Read 5 natural ways to overcome erectile dysfunction. As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician. Erectile dysfunction (ED) is a common condition. One recent study estimated that roughly a third of men struggle with it.1 Though the condition does affect more older men than younger men, its impact spans age groups. Indeed, while half of all ED patients in the U.S. are over the age of 60, one study found that over 25% of men under age 40 suffered from ED to some extent.2 If any of this describes you, then you’re not alone at all. ED is very treatable, and several treatments work for most men, but "most" may technically mean only more than 50% of ED sufferers. The truth is that ED has various underlying causes, and those who are confronting it face varying challenges in treatment due to other potential health conditions. So, the question is: What is the best treatment for you? Aside from underlying health considerations, everything from price to how you take a medication can affect your decision. But we're here to demystify ED and your treatment options.
Other Options for the Treatment of Erectile Dysfunction
Your doctor may start you on a smaller dose of the ED drug if you already take an alpha blocker or may recommend the alpha blocker tamsulosin (Flomax), which affects blood pressure less. ED is often an early warning sign of underlying cardiovascular disease, such as clogged arteries (atherosclerosis). "It can predate a diagnosis of cardiovascular disease by at least a few years," Dr. Liou says. We don't have strong proof yet that starting to live a healthier lifestyle can reverse erectile problems, but it can't hurt. To help you out, we’ve reviewed the major online providers and treatments and analyzed a large swath of relevant scientific research. In this guide, we’ll break down all of your best options. First, to orient you to this landscape, here is a roadmap that breaks down the diverse treatment paths you might take and our characterization of their merits.
- Sildenafil Oral Jelly: A gel form that acts faster than pills for some, available in certain markets.
- Sublingual Tablets: Placed under the tongue for faster absorption than swallowed pills.
- Custom Compounded Formulas: Specialized pharmacies can create tailored blends (e.g., Sildenafil + Tadalafil).
- Herbal Blends (e.g., MaxiMan): Often contain unverified ingredients; efficacy and safety are not guaranteed.
- Yohimbine HCL: Prescription alpha-blocker derived from bark; limited evidence, significant side effects.
Most likely to help: Prescription PDE5i medication like sildenafil (Viagra), tadalafil strongest viagra pill (Cialis), etc.
| Product | Dosage | Quantity + Bonus | Price | |
|---|---|---|---|---|
| Viagra Soft Tabs | 100mg | 90 + 6 Pills | 205.31€ 195.53€ | |
| Viagra Original | 100mg | 4 Pills | 40.94€ 38.99€ | |
| Viagra Soft Tabs | 100mg | 20 Pills | 62.99€ 59.99€ | |
| Viagra Oral Jelly | 100mg | 30 + 5 Sachets | 115.76€ 110.25€ | |
| Viagra Generic | 25mg | 270 + 8 Pills | 184.26€ 175.49€ | |
| Viagra Soft Tabs | 100mg | 180 + 10 Pills | 314.95€ 299.95€ | |
| Viagra Generic | 50mg | 30 + 4 Pills | 54.26€ 51.68€ | |
| Viagra Generic | 100mg | 90 + 6 Pills | 129.02€ 122.88€ | |
| Viagra Super Active | 100mg | 180 + 20 Pills | 280.97€ 267.59€ | |
| Viagra Oral Jelly | 100mg | 10 Sachets | 46.36€ 44.15€ | |
| Viagra Super Active | 100mg | 60 + 8 Pills | 116.84€ 111.28€ | |
| Viagra Super Active | 100mg | 10 Pills | 28.76€ 27.39€ | |
| Viagra Professional | 100mg | 30 Pills | 88.92€ 84.69€ | |
| Viagra Generic | 100mg | 270 + 10 Pills | 270.47€ 257.59€ |
Next most likely to help: Mental health care Best in-office treatment alternative to prescription: Shockwave therapy Best OTC budget options to try: ED rings and/or certain supplements And now, for those in a hurry, here’s a quick snapshot of our specific recommendations across that roadmap. Best for trying an ED medication: BlueChew viagra tablet for sex Best overall for daily ED meds: Hims Best if you know you need sildenafil (generic Viagra): Rocket Rx Best mental health care resource for ED: Cerebral Best OTC supplement: Testosterone Support by Innerbody Labs Best at-home device to try: ED rings If you’re new to ED treatments, there’s simply no more affordable, convenient, or discreet place to start. That’s because BlueChew has an effective selection of PDE5 inhibitors and offers $25 off most prescription treatment plans (or 10% off Gold). This translates to a steep discount on your first month or effectively a free trial of an ED medication (minus a $5 shipping fee). It’s a great way to discover if a prescription PDE5 inhibitor works as well for you as it does for many men. There are other platforms that could suit you better over the long haul once you know what works best — such as Hims for daily tadalafil, or Rocket RX for sildenafil.
