Everything You Need to Know to Treat Erectile Dysfunction (2025)

Erectile dysfunction (ED), also known as impotence, is a condition where a man finds it difficult to achieve or maintain an erection.

While ED is a common condition that affects up to 55% of men^[1] between the ages of 40 and 70, there are numerous ways to treat erectile dysfunction, including the use of ED pills that block certain enzymes in the body to increase blood flow to the penis.

Certain lifestyle adjustments can also be implemented alongside the use of ED treatments to help manage the condition.

This guide comprehensively discusses how to treat erectile dysfunction using clinically proven medication and discusses the science behind lifestyle modifications that can help prevent erectile dysfunction.

Why does erectile dysfunction (ED) occur?

Erectile dysfunction occurs due to one or more physical or psychological factors that affect the biological processes involved in getting an erection.

The physical causes of erectile dysfunction refer to factors that affect a man’s physiology, such that they are unable to achieve an erection.

In contrast, the psychological causes of erectile dysfunction refer to mental or emotional factors, such as stress, anxiety, depression or relationship concerns, that can interfere with the ability to achieve or maintain an erection even when a physical function is otherwise normal.

What type of medicine is used to treat erectile dysfunction?

Erectile dysfunction is typically treated using a class of medication known as PDE-5 inhibitors, which inhibit an enzyme known as PDE-5 to ensure sufficient blood flow to the penis for an erection following arousal.

Normally, sexual arousal triggers the release of nitric oxide, a compound that increases the body’s levels of a molecule known as cyclic guanosine monophosphate (cGMP). cGMP regulates the contraction and relaxation of smooth muscles, including those in the penis, leading to the dilation of blood vessels in the penis, resulting in an erection.

After ejaculation, cGMP is broken down by the PDE-5 enzyme. This causes the smooth muscles in the blood vessels to contract, reducing blood flow to the penis and causing it to return to a flaccid state.

Erectile dysfunction occurs when the PDE-5 enzyme breaks down cGMP too soon, preventing the blood vessels in the penis from staying relaxed long enough to maintain blood flow in the penis for an erection.

PDE-5 inhibitors prevent the early breakdown of cGMP, allowing sufficient blood flow to the penis for an extended period to help sustain an erection.

It is important to note that PDE-5 inhibitors should only be used after consulting with a pharmacist or GP. Do not take more than one tablet of any ED medication within 24 hours and do not take a mix of more than one brand/type of PDE-5 inhibitor on the same day.

What are the most popular medicines to treat erectile dysfunction?

Sildenafil

Sildenafil contains the active ingredient ‘sildenafil citrate’, which treats erectile dysfunction by inhibiting the PDE-5 enzyme responsible for breaking down cGMP. This mechanism ensures sufficient cGMP levels remain in the body to facilitate the contraction and relaxation of smooth muscles in the blood vessels of the penis, enabling the individual to achieve and sustain an erection.

Sildenafil is available in three doses - 25mg, 50mg and 100mg. Sildenafil 50mg is recommended as the starting dose to treat erectile dysfunction. If the individual experiences side effects from taking Sildenafil 50mg, then the 25mg dose can be trialled. Conversely, if Sildenafil 50mg does not have the desired effect, then the 100mg dose can be trialled.

For more information, watch our video guide to Sildenafil in which our patient care expert discusses how Sildenafil treats erectile dysfunction.

Viagra

Viagra is medically identical to Sildenafil, which means there is no difference between Viagra and Sildenafil when it comes to treating erectile dysfunction, other than the fact that Sildenafil is cheaper as it is a generic medication, while Viagra is expensive as it is a branded medication.

The manufacturers of generic erectile dysfunction treatments such as Sildenafil are carefully vetted by the UK Medicines and Healthcare Regulatory Agency to ensure their products offer the same quality, strength, stability and effectiveness as branded ED treatments.

Recommended reading: Everything You Need to Know about the Blue Pill (Viagra)

Viagra Connect

Viagra Connect is an over-the-counter version of Sildenafil and Viagra that can be purchased without a subscription.

