The Most Popular Erection Drug Is…Not Viagra
Cialis has gained substantially on Viagra, and may now be number one.
Immediately after its 1998 approval, Viagra took the world by storm, and ranked, among the best-known brand names on earth, up there with Coca-Cola and McDonald’s. But since the early 2000s, sales of Viagra have gone, uh, rather flaccid.
Why Cialis?
As recently as 2007, Viagra controlled 62 percent of the U.S. erection-medication market. Cialis ran a distant second at 26 percent, with Levitra a distant third at 12 percent. Since then, it’s not exactly clear what’s been happening to sales of erection medications. The companies that manufacture the drugs make contradictory claims. However, one thing seems certain. Cialis has gained substantially on Viagra, and may now be number one.
The reason: Cialis has a longer duration of action. Take one pill, and most users gain erection assistance for 72 hours. Viagra and Levitra last for about four hours, though recent studies suggest some benefit for up to about 10 hours. Even granting Viagra and Levitra extended benefit, Cialis still works much longer. In Europe, it’s marketed as “the weekend pill.” One dose and a man gets an erection boost for three days.
In a dozen published studies, researchers have asked couples to try both Viagra and Cialis. Participants used each drug for two to six months. By the end of all eight trials, the couples preferred Cialis, typically by ratios of more than two-to-one. The main reason: It offers greater freedom from sexual time pressure.
How Do They Work?
Chemically, the three erection medications are quite similar, with similar side effects. But individual men react differently to them. If you’d like to use one, it’s best to try all three to see which provides the greatest benefit with the fewest side effects.
These drugs work in about 70 percent of older men, but they don’t help about 30 percent, so don’t be surprised if you notice little or no benefit.
However, even when they work, erection drugs do not produce the rock-hard erection men recall from their youth or see in pornography. Porn actors are overwhelmingly young men at the stage of life when erections are most firm (not to mention that porn actors pop erection drugs like candy). After around 45, erections become less firm and firmness continues to subside with advancing age. A man in his fifties who takes an erection drug may have a firmer erection than he would without the medication. But chances are his erections won’t be as firm as those he recalls from his twenties.
In addition, erection medications are not aphrodisiacs. They do not boost libido. The just increase blood flow into the penis. In young men, erection and arousal are typically synonymous. But as men age, erection and arousal become uncoupled, and older men find it increasingly difficult to become aroused—and feel aroused even if their penises become turgid. Erections drugs don’t help with arousal.
For most, but not all men, erection drugs are safe.
The most frequent side effects include: headache (16 percent of users), flushing (like menopausal hot flashes, 10 percent), upset stomach (7 percent), nasal congestion (4 percent), and rarely, visual disturbances, mostly in men with severe diabetes or chronic eye conditions such as macular degeneration.
But some men should absolutely never use erection drugs, those taking nitrate medication for heart disease, notably nitroglycerine for angina, or the party drug, amyl nitrate (“poppers”). The combination of Viagra and nitrate drugs can cause a precipitous drop in blood pressure—and possibly death. Before this problem was identified, the combination of Viagra and nitrate medication killed more than 500 men in the U.S. If you take any nitrate drug, don’t use Viagra, Levitra, or Cialis.
[scroll down for related Questions & Answers]
References
Ahn, TY, et al. “Treatment Preferences in Men with Erectile Dysfunction: An Open Lavbel Study in Korean Men Switching from Sildenafil to Tadalafil,” Asian Journal of Andrology (2007) 9:760.
Brock, G. et al. “The Treatment of Erectile Dysfunction Study: Focus on Treatment Satisfaction of Patients and Partners,” BJU International (2007) 99:376.
Conaglen, H.M. and J.V. Conaglen. “Investigating Women’s Preference for Sildenafil or Tadalafil Use by their Partners with Erectile Dysfunction: The Partner’ Preference Study,” Journal of Sexual Medicine (2008) 5:1198.
