Approximately 30 million men have problems with erection according to the Urology Care Foundation. This inability to perform sexually is known as erectile dysfunction (ED) and can be a cause of depression and stress for men.
When ED attacks, many men visit their doctor to discuss a prescription for ED drug. Treating ED with medications was not available until 1983 when a physiologist demonstrated the effect of phentolamine on the erection.
It paved the way for further development of medication for ED and Viagra was the first one to be introduced in 1989.
Since then, other ED drugs like Cialis and Levitra joined Viagra.
How do men decide what is right? Are the medications for ED similar or do they have significant differences?
How Do Drugs for ED Work?
Viagra, Cialis, and Levitra are used to treat ED. They are also known by their generic names of sildenafil (Viagra), tadalafil (Cialis) and vardenafil (Levitra).
Each of them works similarly and belong to drugs called PDE-5 inhibitors. They work by blocking an enzyme called phosphodiesterase type 5 while increasing a chemical in the male body called nitric oxide.
It helps the penis muscles to relax and allow the blood flow into the penis to help achieve and maintain an erection when a man wakes up.
None of the medications produces an instant erection: it takes about 30 minutes to work. These medicines help men to get an erection even if they are not able to have one otherwise. However, the ED drugs are not aphrodisiacs. In other words, they do not stimulate male sex drive. It still has to be done the old way – a man must be sexually aroused for the drugs to work.
Men who are depressed, have low levels of testosterone or have little interest in sex may not have any reaction to ED medications. Also, ED drugs do not work for every man, since about one-third of men who attempt ED do not have the desired result.
Who Should Not Use ED Medications?
Some men are not good candidates for ED medications. Medications for ED are not recommended for men taking any form of nitrates for chest pain, or alpha-blockers of high blood pressure. Drugs for ED can cause a sudden and dangerous drop in blood pressure.
Men who take nitroglycerin or a similar medication for chest pain should not use ED drugs as it can cause low blood pressure.
With ED drugs there is a small risk of priapism, which is a prolonged and painful erection of four hours or more in which blood does not leave the penis. The condition is dangerous and requires a trip to the emergency room.
Some men experience minor side effects after taking ED medications including headaches, blurred vision, heat sensation, back pain, muscle aches, nasal congestion and upset stomach or heartburn.
What Are the Differences Between Drugs?
Since Viagra, Cialis and Levitra work in the same way; there are only a few subtle differences.
Levitra works stronger than Viagra, but both take effect in about 30 minutes. The effect of Levitra lasts for about five hours while Viagra lasts for about four hours.
Cialis comes in two forms – one for daily use and a higher dose as needed, It lasts up to 36 hours, which means it stays in your system longer.
Cialis and Viagra can be taken with or without food, while Levitra should be taken on an empty stomach.
Cialis is not recommended to take with alcohol as it can cause low blood pressure, dizziness or a headache when you get up or sit down.
Viagra and Levitra do not seem to cause low blood pressure when taken with alcohol, but alcohol can inhibit the ability to get an erection.
What are Similarities Between Drugs?
Viagra, Cialis, and Levitra have many similarities. All of them are used only to treat ED, they all come as oral tablets. It is recommended to take a pill 30-60 minutes before sex or once a day. The medicines should be stored at room temperature. They can be bought by prescription or over the counter in most pharmacies. The prices of drugs are about the same.
Most health insurance companies do not cover the cost unless you have certain medical conditions.
When used correctly, each of these ED drugs helps men with ED to produce good results. If one medication does not work, then you should try another. Sometimes you need to get the right dose for each man.
The decision to use an ED drug should be discussed with your doctor. The doctor will advise which ED medication is the best for you to achieve the results you want with the least number of side effects.
Men should always tell their doctor about all over-the-counter or prescription medications or herbal and dietary supplements they take. All health conditions should also be discussed in depth.
Dr. Samadi is Board Certified Urologic Oncologist, trained in open and traditional laparoscopic surgery and is an expert in robotic prostate surgery. He is also a President of Urology, Chief of Robotic Surgery at Lenox Hill Hospital. Dr. Samadi says: “All risks and benefits should be considered before taking an informed decision.”