Since its approval in 1998, Viagra has been one of the most popular and trusted treatments for erectile dysfunction (ED), helping countless men improve their erectile function and boost their sexual health. [1] However, it can be expensive —  if you’re looking for Viagra alternatives, this guide explores affordable and effective treatment options for erectile dysfunction.

What is Viagra and how is it used?

Viagra is a prescription medication that treats erectile dysfunction by improving blood flow to the penis. Its active ingredient, sildenafil, is part of a class of drugs called PDE5 inhibitors. These medications are taken orally, typically 30-60 minutes before sex, to help you achieve and maintain an erection when you’re sexually aroused.

Common side effects of Viagra

• Nasal congestion
• Facial flushing
• Stomach pain
• Headaches

If you experience adverse drug events, such as a prolonged erection or chest pain, seek medical attention immediately.

How do PDE5 inhibitors work?

PDE5 inhibitors like sildenafil (the active ingredient in Viagra) relax the blood vessels in the penis, increasing blood flow during sexual arousal, which helps improve sexual performance. [2]

PDE5 inhibitors are generally safe when used as directed by a healthcare provider, but they may not be suitable for everyone. If you have certain health or medical conditions, like heart disease or low blood pressure, you should seek medical advice before starting Viagra.

Exploring alternative treatments for erectile dysfunction

If Viagra isn’t the right fit for you, there are other treatment options available, ranging from other medications to natural alternatives and non-drug solutions.

1. Sildenafil (Generic Viagra)

The generic version of Viagra, sildenafil, contains the same active ingredient and works just as effectively for erectile dysfunction.

2. Tadalafil (Cialis)

Tadalafil is another PDE5 inhibitor that lasts longer than sildenafil — up to 36 hours. [3] This makes it a good choice for men seeking more spontaneity in their sex life.

3. Avanafil (Stendra)

Avanafil is a newer PDE5 inhibitor that works quickly, and can be taken in as little as 15 minutes before sex. [4]

4. Vardenafil (Levitra)

Similar to Viagra, vardenafil is another PDE5 inhibitor that provides reliable results. It’s more potent than other alternatives, meaning that a lower dose of the drug is required to maintain the desired effect, which could result in fewer side effects. [5]

It’s important to note that all of these treatments have the same potential side effects as Viagra, including nasal congestion, headaches, facial flushing and stomach pain.

5. Compounded erectile dysfunction medications

Compounded medications are custom-made by pharmacists to suit individual needs. These can include chewable versions, unique flavours, or specific doses and ingredient combinations. 

Although they aren’t approved by the MHRA, they can be a helpful option for those who haven’t experienced results with other erectile dysfunction treatments.

To find out if you’re eligible for traditional and compounded ED medications, start a consultation with our clinical team here.

Non-medicinal treatments for erectile dysfunction

If you prefer natural alternatives or non-drug solutions, consider these options:

Creams

Topical creams can increase blood flow locally. [6] They can also be combined with oral treatments for better results.

Penis pumps

Also known as vacuum erection devices, penis pumps use a vacuum to draw blood into the penis, which can help you achieve an erection. [7] They’re effective for many and can be paired with other treatments.

Psychosexual therapy

Psychological factors, like performance anxiety or depression, can contribute to erectile dysfunction. Psychosexual therapy helps address these issues, improving sexual function and well-being.

Lifestyle alternatives

As well as medicinal treatments for ED, there are steps you can take to improve your overall sexual performance and health.

Pelvic floor exercises

Strengthening pelvic muscles can improve sexual function and support other conditions such as premature ejaculation. [8] To practise them, you can tense your pelvic muscles for 3-5 seconds, then rest. This action can be repeated up to 10 times, every few days. [9]

Regular exercise

Improving vascular health through regular exercise supports healthy blood pressure and sexual performance. [10]

Dietary supplements

Although not proven to treat erectile dysfunction, dietary supplements like zinc or magnesium could support your general sexual health, especially if you have nutrient deficiencies. Be wary of using herbal supplements or herbal remedies to improve your erectile function however, as these may not be clinically regulated or suitable for you. Always speak to your healthcare provider before introducing new dietary supplements to your routine.

Choosing the right option for you

There are many ways to improve erectile dysfunction, from oral medications like sildenafil to natural supplements and vacuum devices. Your choice will depend on your health conditions, lifestyle, and preferences. Always consult a healthcare professional for medical advice before starting a new treatment.

Looking for a personalised treatment for erectile dysfunction? Explore your treatment options with an online consultation at MedExpress. Get expert advice from medical professionals and find the right solution for your sexual health needs.

References

1. EMA. Viagra – European Medicines Agency [Internet]. European Medicines Agency. 2018. Available from: https://www.ema.europa.eu/en/medicines/human/EPAR/viagra
2. Dhaliwal A, Gupta M. PDE5 Inhibitor [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2020. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549843/
3. Porst H, Padma-Nathan H, Giuliano F, Anglin G, Varanese L, Rosen R. Efficacy of tadalafil for the treatment of erectile dysfunction at 24 and 36 hours after dosing: a randomized controlled trial. Urology. 2003 Jul;62(1):121-5; discussion 125-6. doi: 10.1016/s0090-4295(03)00359-5. PMID: 12837435.
4. Hellstrom WJ, Kaminetsky J, Belkoff LH, Goldstein I, Tursi JP, Uy J, Peterson CA, Bowden CH, Day WW. Efficacy of Avanafil 15 Minutes after Dosing in Men with Erectile Dysfunction: A Randomized, Double-Blind, Placebo Controlled Study. J Urol. 2015 Aug;194(2):485-92. doi: 10.1016/j.juro.2014.12.101. Epub 2015 Jan 12. PMID: 25591992.
5. Corbin JD, Beasley A, Blount MA, Francis SH. Vardenafil: structural basis for higher potency over sildenafil in inhibiting cGMP-specific phosphodiesterase-5 (PDE5). Neurochem Int. 2004 Nov;45(6):859-63. doi: 10.1016/j.neuint.2004.03.016. PMID: 15312980.
6. Key points from the evidence | Erectile dysfunction: Alprostadil cream | Advice | NICE [Internet]. www.nice.org.uk. [cited 2023 Mar 6]. Available from: https://www.nice.org.uk/advice/esnm50/chapter/Key-points-from-the-evidence
7. Cookson MS, Nadig PW. Long-term results with vacuum constriction device. J Urol. 1993 Feb;149(2):290-4. doi: 10.1016/s0022-5347(17)36059-7. PMID: 8426404.
8. Pastore AL, Palleschi G, Fuschi A, Maggioni C, Rago R, Zucchi A, et al. Pelvic floor muscle rehabilitation for patients with lifelong premature ejaculation: a novel therapeutic approach. Therapeutic Advances in Urology [Internet]. 2014 Feb 20;6(3):83–8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4003840/
9. Male Pelvic Floor Exercises [Internet]. University Hospitals Sussex NHS Foundation Trust. 2022. Available from: https://www.uhsussex.nhs.uk/resources/male-pelvic-floor-exercises/
10. Nascimento E, Maia A, Pereira V, Soares-Filho G, Nardi A, Silva A. Sexual dysfunction and cardiovascular diseases: a systematic review of prevalence. Clinics. 2013 Nov 1;68(11):1462–8.