Medications for Erectile Dysfunction in Los Angeles & San Francisco, CA
Phosphodiesterase type 5 (PDE5) inhibitors are oral medicines that improve blood flow to the penis. These medicines may help you get and keep an erection. If you have ED and low testosterone, health care professionals may prescribe testosterone with PDE5 inhibitors.
| Product Name | Average Cost per Dose | Over-the-Counter Option | Prescription Required | Price Range (USD) |
|---|---|---|---|---|
| Viagra | $30-$50 | No | Yes | $30-$50 |
| Cialis | $35-$70 | No | Yes | $35-$70 |
| Herbal Supplements | $20-$60 | Yes | No | $20-$60 |
You may be given testosterone as an oral medicine, a patch, or a gel. Injectable medicines and suppositories can enhance erections.
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Scientific and engineering discoveries and innovations have bolstered national security, health, economic growth. Today, however, the necessary and well-intended -- but inefficient and risk intolerant -- regulation of this partnership impedes research, researchers and their institutions, and taxpayers' research investments." Reviewed by Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing Since the 1990s, erectile dysfunction (ED) drugs have helped millions of men continue to enjoy an active sex life. "While not much has changed in how they work or the types of drugs available, there still are things men should consider when choosing which one to try," says Dr. Michael O'Leary, a urologist and former director of men's health at Harvard-affiliated Brigham and Women's Hospital's Department of Urology.
3. Urethral suppository
There are four main FDA-approved ED drugs: sildenafil (Viagra), tadalafil (Cialis), vardenafil, and avanafil (Stendra). All of these come as pills; vardenafil also is made in a dissolvable version you place under your tongue. Chewable ED drugs are available that contain the same active ingredients of sildenafil, tadalafil, and vardenafil. However, they are made to order in compounding pharmacies and may include other ingredients. Dr.
Learn More about Medications for Erectile Dysfunction
O'Leary advises against using these custom-made products since they are not regulated or approved by the FDA. The four ED drugs - known medically as PDE5 inhibitors - work similarly to increase blood flow into the penis, which helps men reach and maintain an erection. They do this by inhibiting phosphodiesterase type 5 (PDE5), an enzyme in blood vessel walls that controls blood flow. When a man is aroused, his body releases molecules that relax the smooth muscles in the blood vessels, allowing more blood to flow in. ED drugs prevent PDE5 from breaking down these substances, thus keeping the blood flowing. An injectable medicine causes a quick, automatic erection by increasing blood flow to the penis. Some people with ED prefer a suppository, a solid piece of medicine that you insert into the urethra. Your health care professional will teach you how to give yourself an injection or insert a suppository.
- Future oral drugs may target different pathways beyond PDE5 inhibition.
- Improved topical formulations aim for systemic absorption without side effects.
- Advanced shockwave devices are being refined for better precision and outcomes.
- Nanotechnology could enable targeted drug delivery to penile tissue.
- Brain-computer interfaces are far-future possibilities for stimulating arousal centers.
- Tissue engineering aims to create functional bioengineered erectile tissue.
- Personalized medicine may use genetic profiling to predict best treatments.
- Ongoing research into the role of inflammation and microvascular health in ED.
Some people say certain alternative medicines help their ED symptoms. For safety reasons, talk with your health care professional before using dietary supplements, such as vitamin or mineral supplements, or any complementary or alternative medicines or medical practices. Vacuum erectile devices (VEDs) pull blood into the penis for an erection. a plastic tube to put around your penis an elastic ring that helps you to keep an erection You may need to practice with or adjust your VED. Sometimes, VEDs can make your penis feel cold or numb. Your penis could look purple or bruised.
| Product | Dosage | Quantity + Bonus | Price | |
|---|---|---|---|---|
| Cialis Original | 20mg | 22 + 2 Pills | 129.20€ 123.05€ | |
| Viagra Generic | 200mg | 20 Pills | 61.69€ 58.75€ | |
| Cialis Professional | 20mg | 20 Pills | 78.33€ 74.60€ | |
| Kamagra Gold | 50 mg | 20 Pills | 73.17€ 69.69€ | |
| Cialis Soft Tabs | 20mg | 90 + 6 Pills | 216.71€ 206.39€ | |
| Levitra Professional | 20mg | 270 + 6 Pills | 738.98€ 703.79€ | |
| Super Kamagra | 160 mg | 60 + 4 Pills | 342.71€ 326.39€ | |
| Levitra Generic | 20mg | 30 + 4 Pills | 70.59€ 67.23€ | |
| Cialis Generic | 10mg | 60 + 6 Pills | 105.81€ 100.77€ | |
| Levitra Generic | 60mg | 30 + 2 Pills | 109.43€ 104.22€ | |
| Viagra Professional | 100mg | 120 + 4 Pills | 262.83€ 250.31€ | |
| Levitra Generic | 10mg | 90 + 8 Pills | 150.58€ 143.41€ | |
| Kamagra Soft Tabs | 100mg | 20 Pills | 79.79€ 75.99€ | |
| Viagra Super Active | 100mg | 120 + 16 Pills | 198.37€ 188.92€ | |
| Viagra Generic | 25mg | 90 + 6 Pills | 105.03€ 100.03€ | |
| Levitra Generic | 40mg | 360 + 10 Pills | 704.99€ 671.42€ |
Bruises are usually painless and will disappear in a few days. VEDs erectile dysfunction pills over the counter may weaken ejaculation but this doesn’t affect the pleasure of climax or orgasm.
