erectile dysfunction treatments

Erectile dysfunction (ED), or impotence, is a very common condition that can distress men of all ages and sexual persuasion. Erectile dysfunction, ED is the incapacity to achieve or sustain an erection that is sufficient for satisfactory sexual activity.

In the U.K, ED is thought to affect 1 in 10 men and more than 50% of men over 40 years of age will experience some form of ED. 

A number of men will have difficulties maintaining an erection for a satisfactory period of time whilst others may be completely unable to get an erection at all.

At one time, it was thought that ED only affected older men but it is much more common among younger men than previously believed.

To have an erection you need to have an unrestricted blood flow to your penis and to feel sexually aroused.

To obtain an erection the brain responds to arousal by sending signals to the nerves which are in the penis. The nerves then increase the penis's blood flow, upon which the penis hardens and enlarges.

ED can be seen as the result of an interruption - either medicinal, physical or psychological - of the natural process which causes an erection when sexual excitement is felt.

ED can have a range of causes but the main culprits are physical problems, psychological factors and the side effects of certain medications.

Therefore, the most common causes of ED are high blood pressure, high cholesterol, diabetes, medications for depression, heart disease, prostate problems, and anxiety. It is always best to check with your GP, to rule out the possibility, that your ED may be related to a medical condition that may need another course of treatment.  Your lifestyle can also be a factor that causes ED as it’s more commonly caused in men who drink excessively, are overweight, those who smoke or use illegal drugs.

In younger men, the most frequent cause of ED is anxiety due to worrying about causing a pregnancy, nervousness about having sex or about using a condom.

However, you do not have to suffer in silence as the vast majority of men with ED can look forward to a return of satisfying sexual activity with the treatments now available and many men have found that they have transformed their lives.

Physical causes of ED can include; hormonal conditions such as diabetes, hypogonadism and an under or overactive thyroid, which can affect hormone levels adversely; anatomical conditions such as Peyronie's disease(due to scar tissue inside the penis); vascular conditions like high blood pressure, diabetes and  cardiovascular disease; and neurogenic conditions (affecting the nervous system) such as Parkinson's disease and multiple sclerosis.

Psychological causes of ED can include; emotional problems rooted in past sexual abuse, lack of sexual knowledge or even unease with a new relationship; and mental conditions from anxiety to clinical depression.

Medicinal causes of ED can include; the effect of certain medicines such as antidepressants, diuretics, beta blockers, corticosteriods and cytotoxics.

Lifestyle causes of ED include; smoking, drinking too much and being obese or overweight.

Surgery can also cause ED, especially surgery involving the prostate.

However, the most common cause of ED is simply due to increasing age as arteries narrow over time and restrict blood flow.

The predominant symptom of ED is the inability to achieve an erection, or maintain an erection, when having sexual intercourse. Looking at the symptoms of ED closely can help to both identify and understand the nature of the ED condition in an individual. A man who cannot achieve or maintain a satisfactory erection at all typically has ED which is caused by a physical condition or  a side effect of a medication(s). While men who can only achieve an erection through masturbation, but not through sexual intercourse, are more likely to suffer from ED which is rooted in psychological problems.

In some cases, when ED presents itself, it’s an early indication of a more serious underlying medical condition. This can be true in the case of heart disease, high blood pressure and high cholesterol. These conditions cause a narrowing of the blood vessels with a resulting reduction in blood flow leading to ED.. Because of the serious nature of the conditions which are capable of causing ED, it is recommended that you schedule an appointment with your GP should you experience erectile dysfunction symptoms.

It is accepted that ED symptoms which present themselves suddenly and without warning typically indicate psychological causes, whereas symptoms which develop more slowly normally suggest a physical cause, such as narrowing of the blood vessels.

Because of the obvious nature of the predominant ED symptom - that is, failing to achieve or maintain an erection - ED can normally be self-diagnosed. Despite the fact that ED can be detected from a self-diagnosis, it is important that any new or different symptoms be discussed with a doctor when they arise. Even if you are reluctant to discuss the ED problem itself with a health professional, it is important that you book a check-up in order that any underlying health conditions which may be related to ED are detected and addressed.

