Phosphodiesterase Type 5 (PDE5) Inhibitors: How They Work
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 gel erectile dysfunction to sessions for more support. 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. 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.
Who Shouldn’t Take ED Medications?
Sexual intercourse isn’t the only way to increase intimacy between partners. You can show your partner you care through physical contact such as holding hands or back rubs, spending time with them, kissing, writing notes, being patient and being a good listener. Erectile dysfunction (ED) is common, especially as you get older. It can cause embarrassment, low self-esteem and other more serious psychological conditions. But you shouldn’t feel ashamed or embarrassed to have ED.
Penile Injections (Prostaglandins)
It may be your body’s way of telling you that something isn’t right. It’s important to have an open conversation with a healthcare provider about your symptoms and how they affect your quality of life. They can diagnose ED, determine its cause and recommend the most appropriate treatment for you. Sign up for our Health Essentials emails for expert guidance on nutrition, fitness, sleep, skin care and more. Learn more about the Health Library and our editorial process.
When to see a doctor
Cleveland Clinic’s health articles are based on evidence-backed information and review by medical professionals to ensure accuracy, reliability and up-to-date clinical standards. What Is Erectile Dysfunction ( Updated 6/2018. Erectile Dysfunction (Impotence) ( Updated 8/26/2020. National Institute of Diabetes and Digestive and Kidney Diseases (U.S.) Definition & Facts for Erectile Dysfunction ( Updated 7/2017. At Cleveland Clinic, we offer specialty care that’s focused on you. If you have ED and low testosterone, health care professionals may prescribe testosterone with PDE5 inhibitors. You may be given testosterone as an oral medicine, a patch, or a gel. Injectable medicines and suppositories can enhance erections. 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. 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. Bruises are usually painless and will disappear in a few days. VEDs may weaken ejaculation but this doesn’t affect the pleasure of climax or orgasm. Most people with ED do not need surgery.
| Product | Dosage | Quantity + Bonus | Price | |
|---|---|---|---|---|
| Cialis Generic | 2.5mg | 20 Pills | 40.73€ 38.79€ | |
| Viagra Generic | 150mg | 120 + 8 Pills | 177.58€ 169.12€ | |
| Viagra Generic | 25mg | 120 + 6 Pills | 125.56€ 119.58€ | |
| Viagra Generic | 25mg | 180 + 6 Pills | 154.93€ 147.55€ | |
| Viagra Generic | 25mg | 360 + 10 Pills | 213.68€ 203.50€ | |
| Super Kamagra | 160 mg | 92 + 6 Pills | 478.75€ 455.95€ | |
| Cialis Super Active | 20mg | 20 + 4 Pills | 92.35€ 87.95€ | |
| Cialis Generic | 5mg | 20 Pills | 41.99€ 39.99€ | |
| Kamagra Polo | 100 mg | 60 + 4 Pills | 189.39€ 180.37€ | |
| Priligy Generic Dapoxetine | 60mg | 20 + 4 Pills | 77.31€ 73.63€ | |
| Cialis Professional | 40mg | 270 + 6 Pills | 898.37€ 855.59€ | |
| Cialis Black | 80mg | 270 + 10 Pills | 502.88€ 478.93€ | |
| Viagra Super Active | 100mg | 360 + 30 Pills | 470.93€ 448.50€ | |
| Levitra Original | 20mg | 120 + 8 Pills | 528.19€ 503.04€ | |
| Levitra Generic | 10mg | 120 + 10 Pills | 178.59€ 170.09€ | |
| Kamagra Soft Tabs | 100 mg | 32 Pills | 120.11€ 114.39€ |
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.
- Drug development pipeline: New PDE5 inhibitors, gene therapies, and other novel agents.
- Nanotechnology: Potential for targeted drug delivery to penile tissue.
- Tissue engineering: Research into growing erectile tissue for reconstruction.
- Neuroprosthetics: Experimental devices to stimulate nerves controlling erection.
- Optogenetics: Using light to control nerve cells, a highly experimental approach.
- The role of microRNAs: Being studied for their potential role in regulating erectile function.
- Personalized medicine: Genetic testing to tailor ED treatment to the individual.
- Artificial intelligence: Using AI to diagnose ED and predict treatment outcomes.
- Wearable technology: Devices to monitor physiological signals related to sexual arousal.
- Virtual reality: Potential use in exposure therapy for performance anxiety.
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.
Further reading
Erectile dysfunction can cause you to feel many different emotions. You may feel embarrassed, frustrated, guilty, ashamed, angry or “less than.” This can lead to more serious long-term emotions, like anxiety and depression. But you don’t have to live with these feelings. ED is common, and it doesn’t reflect your worth as a person. Erectile dysfunction is a sensitive topic for many people.