- Vidalista Tadalafil 20mg: Extended-release medication, effective for both ED and benign prostatic hyperplasia.
- Suhagra: Sildenafil-based generic pill, reliable for temporary erectile dysfunction.
- Fildena: Versatile Sildenafil brand, available in different dosages for tailored treatment.
- Fildena 100: Common dose for quick results, typically taken 30-60 minutes before intimacy.
- Super P-Force: Combines Sildenafil and Dapoxetine to target ED and premature ejaculation.
- Zenegra: Generic Sildenafil, offers affordability and fast action.
- Silagra: Cost-effective Sildenafil option, trusted for consistent results.
- Eron Plus: Combines ED medication with supplements to boost testosterone and vitality.
- Penegra: Fast-acting Sildenafil tablet, effective within 30 minutes.
- Erexil: Herbal and pharmaceutical ingredients combined for natural libido support.
- Maxman: Herbal supplement that claims to improve erections naturally.
Most people with ED do not need surgery. If you have tried all other options and your ED does not improve, you and your health care professional may consider surgery to implant a device—called a prosthesis—to make the penis erect, either using a pump in the scrotum or a rod that you can control on your own repair arteries to increase blood flow to the penis, a procedure that works best for younger men Your health care professional will describe the benefits and possible side effects of surgery. ED medicines that you take by mouth, through an injection, or as a suppository can have side effects, including erections that last longer than 4 hours, known as priapism vision or hearing loss after taking oral ED medicines Call your health care professional right away if you develop these problems. Lifestyle factors can often lead to ED or make its symptoms worse. Sometimes, changing a daily habit could help prevent or improve your ED. If you smoke cigarettes, one of the best things you can do for your ED and your overall health is to quit smoking.
Check with your doctor to see if you need to increase your dose.
O'Leary. "Also, switching to another ED drug usually won't make a difference." The most common side effects of ED drugs are headaches, upset stomach, nasal congestion, muscle pain, and facial flushing. But most of these are relatively mild and disappear after a few hours. "ED drugs can make blood pressure temporarily drop, so don't use them if you take nitrates for angina (chest pain) or other heart problems," says Dr. O'Leary.
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However, there's no problem with nitrates found in food - for example, leafy green vegetables (spinach, kale) and root vegetables (beets, carrots). You also need to be careful if you take alpha blockers such as tamsulosin (Flomax) and alfuzosin (Uroxatral), used to treat an enlarged prostate. "Make sure to take these medications at least four hours apart from an ED drug," says Dr. O'Leary. It's also best not to take sildenafil or vardenafil soon after eating, as food can block their absorption.
Lifestyle changes
(Tadalafil and avanafil don't interact with food in this manner.) Matthew Solan, Former Executive Editor, Harvard Men's Health Watch Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Health care professionals treat the underlying cause of erectile dysfunction (ED) when possible. Sometimes, the exact cause of ED is not known. Health care professionals will then focus on tadacip 20mg improving sexual function. Smoking cigarettes is linked to heart and blood vessel disease, which can lead to ED. Eating well helps to maintain erectile function.
| Brand Name | Main Ingredients | Effect Duration | Notes | Age Restrictions |
|---|---|---|---|---|
| VigRX Plus | Horny goat weed, Muira Puama | 4-6 hours | Herbal supplement | 18+ |
| Max Performer | L-Arginine, ginseng | 2-3 hours | Natural ingredients | 18+ |
| ProSolution | Tribulus terrestris | 4-5 hours | Available online | 18+ |
Consider working with a registered dietitian, if possible, to create an eating plan for your individual needs.
- Age is a major risk factor due to increased vascular issues and declining testosterone.
- Diabetes mellitus damages nerves and blood vessels, a leading organic cause of ED.
- Hypertension and atherosclerosis narrow penile arteries, restricting blood flow.
- Metabolic syndrome (obesity, high blood pressure, insulin resistance) strongly correlates with ED.
- Radical prostatectomy or other pelvic surgeries can damage nerves controlling erections.
- Spinal cord injuries or neurological disorders (MS, Parkinson's) disrupt nerve signals.
- Hormonal disorders: Low testosterone, high prolactin, or thyroid problems.