In diagnosing ED, a doctor will typically ask a series of questions, including some on the subject of your sexual history. While these questions are of a personal nature, it is important to answer them as honestly as possible, to help the doctor form an accurate diagnosis. These questions could ask about; your sexual relationships, your sexual orientation, the nature of your sexual desire, if you are able to achieve an orgasm or ejaculation, and to what degree you are able to achieve an erection (if any). These questions are typically supplemented by those which are more general, pertaining to your state of mental and physical health, as well as medication which you may have been prescribed. Questions can also relate to lifestyle, including use of alcohol and drugs, diet choices, and levels of exercise.

Tests which your doctor may perform can include; a heart rate check, ultrasound to measure blood flow in the penis, measurements for weight and height, a blood pressure test, or a physical examination of the penis itself.

Because ED can be caused, at least partially, by elements of lifestyle - from suffering from anxiety, to poor diet choices, obesity, smoking and substance abuse - the risk of developing the condition can be reduced by making lifestyle changes. Among these improvements are losing weight and keeping to a healthy diet, exercising regularly, stopping smoking, moderating alcohol intake, and taking steps to reducing stress levels by a number of means.

By making some of the changes mentioned above, it is possible to enhance general health, and decrease the chance of developing the conditions which are known to cause ED; including cardiovascular disease and diabetes. By achieving a good level of health, the risk of needing medicine which has the potential to cause ED as one of its side effects can also be reduced.

ED is a condition that is very easy to treat and men can take oral medication that can dramatically improve performance.

Viagra or Sildenafil (the generic equivalent), Cialis or Tadalafil (generic equivalent), Spedra and Levitra have been very successful at treating ED for the majority of men. With the choice of treatments available, if one does not suit you then it’s very worthwhile trying another.

You are not alone; we offer a discreet, confidential, professional and secure service that gives you all the facts to consider about each treatment so that you can choose and order, the best ED treatment for your own lifestyle.  You can do this in the comfort of your own home, without having to take time off work or interrupt your busy daily routine.

A range of prescription and non-prescription medicines are available to treat ED. These include the following:

Viagra

Viagra is available in tablet form, commonly in doses of 25mg, 50mg or 100mg. Tablets of 50mg are considered the usual starting dose, which can then be decreased to tablets of 25mg if you suffer any side-effects. Tablets of 50mg are typically tested for effectiveness, and if you have not experienced the desired effects after four separate tries, dosage can be upped to 100mg. In cases where adverse side effects have been seen, increasing dosage to 100mg may not be advised.

Viagra is typically taken around an hour before sexual intercourse. You should not exceed a dosage of one viagra tablet in a 24 hour timeframe. In the UK, Viagra is also sold as generic Viagra called  Sildenafil, which carries the same instructions as the tablets sold as Viagra.
Sildenafil works exactly the same as Viagra, but is much cheaper.

Cialis

Cialis on demand comes in  10mg and 20mg tablets, with the recommended starting dose of 10mg.  This can be adjusted according to the effect on the individual. Before maximum strength is advised, Cialis should have been tested on four separate occasions for its effectiveness, and no serious adverse side effects should be noted. Before Cialis 20mg is confirmed as ineffective, it should be tried on eight occasions. Cialis can be taken as long as 24 hours in advance of sexual intercourse, or as little as 30 minutes before it.

The main differences of Cialis to other ED medication is that it lasts for 36 hours as opposed to 4 -6 hours and is not affected by food.

If you have sex twice or more a week, then you should consider taking Cialis Daily, which comes in lower dosages of 2.5mg and 5mg. This means you don’t have to plan ahead and will be able to respond to sexual stimulation anytime, anyplace, anywhere.

Cialis came off patent in November 2017 allowing other pharmaceutical manufacturers to make a generic version using the same active ingredient called Tadalafil. As with all genuine generic medication, Tadalafil works exactly the same as the branded product but is much cheaper.

There is a Tadalafil On-Demand and Tadalafil Daily.