| Country | Prescription Needed | Over-the-counter Sales Allowed | Online Sales Restrictions | Notes |
|---|---|---|---|---|
| USA | Yes | No | Strict regulation | Prescription mandatory for all brands |
| UK | Yes | No | Strict online regulation | Prescription required, licensed pharmacies only |
| India | No | Yes (online) | Looser regulation | Still recommend consultation before use |
| Australia | Yes | No | Online restrictions apply | Prescription compulsory in most states |
Read on for all of those comparative details. At Innerbody Research, we extensively test each health service we review, including ED medication services, whenever possible. All told, our team has collectively spent over 1,300 hours researching ED, its potential treatments, and the companies offering them. Our team has considered over 187 clinical studies related to ED and its treatments.
- WebMD or Mayo Clinic: For reliable, medically-reviewed information on conditions and treatments.
- International Society for Sexual Medicine (ISSM): Professional society with patient resources.
- Urology Care Foundation: Patient education site from the American Urological Association.
- FDA Medication Guides: Official information on drug benefits, risks, and proper use.
- Peer Support Forums: Online communities (moderated) for sharing experiences and coping strategies.
We’ve heard from men who rely on them and those whose partners require them. To get as clear a picture of the market landscape as possible, we’ve completed the consultation and ordering process for all of the top online ED medication providers. This guide was also scrutinized by members of our Medical Review Board for accuracy.
What special dietary instructions should I follow?
To have sex more than once a day, Cialis is your best bet. The most common side effects of ED drugs, in order of most to least common are headache, flushing, upset stomach, nasal congestion, vision problems, diarrhea, dizziness, and rash. A man who has an erection that lasts four hours or more needs to get to a hospital or risk permanent damage. None of the ED drugs is safe to take with cardiac drugs called nitrates because it could cause a dangerous drop in blood pressure. Drugs that many men take for urinary symptoms, called alpha blockers, can also lower blood pressure, so take them at least four hours apart from ED drugs. We’ll continue to monitor developments among these providers and in the broader landscape of ED treatment. Over the past two decades, Innerbody Research has helped tens of millions of people make more informed decisions about staying healthy and living healthier lifestyles. Erectile dysfunction (ED) refers to the condition of being unable to get or keep an erection long enough to engage in satisfying sexual activity. You can get an erection but can’t maintain it for a long enough period of time. You can get semi-erect but not fully firm.
| Brand Name | Active Ingredient | Typical Dosage | Manufacturer | Price Range ($ per pill) |
|---|---|---|---|---|
| Viagra | Sildenafil citrate | 50mg, 100mg | Pfizer | 10 - 25 |
| Kamagra | Sildenafil citrate | 50mg, 100mg | Ajanta Pharma | 5 - 15 |
| Caverta | Sildenafil citrate | 50mg, 100mg | Ajanta Pharma | 8 - 20 |
| Revatio | Sildenafil citrate | 20mg, 40mg | Pfizer | 15 - 30 |
An erection just won’t happen at all.
- GoodRx & SingleCare: Coupon cards and apps to compare and lower prescription prices at pharmacies.
- Manufacturer Savings Cards: Available for brand-name drugs like Cialis or Stendra (eligibility required).
- Online Pharmacy Verification: Use only VIPPS-accredited pharmacies to avoid counterfeit drugs.
- Insurance Formulary Check: See which ED medications are covered under your specific plan.
- Buying in Bulk: Some services offer cost savings with 3-month or 6-month supplies.
Erections sometimes happen, but sometimes they won’t. ED prevalence is much greater than you might think.
What side effects can this medication cause?
However, neither Cialis nor Stendra interact with food this way. The onset time determines how soon you can engage in intercourse. Stendra and daily-use Cialis are closest to being an "on demand" erectile drug; using the others requires more planning. Dr. Liou says that some men come to him after getting a prescription from their primary care doctors, claiming that the drug doesn't work.
Is Viagra used long term?
Sometimes it's because they used it incorrectly. "The biggest misconception is that these drugs are an on/off switch for erections," Dr. Liou says. But the drugs don't work well without sexual stimulation. "During that time, you need to be with your partner and have foreplay," Dr.
