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Viagra may seem like it’s been around forever, but the little blue pill was only approved by the FDA in 1998. Viagra’s effect on global sexual health was immediate and profound. 

In Viagra’s first year on the market, the $810 pills totaled around $1 billion in US sales. 

Viagra may be a miracle pill solution for some men, but it’s not perfect. The medication has limitations, side effects, and sometimes it simply doesn’t work. 

Let’s discuss the following:

  • How Viagra works
  • How and when to use Viagra for best results
  • Safety considerations before trying Viagra alternatives
  • Best alternatives to Viagra

How Viagra Works

Viagra is a brand name for sildenafil. It’s taken to treat erectile dysfunction (ED), i.e. a man’s inability to satisfactorily achieve or maintain an erection. 

ED is the most common sexual dysfunction for men, and Viagra is the most popular medication for addressing the problem.

Sildenafil blocks phosphodiesterase 5 (PDE5). PDE5 is an enzyme involved in the regulation of blood flow to the penis. 

After taking Viagra, the blood vessel walls of the penis relax. This allows for an increase in blood flow to the shaft, resulting in an erection

After taking Viagra, the blood vessel walls of the penis relax. This allows for an increase in blood flow to the shaft, resulting in an erection. For most men, Viagra effectively leads to erection. However, sexual arousal is required for the drug to take effect.  

How and When to Use Viagra for Best Results

Viagra is a prescription drug, so it’s important that you use Viagra only as instructed by your doctor. Numerous conditions and medications can interact with Viagra, so it’s important to discuss your medical history with a doctor prior to use. 

For best results, Viagra is usually taken around one hour prior to anticipated sexual activity. Effects typically take hold within 3060 minutes but may occur faster or slower depending on arousal and other factors. Effects typically last for 25 hours. 

Avoid large or high-fat meals in the hours before dosing, as these can delay the pill’s absorption

Avoid large or high-fat meals in the hours before dosing, as these can delay the pill’s absorption.

It’s best to avoid alcohol (entirely or almost entirely) during Viagra use, and consider decreasing your overall alcohol use for best results. Remember that lifestyle improvements, such as exercise and quitting smoking, will improve your sexual function with or without the use of Viagra. 

Safety Considerations Before Using Viagra Alternatives

You might prefer a non-prescription approach to ED treatment. However, it’s always best to discuss any health concern with your doctor before attempting treatment. 

If you’ve tried Viagra without success, the source of your ED may not be directly tied to a blood flow problem. Low testosterone, nervous system issues, or other concerns may be preventing you from achieving healthy erections. 

If you’ve tried Viagra without success, the source of your ED may not be directly tied to a blood flow problem

Do your research—and, ideally, consult with your doctor—prior to attempting an alternative  sexual dysfunction treatment. To get you started, let’s review the basic facts on a few of the leading solutions to ED. 

Best Viagra Alternatives

Viagra doesn’t work for everybody. Or, you might not be comfortable with its associated side effects. Perhaps you simply prefer to limit your use of prescription drugs. 

 

best viagra alternatives diagram

 

Fortunately, there are several proven alternatives to Viagra for overcoming erectile dysfunction. 

Penis Pumps

A penis pump is an excellent non-drug treatment method for ED. 

As with any treatment choice, you should discuss your intentions with a doctor prior to using a penis pump. 

A few medical complications, such as blood disorders or the use of blood-thinning medication, may prevent some men from being good candidates for pump use. However, pumping is one of the safest, simplest, and most effective approaches for natural ED treatment

Penis pumps consist of:

  • A tube that the penis is placed into
  • A seal around the penis base
  • A vacuum for removing air from the tube

A pump’s vacuum is operated by a hand-pump or an electric motor. Removing air from the tube results in a change of air pressure, causing blood to rush into the penis and create an erection.

