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Erectile dysfunction (ED) is very common. Fortunately, it’s also very treatable. These days, the question isn’t whether you can treat your ED, but what the best ED treatment is for you.
There are many treatment options, and ED pills are among the most common. They’re popular because they work, they’re safe, and they’re non-invasive. The most common ED medications available are:
Which of those ED medications is the most effective?
The short answer is that none of them are clearly better than the others. While most men (and their partners) prefer as-needed tadalafil over the other options, they’re all equally safe and similarly effective. The best one for you depends on your preferences and lifestyle.
In this article, we go in-depth into the differences between these three ED medications and explain their advantages and disadvantages.
To understand the differences between ED medications, we have to understand a bit about how erectile dysfunction happens and how the medications work. So, here’s a super brief biology lesson.
An erection happens when the penis fills with blood. A man sees something sexual and the brain sends a signal to the penis along his nerves. The signal tells tissue in the penis to do several things including sending out nitric oxide. The nitric oxide dilates the blood vessels and lets blood flow in.
Because achieving an erection is a fairly complex process, a number of things can go wrong. Psychological issues, performance anxiety, or nerve damage can interfere with the brain sending signals to the penis. Medical conditions and medications can interfere with adequate blood flow through the blood vessels. Lifestyle factors, drugs, alcohol, and tobacco use can all affect the process.
In short, there are a number of different causes of ED.
What do PDE5 inhibitors do?
Through several complex processes, they increase the amount of nitric oxide in the penis in response to sexual stimuli. With more nitric oxide, the blood vessels open up more easily, letting more blood flow into the penis, and causing it to get (and stay) hard.
The result? It’s easier to get and maintain an erection.
Note: These medications do not have any effect on sexual desire (libido). Rather, they work only in the context of sexual arousal.
PDE5 medications for ED are generally effective—they help improve the ability to get and maintain an erection for most of the men that experience it. But each of the treatment options has different characteristics, advantages, and disadvantages. The choice of medication is best made on the basis of patient preferences, cost, side effects, and desired duration of action.
In this section, we’ll look at which one might be the most appropriate in different situations.
Some research suggests that tadalafil daily is the most effective of the three. Note that it is not _significantly _more effective than sildenafil or as-needed tadalafil—just a little bit more effective.
Here are the details:
Together, tadalafil daily has a slight edge in terms of effectiveness. But, again, all of them are effective.
Tadalafil is stronger than sildenafil—that’s why it’s usually given in smaller doses. You can get a similar effect with less tadalafil than you can with sildenafil.
To illustrate, here are typical dose strengths for each of the three medications:
Tadalafil lasts significantly longer than sildenafil. Sildenafil typically lasts for about 4 hours whereas as-needed tadalafil lasts about 36 hours. Note that a short-acting agent is the safer option for men at risk of low blood pressure.
When you use daily tadalafil, it will continue to work until you stop taking it. Daily dosing is beneficial for men who desire more freedom in timing their sexual activity.
Tadalafil begins to work faster than sildenafil. Tadalafil kicks in about 30 minutes after taking it, whereas sildenafil takes about an hour.
(Again, tadalafil daily works continuously, so you don’t need to plan how long it takes to start working.)
Sildenafil is the cheapest per dose. For most guys, it’s probably the cheapest ED medication option.
However, the price of each option depends on usage. Sildenafil only lasts four hours whereas tadalafil lasts for 36 hours. If you used sildenafil three times in a 36 hour period, you would be spending more for sildenafil than you would with tadalafil.
Similarly, you purchase tadalafil daily pills for the entire month. For many guys, it may be a little more expensive than as-needed tadalafil or sildenafil. But for guys that would use tadalafil or sildenafil a lot, daily tadalafil could actually be cheaper.
In other words, there’s no clear “cheapest” option. The relative cost of each treatment depends on how patients use them.
These ED medications have similar safety profiles and side effects. That’s not a surprise, since they work in the same way and have similar effects on the body. The main side effects of PDE5 inhibitors are:
Note that each of these medications can result (although rarely) in a condition called “priapism” which is a prolonged erection of the penis. The erection lasts for hours in the absence of sexual stimulation and can be painful. Priapism is a medical emergency and can result in permanent damage; seek medical attention immediately if you experience it.
Note that you need a prescription to buy ED medications in Canada.
At Essential Clinic, you can get evaluated and obtain a prescription online. Our medical professionals are qualified to evaluate your symptoms and provide prescriptions for ED medications in Canada. If you are approved, you can buy the medications immediately and have them shipped discreetly to your door.
Note: Never buy ED pills from websites that do not ask for a prescription. These websites are illegal and often sell fake medications which may be made with harmful chemicals. The safest option is to get a prescription from a legitimate clinic.
Currently, no ED medication has been shown to be better than the others overall. It comes down to personal preferences.
Here’s a high-level summary of each of the three most common medications—tadalafil daily, tadalafil as-needed, and sildenafil:
In our experience, most guys prefer as-needed tadalafil. They like it because it can potentially work faster than sildenafil, it lasts longer, and you don’t have to worry about whether you take it with food. Overall, many men find it more convenient.
To find the right ED medication for you, consult with a qualified medical professional. Start your online visit right now.
Bansal, U. K., Jones, C., Fuller, T. W., Wessel, C., & Jackman, S. V. (2018). The efficacy of tadalafil daily vs on demand in the treatment of erectile dysfunction: a systematic review and meta-analysis. Urology, 112, 6-11
Doggrell, S. A. (2005). Comparison of clinical trials with sildenafil, vardenafil and tadalafil in erectile dysfunction. Expert Opinion on Pharmacotherapy, 6(1), 75-84.
Fink, H. A., Mac Donald, R., Rutks, I. R., Nelson, D. B., & Wilt, T. J. (2002). Sildenafil for male erectile dysfunction: a systematic review and meta-analysis. Archives of Internal Medicine, 162(12), 1349-1360.
McMahon, C. (2004). ED: Efficacy and Safety of Daily Tadalafil in Men with Erectile Dysfunction Previously Unresponsive to On‐demand Tadalafil. The Journal of Sexual Medicine, 1(3), 292-300.
Rajfer, J., Aliotta, P. J., Steidle, C. P., Fitch, W. 3., Zhao, Y., & Yu, A. (2007). Tadalafil dosed once a day in men with erectile dysfunction: a randomized, double-blind, placebo-controlled study in the US. International Journal of Impotence Research, 19(1), 95-103.
Skoumal, R., Chen, J., Kula, K., Breza, J., Calomfirescu, N., Basson, B. R., & Kopernicky, V. (2004). Efficacy and treatment satisfaction with on-demand Tadalafil (Cialis®) in men with erectile dysfunction. European Urology, 46(3), 362-369.
This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.