Viagra Connect contains 50mg of the active ingredient ‘sildenafil citrate’, which inhibits the PDE-5 enzyme to help treat erectile dysfunction in the same way as Sildenafil, Viagra and Viagra Connect.

Tadalafil

Tadalafil contains the active ingredient ‘tadalafil’, which treats erectile dysfunction by inhibiting the PDE-5 enzyme to prevent the breakdown of the cGMP molecule in the body, allowing sufficient blood flow to the penis for an erection.

In comparison with other ED medications, Tadalafil can be used to treat erectile dysfunction for up to 36 hours, as the half-life of tadalafil is 17.5 hours. This means it takes 17.5 hours for the concentration of tadalafil in the bloodstream to halve.

Tadalafil is available in four doses:

• Tadalafil 2.5mg and 5mg, also known as ‘Tadalafil daily’, are formulated to be taken daily, enabling the individual to remain ready for sexual activity at any time.
• Tadalafil 10mg and 20mg, also known as ‘Tadalafil 36-hour’, are formulated to be taken half an hour before planned sexual activity.

Cialis

Cialis is the branded version of Tadalafil. Cialis and Tadalafil are medically identical to one another, which means they are equally effective at treating erectile dysfunction. However, Tadalafil is cheaper than Cialis as it is a generic ED medication.

For more information, watch our Video Guide to Cialis and read our expert guide comparing Cialis and Viagra.

Vardenafil

Vardenafil contains the PDE-5 inhibitor ‘vardenafil’, which prevents the breakdown of cGMP molecules to enable sufficient blood flow to the penis for an erection. Vardenafil is particularly effective at treating erectile dysfunction in diabetic men due to its molecular structure.

Vardenafil is available in three doses - 5mg, 10mg and 20mg. Vardenafil 10mg is recommended as the starting dose to treat erectile dysfunction. If the individual experiences side effects from taking Vardenafil 10mg, then the 5mg dose can be trialled. Conversely, if Vardenafil 10mg does not have the desired effect, then the 20mg dose can be trialled.

Levitra

Levitra is the branded version of Vardenafil. Levitra and Vardenafil are medically identical, which means they contain the same active ingredient (‘vardenafil’) and are equally effective at treating erectile dysfunction.

The only difference between Levitra and Vardenafil is the fact Levitra is more expensive than Vardenafil, given it is a branded ED treatment.

Spedra

Spedra contains the active ingredient ‘avanafil’, which treats erectile dysfunction by blocking the PDE-5 enzyme responsible for breaking down the cGMP molecule that causes the smooth muscle in the penis to relax.

Spedra treats erectile dysfunction faster than other PDE-5 inhibitors, as it takes 15 to 30 minutes for its active ingredient to take effect. In contrast, other ED treatments such as Sildenafil and Tadalafil take at least 30 minutes to take effect.

Spedra is available in three doses - 50mg, 100mg and 200mg. Spedra 100mg is recommended as the starting dose to treat erectile dysfunction. If the individual experiences side effects from taking Spedra 100mg, then the 50mg dose can be trialled. Conversely, if Spedra 100mg does not have the desired effect, then the 200mg dose can be trialled.

VaxAid Deluxe

VaxAid Deluxe is a non-invasive vacuum pump treatment for erectile dysfunction that forms a seal around the pelvic seat to enhance blood flow along the entire length of the penis.

This promotes natural erections while preventing excessive negative pressure through the pump’s elastic recoil strength.

The device features a cycling action that allows users to achieve an erection gradually. Additionally, it is quick to apply and can be used in the shower or bath, providing convenience and seamless integration into daily routines.

Recommended reading: Which Erectile Dysfunction Treatment Is Best For Me?

Treating erectile dysfunction through lifestyle changes

Following a healthy diet

While dietary choices do not directly ‘treat’ erectile dysfunction, certain foods can support vascular health and potentially help prevent ED due to their positive effects on blood circulation^[3].