A pump’s vacuum is operated by a hand-pump or an electric motor. Removing air from the tube results in a change of air pressure, causing blood to rush into the penis and create an erection

After pumping, a ring can be placed around the base of the shaft to help keep blood in the penis, thus maintaining the erection. 

For most guys, pumping is safe and effective. You can learn more about penis pumps here

Penile Injections

Penile injections, or Intracavernosal Injections (ICI), involve the use of a needle to deliver a dose of medication into the side of the penis. 

These three medications are commonly used in ICI therapy:

  • Prostaglandin E1 (PGE1)
  • Papaverine
  • Phentolamine

These medications are prescription-based and often used as a second line of treatment when oral medication fails. A urologist may prescribe one or a combination of ICI drugs. 

Penile injection medications relax the muscles in the penis, allowing blood vessels to widen. Blood circulation increases, improving the chances of gaining and keeping an erection. 

Surgery Implant

Penile implant surgery is an option for men who have tried other ED treatments without success. Surgery is a drastic choice, so this route is typically not appropriate for men whose ED may be reversible. 

During surgery, flexible rods are inserted into the penis

During surgery, flexible rods are inserted into the penis. The insertions help the penis take an erect form during arousal. You can read more about penile implant surgery here

Most men have no interest in pursuing elective surgery on their genitals, but those who do opt for it report high success rates. Around 80 to 90 percent of patients are satisfied with their results and report that they would make the same choice again. 

Cialis

Cialis may be the second-best-known name in ED treatment. However, it frequently bests Viagra in user satisfaction

Cialis is thought to promote penile blood flow by relaxing bladder and prostate muscles. Like Viagra, Cialis is a PDE5 inhibitor, but with a different active ingredient—tadalafil in Cialis, sildenafil in Viagra. Some men may respond better to one or the other. 

The key difference between Viagra and Cialis is the duration of their effects. Cialis may promote a user’s ability to achieve and maintain an erection for an extended period of time, allowing for more flexibility regarding the moment at which a couple chooses to begin sexual activity. 


Viagra vs Cialis

Timing

Viagra

Cialis

Time to take effect

3060 minutes

3060 minutes

Duration of efficacy

46 hours

Up to 36 hours


Like Viagra, Cialis is a prescription medication and should only be taken as instructed by a doctor. 

Frequently Asked Questions

Does Viagra always work?

Viagra enables increased blood flow to the penis, making an erection more likely. However, Viagra does not work for all men all the time. 

Sexual arousal is usually required for the effective use of Viagra. So, if you aren’t “in the zone,” taking Viagra may not result in a satisfactory erection. Additionally, the following medical complications could limit Viagra’s effectiveness:

  • Diabetes 
  • Very low testosterone 
  • Mental health issues
  • Nervous system issues

Alcohol use or heavy, high-fat meals may also decrease Viagra’s effects.

Is it safe to take an increased dose of viagra? 

Viagra doses range from 25 to 100 mg. Never take a dose other than the amount recommended by your doctor. Viagra should not be taken more than once per day.

Is there an effective over-the-counter supplement for ED? 

Various over-the-counter (OTC) supplements are marketed and consumed for natural ED treatment. Popular herbal and other OTC products that men turn to include:

  • Red ginseng, an herbal supplement
  • L-arginine, an amino acid
  • Yohimbine, a tree bark extract

While a limited amount of research supports alternative ED supplements, there is evidence that some products may be effective. Herbal supplements could boost erectile function by improving blood flow (as with yohimbine and L-arginine) or releasing nitrous oxide (as with red ginseng). 

Do not take alternative ED supplements in combination with Viagra. Do not assume that an OTC product can be safely taken without first consulting with your doctor.

Sources

https://my.clevelandclinic.org/health/treatments/10054-surgical-penile-implants 

https://www.grandviewresearch.com/industry-analysis/erectile-dysfunction-drugs-market

https://www.aarp.org/home-family/sex-intimacy/info-12-2013/sex-erection-viagra-castleman.html

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