Levitra

Levitra (vardenafil) is considered one of the most suitable ED treatment options for diabetics. It typically comes in 10mg and 20mg tablets, with dosage being adjusted according to the effect on the individual. The maximum dosage should be tried eight times before it is deemed not to be an effective treatment. The effects of Levitra are known to last longer than those of Viagra.

Spedra

Spedra is recognised as being the fastest acting oral medication for ED. Doses are 50mg, 100mg or 200mg tablets. The 100mg strength is the recommended starting does which should be tried four times before an increase to the 200mg dose is advised. The maximum dose should be tested on eight occasions before it is confirmed as being ineffective for an individual. Spedra can be taken as little as 15 minutes before sexual intercourse.

There are a number of accepted alternative treatments which can be effective for ED. They include:

Therapy

Therapy types for men with ED due to psychological issues include; couples sex therapy which works to build intimacy; cognitive behavioural therapy (CBT) which addresses issues such as low confidence and negative thinking; and psychosexual counselling which offers the opportunity to discuss issues related to sex.

Weight loss

Weight loss programmes, for those who are overweight or obese, can be key to addressing the physical causes of ED. Sexual function can be improved significantly by following a weight loss programme consistently.

Lifestyle changes

Making positive alterations to lifestyle can also put men on the path to improving their ED condition. These steps can include healthy changes which can lead to improved erections and lessen the need for mediciation. Maintaining a healthy diet is one of the ways to improve ED symptoms, avoiding fried foods and sugary snacks, in favour of fresh foods with a higher nutritional value.

Exercise more

Exercising can be an important part of a healthy lifestyle, and there are specific exercises which are recognised as being conducive to improved sexual health, such as pelvic floor exercises and other routines based on the core muscle group.

Stop smoking

As the chemicals in cigarette smoke are recognised as being harmful to the blood vessels, stopping smoking has the ability to improve blood flow to the penis. Those who quit smoking can also benefit from stopping their intake of the nicotine, contained within cigarettes and e-cigarettes, as nicotine also causes your blood vessels to contact which reduces blood flow to the penis.

Vacuum pumps

Vacuum pumps are a physical, non-medical ED treatment which serve to improve the quality of erections by improving blood flow and providing a firmer erection.

All of the ED medications belong to a group of drugs called ‘PDE5 inhibitors’ and work in the same way. They dilate the blood vessels leading to the penis resulting in a firm, longer lasting erection.

As everybody is different, in many cases it can be impossible to tell which ED treatment will be most effective. Drugs such as Viagra, Sildenafil, Cialis, Tadalafil, Levitra and Spedra are similar in some respects, but take effect in different ways.

Points to consider when making your choice:

They have different durations of action :-

Viagra, Sildenafil, Levitra and Spedra all remain in your system for about 4-6 hours. This doesn’t mean that you will have an erection for that length of time but that you will be able to achieve and maintain an erection when sexually stimulated for that window of time.

Cialis and Tadalafil have a much longer duration of action, 36 hours, and that is why it’s referred to as the week-end pill as you can take it on a Friday night and it’s still in your system on Sunday morning.

They also have different onsets of action with Viagra, sildenafil, Levitra and Cialis being active within 30-60 mins but the newest medication to be introduced, Spedra, as its name would suggest, can be active in as little as 15 mins, and therefore is the quickest to have an affect.

Cialis and Tadalfil are the only ones not affected by food.

There is some medical evidence to suggest that Levitra is best for diabetics.

The most important thing to remember is that if one ED medication doesn’t work for you then it’s worthwhile trying another. Ultimately, an individual's diet and their daily habits can be a factor in which tablet suits them best. It can be wise to try different treatments until an effective treatment is determined, or the most effective is identified. Each treatment should be tried at least four times before it can be deemed effective or otherwise.

ED is often seen has having two sufferers - the man with the condition and their partner. That's because sexual partners can also feel negative effects as a result of the condition.