- Certain prescription medications: Antihypertensives, antidepressants, antipsychotics, diuretics.
You can find a registered dietitian online through the Academy of Nutrition and Dietetics or through your health care professional. A dietitian can create a custom meal plan for you.
Why trust our experts?
ED drugs are effective in about 70% of men, according to Dr. O'Leary, but the results can vary. "A man with nerves or arteries damaged by prostate surgery, diabetes, or cardiovascular disease will not respond as strongly to ED drugs," he says. Also, while ED drugs can help men achieve and maintain an erection, they don't help with other sexual issues, such as low libido, premature ejaculation, or the inability to reach orgasm. The main differences between ED drugs are how quickly they act and how long the effect lasts.
Erectile dysfunction care at Mayo Clinic
Avanafil takes about 15 to 30 minutes to work and lasts six to 12 hours. Sildenafil and vardenafil take effect in 30 minutes to an hour and last four to five hours. Tadalafil kicks in after 30 to 45 minutes and can last 24 to 36 hours. "Many doctors first prescribe sildenafil because it 10mg vardenafil online has been around the longest and has a high success rate," says Dr. O'Leary.
5. Penile implant
Men who want a longer-lasting effect might opt for tadalafil. Tadalafil is also available as a low-dose daily drug, so you have a constant amount of the drug in your bloodstream, which helps with spontaneous sex. (This version is also used to treat benign prostatic hyperplasia, or an enlarged prostate.) The maximum dosages for ED drugs vary from 20 milligrams (mg) for tadalafil and vardenafil to 100 mg for sildenafil and 200 mg for avanafil. Your doctor usually begins with a low dose and increases it as needed. "Once you reach the maximum dose, and the drug still doesn't work, taking more won't help," says Dr. A healthy weight can improve testosterone levels and self-esteem, which may help prevent ED. Maintaining a healthy weight can also prevent diabetes and high blood pressure, which can cause ED. Physical activity increases blood flow through your body, including the penis, and can help keep you at a healthy weight. The Physical Activity Guidelines for Americans, 2nd edition, recommends at least 150 minutes, or 2 hours and 30 minutes, of moderate-intensity physical activity, such as brisk walking, each week.2 Taking care of your mental and emotional health can help prevent ED. If you feel stressed, try relaxation techniques and other activities that might soothe you. A simple way to relax is deep breathing, which you can do anywhere.
| Pill Type | Main Action | Common Drugs/Pills | Effect Duration | Notes |
|---|---|---|---|---|
| Phosphodiesterase Inhibitors | Increase blood flow by relaxing smooth muscles | Viagra, Cialis, Levitra | 4-6 hours | Most prescribed class; require sexual stimulation |
| Herbal/Energy Boosters | Improve blood circulation and libido | VigRX Plus, Horny Goat Weed | Varies (hours) | Often mild effects; consider safety profile |
| Testosterone Boosters | Increase testosterone levels | Tribulus, Fenugreek | Varies | Not direct erection pills, but can enhance libido |
You can help prevent ED by avoiding recreational and illicit drugs and limiting how much alcohol you drink.
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Your health care professional may review any medicines you are taking to see if a medicine you need for another health condition is causing ED. They may suggest taking a different dose of medicine or switching to another medicine. Do not stop taking any medicines on your own. Talk with your health care professional first. Health care professionals may also prescribe other types of medicines for your ED. Some drugs can prevent arousal or other sensations that are important for getting and keeping an erection.
Which Erectile Dysfunction Treatment Option Is Right for You?
Choosing an ED treatment is a personal decision. If you have a partner, you may want to talk together about treatments that work for you as a couple. Your health care professional may suggest lifestyle changes to help improve your ED symptoms, including Health care professionals may suggest counseling if mental health or emotional issues are affecting your ED. Counselors can help you lower anxiety and stress about sex. Your counselor may ask you to bring your partner to sessions for more support. Sometimes, illicit drugs and too much alcohol may mask other mental health, emotional, or physical factors that cause ED.
- Herbal Viagra: Natural alternative with herbal extracts claiming to boost erections.
- Rhodiola Rosea: Herb thought to improve stamina and reduce fatigue affecting performance.
- Ginseng: Traditionally used to enhance libido and erectile function.
- Maca Root: Plant-based supplement purported to increase libido naturally.
- L-Arginine: Amino acid that improves nitric oxide production for better blood flow.
- Horny Goat Weed: Herbal supplement believed to treat ED and enhance libido.
- Tribulus Terrestris: Used to improve sexual function and testosterone levels.
- Muira Puama: Historically used as a libido booster and for erectile issues.
- Yohimbine: Extract used to improve blood flow and nerve function.
- Tongkat Ali: Traditional herb to boost testosterone and sexual performance.
- Ashwagandha: Adaptogen that may reduce stress and improve sexual stamina.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health.