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Oral Treatments for Erectile Dysfunction: Light background image with a pill pack on a flat surface.

Oral Treatments for Erectile Dysfunction: Sildenafil, Tadalafil and Their Side Effects

Treatments using oral medications for erectile dysfunction may work for some men, but caution is necessary. Learn why and how to avoid risks.

Sildenafil and Tadalafil are the primary oral treatments for erectile dysfunction. We’ve discussed them extensively on this blog, but there are also other options. Like any medication, they come with side effects. Are you prepared for them?

Continue reading to discover:

  • What are the main medications for erectile dysfunction?
  • What is the ideal dosage?
  • Is it possible to combine medications?
  • What are the expected side effects?
  • Does the treatment also increase testosterone levels?

What is the best oral medicine for erectile dysfunction?

The best medication for erectile dysfunction is the one that best suits the patient.

There are basically four medications for erectile dysfunction before considering other alternatives, such as a surgical procedure. They are: Sildenafil, Tadalafil, Vardenafil, and Lodenafil.

All these options are from the same chemical ‘family’ and act in the same way. We say they are erection facilitators, and may work for certain degrees of the condition.

Determining factors for a good erection

A facilitator is different from an inducer. In other words, merely swallowing the pill won’t guarantee an erection; for the desired effect, sexual stimulation (or eroticization) is essential.

As a facilitator, this type of medication needs to be in the bloodstream. This means it requires time to take effect after being swallowed. If you don’t take the medicine within the appropriate interval for absorption, it won’t be effective.

The response time also depends on the active ingredient and dosage. Some medications act more quickly than others. For example, Sildenafil acts faster but has a shorter duration. On the other hand, Tadalafil acts more slowly, despite having a longer duration.

Ideally, the best medicine should be tailored to each patient’s profile. Therefore, some may need Sildenafil for quicker relations, while others have a greater intercourse frequency, requiring Tadalafil, and so on.

The patient also needs to follow a pharmacological concept. This means they should start testing on themselves what the smallest dose is to achieve the desired effect — producing a good erection.

We must remember that all of these medications require eroticization and absorption time to analyze whether there was a good erectile response (to the medication), with the production of a high-quality erection from start to finish of the intercourse.

Some foods can interfere with the absorption of medications. Taking the medicine on an emptier stomach is advised, since absorption is better, as will be the desired effects. In some cases, even a smaller dose on an empty stomach can produce the same response as higher doses.

What is the ideal dosage?

Once you test the medication, you need to check the response level. The response level varies according to sexual stimulation and the medication absorption time.

You can conduct some tests and wait a few minutes, or hours, before taking action. This way, the patient can identify the characteristics of his body that facilitate or hinder their absorption rate. From there, the patient can adjust the timing between taking the pill and actual sexual activity.

If you have a good response to the medication, with an absorption time you consider suitable for your reality, you can decrease the dosage and maintain the time to test the absorption rate, until you find the smallest dose aligned with the best time of the day for taking the pill — considering your own life and circumstances.

How long does the medication last in the body?

The duration of the effect of each pill varies for each type of medication.

Tadalafil, for example, remains in the body the longest. Therefore, it is often recommended for men who have sex without a defined frequency.

For those with a pattern in their sexual intercourse acts, the most common recommendation is Sildenafil, which has a shorter duration.

Is it possible to combine different medications?

The combination of different medications is possible, and depends mainly on the patient’s response to the chemical compounds.

The recommended daily use medication for erectile dysfunction is Tadalafil, at a lower dosage of 5 mg (the conventional version is 20 mg). If you have an average of two to three sexual relations per week, daily use is justifiable, as you will be ready for the act without worries.

Furthermore, if you use the daily medication and the erectile response is below the expected level, the treatment can be enhanced by combining it with a dosage of up to 100 mg of Sildenafil, for example, about two hours before fasting relations. This will reinforce the erectile response.

What are the side effects?

Established medicinal treatments for erectile dysfunction are safe, provided you undergo medical supervision, whether with a urologist, cardiologist, or general practitioner.

For this, your doctor needs to assess your cardiac condition, and diagnose any conditions such as arrhythmias and high blood pressure, as well as keeping any other conditions under control. Obstructions in the coronary artery, which may lead to a heart attack, need extra care — be it by revascularization or stenting procedures.

That being said, the currently available oral treatments for erectile dysfunction have known side effects — and each type of medication presents their respective typical side effects.

Tadalafil is closely related to back and muscle pain in the lower limbs – called myalgia. Sildenafil is associated with facial flushing, nasal congestion, and headaches. Other effects include heartburn, stomach burning, and low blood pressure (especially in the case of hypertensive individuals taking the medication).

It is important to remember that the higher the dosage, the greater will be the side effects that the patient may experience.

If the adverse effects are not well tolerated by the patient, a possible solution is to switch to another type of medication, or start a treatment to alleviate the side effects.

A higher risk for a heart attack?

Sildenafil, Tadalafil, Vardenafil, and Lodenafil are oral medications for vasodilation, to treat erectile dysfunction. They are ingested for an activity that involves energy expenditure equivalent to climbing two flights of stairs, as is the case with sexual relations.

If you are not fit for such physical activity due to coronary problems, these types of medications are not safe for you.

Therefore, before starting an oral medication treatment for erectile dysfunction, you need to consult a doctor to avoid the risk of a heart attack.

Does the treatment for ED increase testosterone levels?

Oral treatments for erectile dysfunction do not have the function of increasing testosterone. For this purpose, different medications are prescribed — only for men who have low testosterone levels, and may indeed need to increase it.

There are also non-hormonal medications that stimulate testicular function. If testicular failure is confirmed, then the doctor may recommend testosterone replacement, through pills, injections, or topical gels.

None of these treatments, however, are related to the erection facilitators we mentioned.

If you still have doubts about this subject and other treatments for erectile dysfunction, watch the video and reach out to us! You can also find out if these medications cause dependence.

Leave your questions here in the comments, on our social networks, or on our WhatsApp. Your penetrative dysfunction has possible treatments, but only a urologist can guide you towards having a pleasurable sexual life again.

Dr.Paulo Egydio

Dr.Paulo Egydio

Médico PhD em Urologia pela USP, CRM 67482-SP, RQE 19514, Autor dos Princípios Geométricos (conhecido como “Técnica de Egydio”), além de outros artigos e livros cientifícos na área. Professor convidado para ministrar aulas e cirurgias ao vido, em congressos no Brasil e Exterior.

Dr. Paulo Egydio é dedicado ao tratamento da curvatura
peniana e do implante de prótese.

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