In order to provide the best support possible, it is important that partners do the necessary level of research to establish the cause of the ED,  to find out whether it is due to a  physical condition, psychological  or due to medication. . Not only will this improve the partner's understanding of ED, but it will allow them to become more empathetic to the man with the condition.

Partners should try and talk about the condition with the sufferer, as this can help alleviate some anxiety and let him know that you are ready to confront the condition as a partnership, rather than alone. As much open communication as possible can be key.

Partners of ED sufferers can also play an important role in leading them towards the treatment which they need - be it medicinal, physical or psychological. The partner can be a stable presence throughout the treatment programme itself. Following the treatment process, the partner can continue their supporting role, particularly in cases where sexual anxiety continues - this can play a crucial role in recovery over the long term.

Tadalafil, a generic form of Cialis, is seen by some as the best pill for ED. Not only does it offer a 36 hour time frame for effectiveness, but it is also typically cheaper to buy than branded products. Ultimately, however, the best pill can vary according to the individual. Tadalafil or Cialis are the only ones not affected by food.

Cialis is considered to be the strongest ED pill available in terms of time. It is recognised as being effective over a 36 hour time frame.

There are a number of oral medications available for ED sufferers with diabetes. These include Viagra, Sildenafil, Cialis, Tadalafil, Levitra and  Spedra. The most suitable of these treatments will vary according to the individual although there is some evidence to suggest that Levitra might be the best choice for diabetics.

If you are suffering from high blood pressure then it is very important that you visit your GP for treatment. If the condition or subsequent treatment causes ED, then there are a number treatments available. 

These include oral medications such as Viagra, Sildenafil, Cialis, Tadalafil,  Levitra and Spedra. The most effective treatment will vary from person to person.

The cheapest ED medication is usually generic Viagra, called Sildenafil.
The price of sildenafil offered by each pharmacy varies as each supplier decides on their own prices. Some pharmacies mark the product price up more than others.

At Webmed Pharmacy we choose to keep the prices as low as possible while still offering the best service with guaranteed next working day tracked delivery as standard.

We aim to offer our customers the best value with a discreet, fast delivery service so that that they return to us time and time again.

What is the best brand of sildenafil?

If purchased from a UK registered and regulated pharmacy, all brands of sildenafil will be genuine medication and have the same desired effect. The active ingredient in all of the brands is exactly the same but the other ingredients or ‘excipients’ that make up the bulk of the tablet may vary. Our Mylan brand of sildenafil is lactose free which is very important for those who have an intolerance or are allergic to lactose. The patient information leaflet supplied with each brand of sildenafil gives a full list of all the ingredients of each tablet.

Some medications given for benign prostatic hyperplasia (BPH), also known as an enlarged prostate, can cause ED. Decreased ejaculation can also be experienced. The medications given for BPH are called alpha blockers and include Tamsulosin, Doxazosin (Cardura),  Alfuzosin, Prazosin and Terazosin (Hytrin).

There are a range of non-medicinal treatment options for ED. These include physical treatments such as making lifestyle changes, stopping smoking, improving diet and increasing exercise. Psychological treatments such as counselling and couple therapy can also be effective.

All ED medication should not be taken more than once in 24 hours.

Tadalafil on-demand should only be taken every 36 hours.

Side effects that may be experienced:

• Runny or blocked nose
• Dizziness
• Headache
• Facial flushing
• Indigestion
• Blurred vision or sensitivity to light

It’s a very rare side effect, but if you have a prolonged erection for more than 4 hours then you need to contact your doctor immediately.

Interactions :-

• Nitrates interact very adversely with all phosphodiesterase type 5 inhibitors like Spedra, Viagra, Cialis, Levitra and sildenafil. They can cause a FATAL lowering of blood pressure and should NEVER be used together.

Nitrates include medications like GTN spray, isosorbide mononitrate or nicorandil for angina. Also, the recreational drugs called "poppers" should be avoided.

We include a Patient Information Leaflet (PIL) with each medication that has a full list of potential side effects.

ED medication is typically taken in advance of sexual activity. Medications normally take from 15 to 60 minutes to take effect. Alternatively, those who wish to engage in more regular sexual activity (twice or more a week) can take daily tablets such as Cialis Daily or Tadalafil Daily.

