Erectile dysfunction

Medical information

Written and reviewed by a team of doctors. Dr Fox is regulated by the CQC & GPhC.

About erectile dysfunction

Erectile dysfunction (ED) is common. It is not unusual for most men to have problems occasionally getting or maintaining an erection. This is usually caused by tiredness, stress, drinking too much alcohol, or anxiety. It is not usually caused by low hormone levels. Most men with erectile dysfunction are in reasonable health, although erectile dysfunction may be a symptom of poor circulation or early diabetes. Erectile dysfunction is more common in smokers and men who are overweight. Some medicines can contribute to ED as can many recreational and frequently abused drugs. Some men with ED have low testosterone levels. Cycling more than 3 hours a day can also lead to ED.

All men with persistent ED should tell their GPs about it.

ED treatments

Over the last few decades medications have revolutionised the treatment of erectile dysfunction. These medications work by enhancing the natural reaction to sexual stimulation, improving the blood flow needed for erections. Other treatments for ED include topical applications, injections into the penis, surgical devices, and counselling.

Types of medicine

Eight different erectile dysfunction tablets are available to buy online from Dr Fox pharmacy:

• Viagra (25mg, 50mg, 100mg)
• Viagra Connect (50mg only)
• Sildenafil (25mg, 50mg, 100mg)
• Cialis (2.5mg, 5mg, 10mg, 20mg)
• Cialis Together (10mg)
• Tadalafil (2.5mg, 5mg, 10mg, 20mg)
• Vardenafil (5mg, 10mg, 20mg)
• Spedra (50mg, 100mg, 200mg)

Each tablet has a different duration of action and side effects – see tablet differences below.

No combination of Viagra/sildenafil, Cialis/tadalafil, Levitra/vardenafil, Spedra/avanafil or other ED treatment should be used at the same time - a break of at least 24 hours should be left.

Cautions

• There is a very rare theoretical risk of abnormal heart rhythm (Prolonged QT interval) if Viagra (sildenafil) or Levitra (vardenafil) are taken at the same time as some other medications. If you are taking other medication please check this list. This risk is not applicable if taking Cialis (tadalafil) or Spedra (avanafil).
• Serious reaction possible if any ED medication is taken at the same time as Nitrates for angina or heart failure, including glyceryl trinitrate, isosorbide mononitrate, isosorbide dinitrate, GTN spray, tablet, patch or gel, nicorandil, sodium nitroprusside.
• Serious reaction possible if any ED medication is taken at the same time as recreational drugs, particularly amyl nitrate ('Poppers').
• Caution taking any ED medication if taking alpha-blockers (for high blood pressure or prostate enlargement) including alfuzosin, doxazosin, indoramin, prazosin, tamsulosin, terazosin.
• Do not take any ED medication if taking riociguat (for high blood pressure in the lungs).

Also see Tablet differences: Warnings and cautions in table below.

Investigating erectile dysfunction

You should always tell your regular doctor if you are having problems with erections.

Erectile dysfunction can be a symptom of conditions such as diabetes, high blood pressure, high cholesterol, or narrowing of the arteries. Some simple tests may be required. An assessment with a doctor is particularly important if symptoms develop over a period of weeks or months, or even suddenly, without an emotional event to set them off. Erectile dysfunction can be a complication of previous operations or a side effect of some prescribed medication.

Lifestyle and risk factors

Improving lifestyle factors such as diet, exercise, stopping smoking, reducing alcohol intake, and maintaining an active lifestyle has shown improvement in ED in men of all ages. Apart from the general benefits of a healthy lifestyle, studies show improvement in erectile dysfunction symptoms and a reduced need for tablets. ED also shares risk factors with a range of other medical conditions including diabetes, heart disease, and circulatory problems, all of which are also likely to benefit from lifestyle modification.

Starting treatment

It is best to start with a lower strength tablet and build up as needed (see how to start treatment). One type of tablet sometimes works better than another. You may like to try out different tablets to see which ones suit you best.

Sexual stimulation is required for tablets to work. Without it tablets will have no effect.

You can request more than one type of tablet at a time. It is advised to try the same treatment several times before deciding to change tablet type or dosage strength.

Counselling

Erectile dysfunction can be distressing and lead to relationship difficulties, anxiety, and depression. Your regular doctor may recommend counselling. This may help resolve the cause of erectile dysfunction. In some cases a problem of performance anxiety can be overcome by breaking the cycle of failure with tablet treatments.

Buy treatment

Dr Fox pharmacy supplies erectile dysfunction medication on prescription – you are required to answer a short medical questionnaire before your order can be completed.

---

Tablet differences

1. Medical questions
2. Choose treatment
3. Complete order

Answer medical questions to order(erectile dysfunction)

Men only

Honest & accurate responses are necessary for safe medical assessment