.
Another option you may want to consider is an erectile dysfunction suppository. Urethral suppositories, or pellets, can be inserted into your urethra using a small, hand-held device. This method is referred to as the “ Medicated Urethral System for Erections ” (MUSE).
Using MUSE can take five to ten minutes to get an erection.
Penile Implants
One option to consider is a penile implant, which involves placing a device inside your penis that creates an erection. The device consists of a semi-rigid rod or internal fluid mechanism.
A penile implant is a significant surgical procedure and should only be considered if you’ve exhausted all other options.
Therapy
While most cases of erectile dysfunction are related to physical health conditions, sometimes mental health issues play a role in causing psychological ED . For this reason, you may see an improvement in your erections if you combine medication with therapy.
Cognitive behavioural therapy is one type of therapy that can help treat sexual health issues. CBT involves identifying and changing destructive or harmful thought processes that affect your wellbeing and sexual function.
Experts believe that CBT can help individuals with erectile dysfunction improve their overall sexual health .
No matter which medication or treatment you may be testing for erectile dysfunction, working with a licensed therapist can help reduce anxiety, stress, or pressure in the bedroom.
Key Takeaway
Viagra not working? You’re not alone. An estimated 3 million Canadian men over 40 are affected by erectile dysfunction.
If your prescribed ED medication isn’t working, it may be time to talk with a health provider.
You may be able to relieve symptoms by adjusting your dose, changing certain lifestyle factors, or switching to different ED treatments. Making easy but influential changes to your lifestyle and habits may also help to improve your sexual function.
UPGUYS can easily connect you with a licensed Canadian medical practitioner who can discuss the many treatment possibilities with you.
If you are suffering from ED, don’t waste any more time and explore your medication options today .
Disclaimer
This article is written for informational purposes only and does not constitute medical advice. The information provided in the articles cannot and should not replace advice from a healthcare professional. Talk to your healthcare provider about any physical or mental health concerns or the risks and benefits of any treatment or medication.What Does It Mean When Viagra Is Not Working Anymore?
Some people have success with “the tiny blue pill” (aka Viagra) and find that it’s enough to address their erectile dysfunction (ED). But many others discover that Viagra never works for them or gradually stops working after they’ve used it successfully.
Why does Viagra work for some but not others? We explore the reasons and share options you can try.
Becoming aroused is a complex combination of factors — from physical responses to mood and emotions — so it’s important to understand the physiology of an erection. And it can help you understand why Viagra may not be working.
“Erections occur when there is a net increase of blood flowing into, as compared to blood exiting, the erectile spongy bodies of the penis,” said S. Adam Ramin, MD, urologic surgeon and medical director of Urology Cancer Specialists.
In order to have a net increase in blood flow, Ramin said these four crucial steps must take place:
- First, the nerves in the pelvis must send neurotransmitters to the arteries of the penis, directing increased flow.
- Second, the arteries must respond to the command of the nerves by dilating and widening their diameter to allow for increased flow.
- Third, the erectile spongy bodies of the penis must be compliant, able to stretch out and elongate to accommodate the increased blood flow.
- Lastly, the veins of the penis must allow for a net increase in blood flow by closing their drainage valves to keep blood in the penis.
“Viagra works at the artery level by enhancing the command of the neurotransmitters to cause dilation and increase flow through the arteries,” Ramin said.
But if there’s a problem with any of these four steps on the way to an erection, Viagra won’t work, according to Ramin.
What causes erectile dysfunction?
The causes of ED are complex and can include mental and physical aspects. Erections happen from and are influenced by a complicated combination of:
Several factors can impact Viagra’s effectiveness. These include:
According to the American Urological Association, incorrect use of phosphodiesterase type 5 (PDE5) inhibitors accounts for 56 to 81 percent of treatment failures.
Here are common mistakes to avoid, and what you can do to make sure Viagra has the best chance to work.
1. Avoid taking Viagra with a large meal or high-fat meal
Viagra blood levels peak an hour after you swallow the tablet on an empty stomach. According to Ramin, if you eat a large or high-fat meal and then take Viagra, the medication will lose its effectiveness and may take longer to start working.
2. Avoid taking Viagra with alcohol
Drinking alcohol, especially chronic use, can contribute to ED. If Viagra is losing its effectiveness, you may want to consider decreasing or eliminating alcohol to see if that helps.
3. Don’t expect Viagra to work just minutes before sex
If you take Viagra and immediately try to have sex, Ramin said, it won’t work.
“The most optimal way to take this medication is on an empty stomach, with no alcohol in your system, one hour before sex,” Ramin explained.
4. Don’t expect Viagra to work alone
Viagra packs a punch, but it can’t produce an erection on its own. In order for it to work, you must be sexually aroused.
5. Make sure your testosterone levels get checked
Viagra and other PDE5 inhibitors won’t work well if your testosterone levels are too low.
Testosterone therapy alongside or instead of an ED medication may be a treatment to consider. Your healthcare provider should be able to test testosterone levels and evaluate this with you.
Be sure to use Viagra in several different scenarios
If you’ve taken Viagra in the most optimal situation more than five times and it hasn’t worked, then it may not be the right treatment for you, according to Ramin. Before you decide Viagra isn’t for you, though, Dr. Myles Spar recommends using it at least once when alone masturbating to make sure it isn’t a relationship issue.