It is recommended that each form of ED medication is taken at least eight times before it is deemed to be effective or otherwise. The effectiveness of any medication will vary according to the individual, so it is advised that you try the range of ED medicines available in order to find the most suitable one for you.

Erections which last for over a four-hour period - known as a priapism - risk causing long term damage to the penis and require urgent medical attention. This is a very rare side effect.

ED treatments are not considered to be addictive, although they can result in psychological dependence where men with performance anxiety come to rely on them.

Erectile dysfunction or ED is also referred to as male impotence, which refers to the inability to achieve or maintain a firm enough erection for satisfactory sexual activity.

ED is a common condition in men over 40, although it can occur at any age. Older men are more likely to develop the physical conditions which can cause ED.

ED doesn't have to be permanent. The most important thing is to identify the cause and then get the right treatment.

ED can be experienced intermittently and can be related to the efficiency of blood flow which typically improves with treatment. ED can sometimes come back without warning, after its symptoms appear to have gone.

The first line treatment for ED is the PDE5 inhibitor medications Viagra, Sildenafil, Cialis, Tadalafil, Levitra and Spedra. They are all recognised as being  effective in treating the condition in the majority of cases.

ED does not typically require counselling and surgery, although forms of psychological treatment such as counselling can help address the problem if the ED is caused by anxiety or depression. Surgery can help in cases where physical defects can be corrected. 

Yes. There are a wide range of ED treatments available online from Webmed Pharmacy. They are all prescription only medicines except for Viagra Connect.

Your prescription is issued by our GMC registered doctor and dispensed from our UK registered pharmacy. So, you can be sure of receiving genuine medication.

At Webmed pharmacy our doctor issues you a prescription electronically that is sent straight to our pharmacy where we dispense it and deliver it to your chosen address. Therefore, you don’t need to visit your GP and can order in the comfort of your own home.

Any websites which sell ED pills in the UK should be registered with the Care Quality Commission (CQC). Medicines must originate from a pharmacy which is GPhC-registered. Choose a trusted website such as Webmed Pharmacy which is fully compliant with guidelines set out by regulatory bodies in the UK.

On all fully approved and regulated websites you should be able to click on a link that will take you to the CQC register.

We would advise anyone obtaining medicines from an online pharmacy to check if the website is legitimately registered by looking for the General Pharmaceutical Council, GPhC, voluntary logo and the mandatory EU common logo.  We would then recommend that you click on each logo which should take you through to that particular pharmacy’s entry on the GPhC register and the Medicines and Healthcare products Regulatory Agency (MHRA) register.

The common logo for legally operating online pharmacies/retailers in the EU Member States was introduced by Directive 2011/62/EU (the Falsified Medicines Directive) as one of the measures to fight against falsified medicines.

Therefore, since 1st of July 2015, all online pharmacies or retailers of medicines, legally operating in the EU have to display the following logo:-

How does the logo work?

The logo links to the website of the national competent authority listing all legally operating online pharmacies/retailers. National websites are listed with the European Medicines Agency. By simply clicking on the logo a purchaser of the medicines online will be sent to the entry of the pharmacy on that national list, thus completing the verification process.

The logo can be trusted only if a purchaser, after clicking, is redirected to the entry of that pharmacy on the list of legally operating on-line pharmacies and retailers registered in that Member State on the national authority web-page

Also, all pharmacies in Great Britain, including those providing internet services, must be registered with the GPhC and meet their standards for registered pharmacies.

The GPhC operates a voluntary internet pharmacy logo scheme to provide reassurance to patients and the public that they are purchasing medicines online from registered pharmacies who have to meet GPhC standards.

Therefore, anybody buying medicines from an online pharmacy can check if the pharmacy is legitimately registered by clicking on the logo or going directly to the GPhC website and searching their online register.

The EU common logo is a legal requirement across Europe that applies to all retailers of medicines whilst the GPhC voluntary logo is applicable only to UK registered pharmacies.

What other checks can be made?

