Viagra® and Cialis® help many men manage erectile dysfunction (ED), but these medications do not always continue providing the same results. You may notice that achieving an erection takes longer, the erection does not remain firm, or the medication has stopped working.
At his practices in Philadelphia, Pennsylvania, Paul Chung, MD, FACS, and our team evaluate the underlying causes of erectile dysfunction and provide treatments. When oral medication no longer works reliably, several other options may help restore sexual function.
Viagra (sildenafil) and Cialis (tadalafil) belong to a class of medications called phosphodiesterase type 5 inhibitors. They improve blood flow to the penis, making it easier to develop and maintain an erection in response to sexual stimulation.
These medications do not automatically cause an erection or increase sexual desire. You still need adequate nerve function, blood flow, and sexual stimulation for them to work.
Several factors can reduce the effectiveness of Viagra or Cialis. In some cases, the medication has not truly stopped working. The timing, dose, or way you take it may prevent you from receiving its full benefits.
For example, eating a large or high-fat meal before taking Viagra may delay its effects. Drinking excessive alcohol can also interfere with your ability to achieve an erection.
Your erectile dysfunction may also worsen because of an underlying health condition. Possible contributors include:
Erectile dysfunction often changes over time. A dose that worked previously may no longer provide enough support if your circulation, hormones, nerve function, or overall health changes.
Do not increase your dose or combine erectile dysfunction medications without medical guidance. Taking more than prescribed can cause dangerous side effects, including a severe drop in blood pressure.
Dr. Chung can review how you take the medication, assess your response, and determine whether adjusting the dose or switching medications may help. He may also recommend testing for:
Addressing the underlying cause may improve both your erections and your overall health.
Oral medication is only one option for treating erectile dysfunction. When Viagra or Cialis does not work, Dr. Chung may discuss:
A vacuum erection device uses suction to draw blood into the penis. A tension ring placed around the base helps maintain the erection during sexual activity.
Penile injection therapy delivers medication directly into the side of the penis. The medication relaxes blood vessels and increases blood flow, often producing an erection within several minutes.
A penile implant is a surgically placed device that allows you to create an erection whenever you choose. Implants provide a reliable solution when other treatments fail or are unsuitable.
The right option depends on the cause and severity of your ED, your general health, and your personal preferences.
Occasional difficulty achieving an erection can happen, but persistent or worsening ED deserves medical attention. Erectile dysfunction can sometimes provide an early warning of diabetes, cardiovascular disease, or another health problem.
If Viagra or Cialis no longer provides dependable results, call Dr. Chung’s office. A thorough assessment can identify why your treatment has stopped working and help you choose the next step toward restoring satisfying sexual function.
