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Publication date: 2018-05-07 07:41

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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."

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About half of men ages 95 to 75 have erectile dysfunction (ED) to some degree, although only one in 65 report a complete inability to have erections. Taking an ED drug produces an erection sufficient to start intercourse in about 75% of otherwise healthy men.

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ED drugs produce an erection sufficient for intercourse in about 75% of men. But the results vary quite a bit from one individual to another. 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.

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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. 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.

"Will it last through another cycle? It's not guaranteed," Dr. Liou says. To have sex more than once a day, Cialis is your best bet.

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.

In addition to Viagra and Stendra, the two other ED drugs available in the United States are 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. There is also a fast-dissolving form of Levitra, called Staxyn, that you put under your tongue.

The most common side effects of ED drugs, in order of most to least common are headache , flushing, upset stomach, nasal congestion, urinary tract infections, 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.

A pedometer or other "wearable" can track your daily activity so you can determine if you need to adjust your activity level. A simple pedometer that counts your steps is a great place to start.

One ED drug, Cialis, is FDA-approved for use daily in a dose of 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.

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