You should be able to easily find the name and address of the pharmacy operating the website, as an online supplier who conceals its physical address is a warning sign that their products could be dangerous. The WHO estimates that 50 per cent of medicines available from such websites are counterfeit.

You should avoid websites which offer to supply prescription only medicines without a prescription as registered pharmacies are required to check that a medicine is suitable for a patient before selling it. Therefore, if you are not asked to provide information about your health before making a purchase then you would be wise to go elsewhere.

When you order any medication from our UK registered and regulated pharmacy you can be assured that you are doing so safely, legally and discreetly.

Read our blog - Are you buying fake medicines online?

Not at all. ED and infertility, the inability to produce good sperm,are not the same. 

While the predominant symptom of ED is failure to achieve an erection, in some cases men can still ejaculate, and achieve orgasm, with ED. ED can only affect fertility in men by preventing sexual intercourse due to the inability to achieve an erection.

If you identify the cause of your ED and get the right treatment then your  ability to be a father will not be affected. 

While there are cases in which premature ejaculation and ED are experienced concurrently, they are not related directly.

ED is linked to a number of physical and psychological problems. These include physical conditions such as heart disease, high blood pressure,  high cholesterol, diabetes, multiple sclerosis and Parkinson's disease Psychological and emotional problems  such as stress, anxiety and tiredness.

Hormonal problems due to abnormal thyroid levels or low testosterone.

Lifestyle causes, obseity and drinking too much alcohol.

Side effects of prescribed medicines.

While condoms can make arousal more difficult, there is no link between wearing condoms and ED.

It’s best to avoid drinking alcohol when taking sildenafil. If you do choose to drink, then you should limit the quantity to one or two units as alcohol can reduce the effectiveness of sildenafil. Also, as both alcohol and sildenafil can lower blood pressure you may find that you feel dizzy and ruin your enjoyment of the experience.

We will send your order in discreet packaging with no mention of the contents or who it’s from.

Your order will be delivered by guaranteed fast next working day delivery in a 1 hour time slot to all mainland UK.

You can track the progress of your parcel “live” down to a 15 minute window or you can divert it to one of our 2,500 pickup shops.

This is a picture of how your order will be delivered to you.

For the Scottish Highlands and Islands (see post codes in the delivery & postage section), Northern Ireland, Scilly Isles and Isle of Man we use Royal Mail Special Delivery Guaranteed by 1pm the next working day.

In some of the more remote locations it may take 2 – 3 days, but the vast majority will be next day, please see list below for the full details. Again, this is all included – no hidden extra costs.

Sildenafil is available on the NHS to those who meet very strict eligibility criteria and then only in limited amounts. If you meet the criteria you may still wish to buy extra if you find that you are not being prescribed a sufficient quantity.

No. You should never take two types of ED medication at the same time as it could lead to a dangerous overdose.

If you start with the recommended dose of 50mg sildenafil and find that it’s still not effective after several attempts then you can try 100mg the next time.

If you wish to try a different strength of sildenafil or another type of ED medication then you should wait at least 24 hours after taking sildenafil, Levitra or Spedra and 36 hours after taking Cialis. You have to wait longer after taking Cialis as it has a much longer duration of action than the others and will be in your bloodstream for much longer.

Viagra was the original ‘blue pill’ for erectile dysfunction, made by Pfizer. When it’s patent expired in 2013 other drug manufacturers could make it under the generic name, Sildenafil.

It’s medically identical to Viagra and has exactly the same effects and side-effects. Viagra is simply a branded form of sildenafil and like most branded products, it comes at a premium price. Sildenafil is much better value for money.

Since Pfizer’s patent expired, other drug companies have been able to manufacture generic Sildenafil. There are many companies that make generic medicines to be marketed it the UK. These companies include Mylan, Sandoz, Accord, Teva, Torrent, Ajanta, Dr Reddy’s and Zentiva. Even Pfizer make a generic brand of sildenafil that is cheaper than Viagra but more expensive than other generic equivalents. The tablets may differ in size, shape and colour but they are all medically very similar.