Dean, J. et al. “Psychosocial Outcomes and Drug Attributes Affecting Treatment Choice in Men Receiving Sildenafil and Tadalafil for Treatment of Erectile Dysfunction: Results of a Multicenter, Randomized, Open Label, Crossover Study,” Journal of Sexual Medicine (2006) 3:650.
Dzelaludin, J and S. Bajramovic. “Evaluation of Therapeutic Responses of Patients with Erectile Dysfunction,” Medicinski Arhiv [Bosnian journal] (2009) 63:274.
Eardley, I. et al. “Factors Associated with Preference for Sildenafil and Tadalafil for Treating Erectile Dysfunction in Men Naïve to PDE-5 Inhibitor Therapy: Post Hoc Analysis of Data from a Multicenter, Randomized Open-Label, Crossover Study,” BJU International (2007) 100:122.
Eardley, I. et al. “An Open-Label, Multicenter, Randomized, Crossover Study Comparing Sildenafil and Tadalafil for Treating Erectile Dysfunction in Men Naïve to PDE-5 Inhibitor Therapy,” BJU International (2005) 96:1323.
Fusco, F. “Tadalafil Versus Sildenafil in the Treatment of ED: Italian Patients’ Preferences and Explanatory Notes,” Urologia (2008) 75:24.
Gong, B.S. “ED Patients and their Female Partners Prefer Tadalafil,” Zhonghua, Nan Ke Xue [Chinese journal] (2011) 17:571.
Hatzichristou, D. et al. “Patterns of Switching PDE-5 Inhibitors in the Treatment of Erectile Dysfunction: Results from the Erectile Dysfunction Observational Study,” International Journal of Clinical Practice (2007) 61:1850.
Lee, J. et al, “Physician-Rated Patient Preference and Patient- and Partner-Rated Preference for Tadalafil and Sildenafil: Results from the Canadian Treatment of Erectile Dysfunction Observational Study,” BJU International (2006) 98:623.
Melnik T. and C.H. Abdo. “Psychogenic Erectile Dysfunction: Comparative Study of Three Therapeutic Approaches,” Journal of Sex and Marital Therapy (2005) 31:243.
Morales, A.M. et al. “Patients’ Preference in the Treatment of Erectile Dysfunction: A Critical Review of the Literature,” International Journal of Impotence Research (2011) 23:1.
Von Keitz, A. et al. “A Multicenter, Randomized, Double-Blind, Crossover Study to Evaluate Patient Preference Between Tadalafil and Sildenafil,” European Urology (2004) 45:499.
Questions & Answers
I’ve answered more than 12,000 sex questions from people around the world, of all ages, for free. Here are a few that relate to the topic of this post.
If you’d like to ask me a question of your own, please go to GreatSexGuidance.com.
I’m 43 years old and suffering for Erectile Dysfunction. I tried Viagra (sildenafil) 50 mg last year and the pills worked very well the first month, but after that, not very well. I increased the dose to 100 mg, which worked great for a while, then less effectively. Now I’m to a dosage of 200 mg. Sometimes this works, sometimes not. Read more and my response…
When I started getting anxious about more frequent loss of erections I went the pharmaceutical route. Viagra is really effective, but sometimes causes headaches and a flushed feeling in my face. Now trying Levitra, which comes on more gently and doesn’t have the above 2 symptoms for me, but even with 20 mg, produces erections that are less reliable, meaning we rarely can have vaginal sex to conclusion, which distresses me a little and my partner more. Any advice? Read my response…
I’m 62, healthy, happily married (34 years)–and not very hard anymore, even with Viagra. At the health food store, they have a good dozen supplements that claim to boost male sexual energy and performance with ingredients like ginseng, ginkgo, maca, and yohimbe. Do these products work? Or are they a rip-off? Read my response…
What’s going on with me? I’m a 56-year-old man. The last couple of years I’ve noticed some erection problems, so I started taking Viagra. It’s helped, but now I’m ejaculating way before I want to. I haven’t had that problem in 20 years. And now I’m having more erection trouble, even with the Viagra. My wife is upset and so am I. Help! Read my response…
And if your Medical Condition precludes the use of Pharma Erection Pills
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