The Bottom Line
Liou says. "Don't take it, do the taxes or the dishes, and then meet at the bedroom thinking you'll be ready to go. The ED drugs break down at different rates in the body. The durations of action range from four hours to more than a day (for Cialis in the higher doses). Each dose should be sufficient to provide a full cycle of intercourse, from erection to climax. Various studies indicate that anywhere from one-third to one-half of all men deal with ED at some point.6 And incidences of ED increase steadily with age.
The Best Type of Viagra?
There is also a fast-dissolving form of Levitra, called Staxyn, that you put under your tongue. One ED drug, Cialis, is FDA-approved for use daily in a dose of 2.5 or 5 milligrams. This helps to produce erections on demand and may also help relieve urinary problems, like difficulty starting urination, that result from an enlarged prostate. The cost to you for ED drug therapy varies considerably, depending on the pharmacy price, prescription co-pays, and your level of health plan coverage. Even if private insurance covers it, you may be limited to four doses per month.
Other Interactions
Here are a few things you can do to contain costs: Various web-based tools can help you compare prices easily. Ask your doctor about pill splitting, where you get the pills at a higher dose than you need and divide them. These allow you to obtain a limited supply of medications not covered by your insurance. ED drugs produce an erection sufficient for intercourse in about 70% of men. But the results vary quite a bit from one individual to another.
Dosage adjustments
A man with nerves or arteries damaged by prostate surgery, diabetes, or cardiovascular disease will not respond as strongly to ED drugs. "There are some men in whom none of these drugs work," Dr. Liou says. How soon the drugs start working ranges from 15 to 60 minutes. Neither Viagra nor Levitra will work if you take them after a meal, which blocks their absorption. There are numerous potential causes of ED.
| Brand Name | Common Side Effects | Rare Side Effects | Contraindications | Warnings |
|---|---|---|---|---|
| Viagra | Headache, flushing, nasal congestion | Vision changes, dizziness | Nitrate medications, heart conditions | Use with caution in cardiovascular disease |
| Kamagra | Dizziness, nausea | Priapism, allergic reactions | Heart issues, or if allergic to Sildenafil | Not approved in some countries |
| Caverta | Flushing, stomach upset | Sudden vision loss | Nitrate drugs, allergy to sildenafil | Consult doctor if side effects persist |
| Revatio | Headaches, muscle pain | Hearing loss, vision disturbances | Similar to Viagra contraindications | Needs doctor supervision |
Though it occurs more frequently as men age, it isn’t a condition that’s a natural part of the aging process, nor is it something that men or their partners should just accept or something that should be a source of shame or embarrassment.
Start your treatment journey
Taking an ED drug produces an erection sufficient to start intercourse in about 70% of otherwise healthy men. Does it make any difference which of the four drugs for erectile dysfunction you take? "Yes, there can be differences," says Dr. Louis Liou, chief of urology at Harvard-affiliated Cambridge Health Alliance in Boston. "For new patients, I have them try different ones to see what works best." Sildenafil (Viagra) is often the first drug your doctor offers.
Ginkgo biloba
It's been on the market longest and its side effects and the medications and foods it interacts with are well known. But the main challenge to finding the best ED drug for you may turn out to be health insurance rules—not biochemistry. It's a common practice among insurers to limit the number of pills you can obtain per month. After you hit your limit, the out-of-pocket cost for a single pill can be very high. "The main obstacle in my practice is the cost," Dr.
Drug Interactions
Liou says. You'll need to work with your doctor to get the pill you need at a price you can afford. In addition to Viagra, other ED drugs available in the United States include avanafil (Stendra), tadalafil (Cialis) and vardenafil (Levitra). These all improve blood supply to the penis. In combination with sexual stimulation, the drugs can produce an erection sufficient to initiate and complete intercourse. ED is a common condition, and many roads may lead to it, including: Use of alcohol, tobacco, or drugs (recreational or prescription) It would be wise to speak with your doctor to rule out any of these potential causes before taking a prescription for ED, as each of those listed ailments can have far-reaching consequences beyond sexual health.
- KAMAGRA (Sildenafil Jelly): Easy to take, fast-acting, popular in some regions as an alternative to pills, buy responsibly.
- Apcalis SX: Tadalafil variant, quick onset, lasts longer, ideal for flexible timing in intimacy.
- Penegra: Generic sildenafil citrate, affordable, effective, but always ensure purchase from reputable sources.