For instance, spinach is naturally rich in nitrates^[4], which the body converts into nitric oxide. Nitric oxide helps relax blood vessels, promoting vasodilation (the widening of blood vessels)^[5] and improving blood flow to the penis. Therefore, increasing one’s intake of spinach can contribute to preventing ED.

Similarly, certain compounds found in berries, particularly flavonoids, contribute to endothelial function^[6]. The endothelium is responsible for the health of the cells that line blood vessels, which is why the proper functioning of the endothelium aids blood circulation throughout the body, including to the genital area to prevent ED.

Exercising

Regular physical activity plays a critical role in reducing risk factors associated with ED, such as hypertension, cardiovascular disease and obesity. Incorporating lifestyle modifications alongside targeted exercises can help individuals support overall vascular health and erectile function.

In addition to general physical exercise, individuals can also consider targeted exercises that help strengthen the pelvic floor muscles, such as Kegel exercises^[7].

Kegel exercises involve tightening and relaxing the pelvic floor muscles, similar to the action undertaken to stop and start a flow of urine.

Evidence suggests that Kegel exercises help strengthen the muscles that support the pelvic organs, including the erectile tissue.

Strengthening the pelvic floor muscles can improve blood flow to the penis, enhance the ability to maintain an erection, and potentially reduce symptoms of erectile dysfunction.

To perform Kegel exercises, contract and hold the pelvic floor muscles for 3 to 5 seconds, then relax. Aim to repeat this sequence 10 times, completing several sets daily.

Kegel exercises are especially useful as they can be performed discreetly in various positions, such as lying down, seated, or standing, to maximise their benefits.

With consistent practice, improvements in erectile function may be noticeable within 4 to 6 weeks.

While these exercises do not offer the same level of efficacy as PDE-5 inhibitors, such as Sildenafil, they can serve as a valuable complementary practice alongside medical treatments.

Quitting smoking

Smoking products contain nicotine and other harmful chemicals that increase the build-up of plaque in the lining of the blood vessels, causing them to narrow (known as atherosclerosis^[8]).

This condition, known as atherosclerosis, impedes the normal flow of blood, which is essential for achieving and maintaining an erection.

While quitting smoking does not directly treat erectile dysfunction, it improves overall vascular activity, enhancing the body’s ability to pump blood effectively.

This subsequently ensures sufficient blood flow in the penis, reducing the probability of experiencing erectile dysfunction.

Moderating the intake of alcohol

Alcohol is a depressant that can interfere with the normal function of the nervous system and hormonal balance, reducing the effectiveness of the erectile response.

Alcohol enhances the activity of gamma-aminobutyric acid (GABA), a neurotransmitter that slows down brain activity and induces a calming, sedative effect.

While this can initially help you fall asleep faster, it disrupts the natural sleep cycle by reducing overall brain activity throughout the night, disrupting the natural sleep cycle.

Reducing alcohol intake supports healthier sleep patterns by minimising disruptions to deep and REM sleep, lowering the risk of sleep disorders often associated with ED.

These restful stages are crucial for hormone regulation, including testosterone production, and help maintain a stronger circulatory system for better overall sexual health.

Are there any natural remedies to treat erectile dysfunction?

There is no scientific evidence to suggest that natural remedies, such as herbal remedies, can treat erectile dysfunction.

Unlike clinically proven erectile dysfunction treatments, natural remedies lack the rigorous testing and regulatory oversight required to ensure their safety and effectiveness.

Key takeaways

The optimal way to treat erectile dysfunction is by taking PDE-5 inhibitors such as Sildenafil and Tadalafil, in addition to making lifestyle adjustments that address the physical and psychological causes of erectile dysfunction.

Our range of erectile dysfunction treatments at Pharmica includes all of the PDE-5 inhibitors we have discussed in this article - simply complete our free online consultation for ED treatment to determine treatment eligibility.

You can also contact our pharmacy team at no cost to obtain valuable medical advice on treating erectile dysfunction safely and effectively.