Experiencing erection problems? Whether you’re 25 or 60+ years old, you’re certainly not alone.
About 20 million American men are affected by erectile dysfunction, or ED. Interestingly, while ED is often thought of as a condition that affects middle aged and older men, around a quarter of all men under 40 experience ED on a regular basis.
Luckily, a range of treatments are available to treat the effects of ED and help you develop and maintain an erection without any problems.The three most popular erectile dysfunction treatments on the market are sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis).
There are also some less common ED drugs out there, such as avanafil. However, since these treatments are newer and aren’t as widely used or prescribed as the “big three,” they aren’t on our list.
All three erectile dysfunction treatments provide the same key benefit — better blood flow to the penis and fewer difficulties developing an erection. However, they also have some differences, ranging from shorter or longer half lives to slightly different side effect profiles.
Below, we’ve compared sildenafil, vardenafil and tadalafil to give you a better understanding of the most popular ED treatments available today.
Sildenafil, better known by the brand name Viagra, is one of the most common and widely used erectile dysfunction treatments available today.
Originally developed as a treatment for high blood pressure, sildenafil was approved as an ED drug in the late 1990s. From its introduction until 2007, Viagra was by far the most widely used erectile dysfunction drug on the market, accounting for 92% of global sales in 2000.
While sildenafil isn’t quite as dominant as it once was, it’s still by far the most popular treatment for ED.
Sildenafil works by increasing blood flow to the spongy tissue of the penis, making it easier to achieve an erection. It usually works within 30 to 60 minutes of consumption and lasts for three to five hours, depending on the person.
The potential side effects of sildenafil are the same as most other ED drugs — headaches, nasal obstruction, flushed skin and heartburn. Most of the time, the side effects from sildenafil stop in three to five hours as the drug stops being effective as an ED treatment.
Sildenafil can also potentially lead to more serious side effects, particularly in people with heart conditions or those who take other prescription medication. Because of this, it’s important to talk to an experienced, qualified doctor before using sildenafil.
Sildenafil comes in a variety of doses, ranging from 20mg to 100mg. Higher doses are typically used to treat more serious cases of erectile dysfunction for people that don’t respond to the 20 or 50mg tablets.
All in all, sildenafil is popular for a reason — it works. For most men, sildenafil makes it easier to develop and maintain an erection and acts as a reliable, safe treatment for erectile dysfunction.
Developed in the 1990s and approved by the FDA in 2003, tadalafil is a longer-lasting ED drug that provides similar effects to sildenafil.
Tadalafil is better known by the brand name Cialis. With a 17.5 hour half life, tadalafil remains active for up to 36 hours after it’s taken, making it the longest acting of the erectile dysfunction drugs available today.
To put this in perspective, a typical dose of sildenafil lasts for about three to five hours, meaning you’d need to take multiple doses over a long period to get the same results as a single dose of tadalafil.
Tadalafil starts working anywhere from 16 to 45 minutes after taking it.
The side effects of tadalafil are similar to sildenafil, with headache, stuffy nose, heartburn and facial flushing the most common. Tadalafil can also cause muscle aches and back pain, which are usually a result of the drug’s vasodilation effect.
For most people, the biggest advantage of tadalafil over sildenafil is its longer half life. A single dose of tadalafil usually lasts for most of a weekend, eliminating the need to take the pill directly before sexual activity.
Compared to sildenafil, the typical dosages of tadalafil are lower. The normal starting dose is 10mg taken before sexual activity, with doses of 20mg and 5mg also used depending on the way people respond to treatment.
Vardenafil is another ED drug that works similarly to sildenafil and tadalafil. Like tadalafil, it was introduced in the early 2000s as an alternative to sildenafil with a slightly longer half life, making it a longer lasting ED treatment.
The most common brand name for vardenafil is Levitra. Like sildenafil and tadalafil, vardenafil is available as a prescription medication in most countries.
Compared to sildenafil, which lasts for three to five hours, vardenafil usually lasts for five to eight hours, after which it remains active in the body but doesn’t provide as strong an effect . A normal dose of vardenafil takes action in about one hour.
On a per-milligram basis, vardenafil is significantly stronger than sildenafil and is usually used at a lower dose. The normal starting dose of vardenafil is 10mg, with tablets available in 2.5, 5, 10 and 20mg dosages.
The side effects of vardenafil are similar to other ED medications. The most commonly reported side effects include facial flush, headaches, stuffy nose and heartburn. Like other ED drugs, it’s also linked to more serious side effects in people with pre-existing heart conditions.
Because of this, it’s important to talk to a doctor before considering vardenafil or any other ED treatment.
Which ED Treatment is Best For You?
All three of the ED treatments listed above — sildenafil, tadalafil and vardenafil — are widely used and scientifically proven to treat ED. The main differences between each drug are the amount of time it takes to become effective and the total amount of time it lasts in the body.
Ultimately, the best ED drug for you depends on your needs. If you’re interested in treating ED but don’t know which drug is the best choice, you should speak to an experienced ED doctor to learn more about the potential benefits and side effects of each treatment option.
This article was reviewed by Ho Anh, MD.