Sildenafil may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
The following tips can help you support your partner if they have erectile dysfunction: Tell your partner you care about their feelings and well-being. Find appropriate times to talk to your partner that won’t make them feel vulnerable. Remind your partner that they’re not alone. ED is common, and treatment is available. Therapists and support groups can help your partner process their feelings.
Avoid drugs and limit alcohol
Focus on the benefits of regular exercise, healthy foods and cutting back on substances that may cause ED. Your partner will feel supported if you have accurate, up-to-date information on erectile dysfunction and its treatment options. Offer to go with your partner to their appointments. You can help your partner ask questions, take notes and relay information to a healthcare provider that can help them in making a diagnosis. Respect their privacy if they prefer to see a provider alone. Sometimes, changing a daily habit could help prevent or improve your ED.
- Definition of ED: The consistent inability to achieve or maintain an erection.
- Prevalence: Affects millions of men, with incidence increasing with age.
- Risk factors: Include diabetes, heart disease, smoking, obesity, and sedentary lifestyle.
- Types of ED: Can be psychogenic, organic (vascular, neurological, hormonal), or mixed.
- The erection process: Involves neural, vascular, hormonal, and psychological components.
- Vascular ED: Caused by problems with blood flow into or out of the penis.
- Neurogenic ED: Caused by nerve damage from diabetes, surgery, or spinal cord injury.
- Hormonal ED: Caused by imbalances in testosterone, thyroid, or other hormones.
- Psychogenic ED: Caused by mental health issues like stress, anxiety, or depression.
- Mixed ED: A combination of physical and psychological causes is very common.
If you smoke cigarettes, one of the best things you can do for your ED and your overall health is to quit smoking. Smoking cigarettes is linked to heart and blood vessel disease, which can lead to ED. Eating well helps to maintain erectile function. Consider working with a registered dietitian, if possible, to create an eating plan for your individual needs. 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. 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.
What Lifestyle Changes Can Help With Erectile Dysfunction?
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 improving sexual function. 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. 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.
| Population | Considerations | Approved Usage | Notes |
|---|---|---|---|
| Elderly Men | Increased risk of side effects | Yes | Dose adjustments may be needed |
| Men with Diabetes | May require higher doses | Yes, with caution | Monitor for cardiovascular effects |
| Men on Heart Medication | Risk of interactions | Yes, but caution needed | Consult healthcare provider |
| Post-prostatectomy | Reduced efficacy possible | Often used with counseling | Tailored treatment needed |
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.
What Causes ED?
The outlook for ED is good and it’s a very treatable condition. Though there aren’t cures for some causes of ED, many treatment options can help you get and maintain an erection hard enough for sexual intercourse. Certain lifestyle changes can help lower your risk of developing erectile dysfunction, including: Being more physically active, especially doing cardiovascular exercises like running, jogging or bicycling. Eating healthy foods with low saturated fats, such as fruits, vegetables and whole grains. Talk to a primary care physician or a urologist if you suspect you have erectile dysfunction.
What Is Erectile Dysfunction?
They can help diagnose ED, identify its cause and recommend the best treatment option for you. A urologist is a healthcare provider who specializes in diagnosing and treating conditions that affect your reproductive system and urinary system. Go to your nearest emergency room if you’re taking medication for erectile dysfunction and have a painful erection that lasts longer than two to four hours. This may be a sign of priapism, which can cause permanent damage to your penis without treatment. Is it normal to have erectile dysfunction?
FYI on ED
How do you know I have erectile dysfunction? What ED treatment option do you recommend? Can erectile dysfunction cause other conditions that affect my sexual health? Can you recommend a support group for people who have erectile dysfunction? Am I a candidate for a penile implant procedure? You can help prevent ED by avoiding recreational and illicit drugs and limiting how much alcohol you drink. Some drugs can prevent arousal or other sensations that are important for getting and keeping an erection. Sometimes, illicit drugs and too much alcohol may mask other mental health, emotional, or physical factors that cause ED. 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. NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by NIDDK is carefully reviewed by NIDDK scientists and other experts. Other names: ED; Erection Problems; Impotence; Sexual Dysfunction, Male Medically reviewed by Carmen Pope, Senior Medical Editor, B. Pharm. Erectile dysfunction (ED) is a consistent inability to achieve or sustain an erection sufficient for sexual intercourse, commonly known as impotence. ED can have physical or psychological causes, or a combination of both.