You may need to try Viagra as many as 10 times, just to get comfortable with the steps of using it and how it makes you feel, as well as to understand how it may be affecting you.
Speak with a healthcare provider about your treatment so they can adjust dosing, make suggestions, and help you find what works.
Spar, who is chief medical officer at Vault Health, said that Viagra not working could mean that the issue isn’t vascular — meaning, increasing blood flow isn’t helping.
“This can happen because of neuropathy or other issues,” he said.
Even if you’ve had success getting or keeping erections while using Viagra, you may notice it doesn’t work as well anymore. But before you ditch the Viagra prescription, it’s important to consider why it might not be as effective anymore.
Viagra can lose its efficacy over time, due to changes in your body or changes in your health. If that happens, Spar said, you can try switching to another medication in the same class (meaning, another PDE5 inhibitor).
Yes, if Viagra isn’t cutting it, you can try another PDE5 inhibitor — but don’t expect rock-star results.
While a change to a different medication may do the trick, it’s not always a guarantee. A doctor can help you decide if another PDE5 is worth trying.
In addition to Viagra, the other oral medications that are considered the first-line treatment for ED, according to a 2016 review, include:
The four PDE5 inhibitors are the only oral medications approved in the United States by the Food and Drug Administration to treat ED.
In this case, tadalafil may be a good bet.
A reason that this PDE5 inhibitor is preferred by many people, including healthcare providers treating ED, is that tadalafil has a longer window of activity, meaning you can take it in a daily dose.
This can remove some of the psychological aspects and uncertainty of timing a pill before sex. Plus, it can help to see how effective PDE5 inhibitors are for you.
Viagra may not be the most effective for everyone, either because of its dosing schedule, how it works, or health conditions it’s not right with.
Here are some of the more common physical and emotional reasons why Viagra may not work.
Malfunction of nerves
According to Ramin, people with diabetes who have neuropathy or people who’ve had prostate surgery and injury to their nerves may find that Viagra doesn’t work.
Atherosclerotic heart disease
Viagra not working could mean there’s significant obstruction to the blood flow in the penile artery. This can be a sign of general atherosclerosis or plaque in the arterial system, Spar said, which is a risk factor for heart attack and stroke.
People with atherosclerotic heart disease have arteries that are plugged with cholesterol plaques or have lost their elasticity, said Ramin. In this situation, the arteries won’t respond to Viagra because it’s a vasodilator. This means it’s a chemical that causes dilation, or widening, of the artery.
Penile erectile body disease
In people with an injury to the body of the penis or Peyronie’s disease, the erectile body may not be able to accommodate increased blood flow, Ramin said.
Venous leak
If you have leaky valves, Ramin said, the blood may flow at an increased rate to your penis, but it will all leak out and not stay long enough to cause an erection.
It’s also possible that you can get an erection, but the venous leak means you’re unable to maintain it.
One cause of venous leak ED is Peyronie’s disease, which affects the connective tissue of the penis.
Anxiety, depression, stress, or relationship issues
Spar said another reason Viagra does not work for everyone has to do with anxiety and emotional health. This can make it difficult to get sexually excited from a neurotransmitter perspective.
The good news is that some of the things that can have the biggest positive impact on ED symptoms involve actions you can take without a prescription.
Make lifestyle changes a priority
In addition to medical interventions, it’s important to address lifestyle factors that play a role in ED. Some common factors that can lead to conditions affecting blood circulation include:
To help improve your overall health and improve ED symptoms such as circulation, consider these changes:
- Quit smoking.
- Minimize daily stress.
- Manage your weight through a healthy diet and regular activities.
- Participate in daily exercise and physical activity.
- Reduce or eliminate alcohol intake.
Work with a urologist
There are several options to treat erectile dysfunction aside from oral medications like Viagra, including:
Work with a therapist
No matter what treatment or medication you may be trying for ED, talking with a licensed counselor can help you get the most out of your treatment and help you work on reducing stress, pressure, or anxiety — in general and in the bedroom.
Sex therapists, for example, focus on intimacy, communication, relationships, and yes, sex.
Online search tools, like Healthline’s FindCare tool, can help you find general physicians and specialists in your location.
If you’re dealing with ED, you’re not alone. The inability to get or keep an erection firm enough for sex may affect as many as 30 million men, according to the Urology Care Foundation.
If Viagra isn’t working for you, there are things you can try that increase the chances of it working. You can also try lifestyle changes or consulting with a urologist or therapist instead.
Last medically reviewed on October 29, 2020
How we reviewed this article:
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viagra.com/taking-viagra - Mulhall JP, et al. (2016). Relationship between age and erectile dysfunction diagnosis or treatment using real-world observational data in the United States.
ncbi.nlm.nih.gov/pmc/articles/PMC5540144/ - Ramin SA. (2020). Personal interview.
- Rew KT, et al. (2016). Erectile dysfunction.
aafp.org/afp/2016/1115/p820.html - Spar M. (2020). Personal interview.
- What is erectile dysfunction? (2018).
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