What to do if your ED medication isn’t working

Erectile dysfunction (ED) medication may not work for everyone, but don't give up just yet.

Updated: Thursday 15 April 2021

using ed medication

Like with any medication, erectile dysfunction (ED) medication may not work for everyone that takes them. Your doctor will usually explain exactly how to use it, what to expect taking it and the side effects associated with it but you need to have tried it on a number of attempts in order to see results.

Don’t completely abandon the ED medication if you feel it hasn’t worked for you, but take the time out and understand the various options available and learn how they work and decide whether you want to give the medications another try or move onto alternative treatments.

How do ED medications work?

Erectile dysfunction, sometimes known as impotence, is the inability for men to achieve and maintain an erection firm enough to have sexual intercourse.

When a max is aroused, a chemical from the brain to allow more blood flow into the penis which results in an erection. The phosphodiesterase type 5 (PDE-5) enzyme constricts the blood vessels, returning the penis to its normal size. In men without ED, there is a harmony between erections and the PDE-5 enzyme where erections will last long enough for sexual activity.

The active ingredient in the ED medications are PDE-5 inhibitors which work by relaxing the muscles, thereby allowing an increase in blood flow to the penis to help achieve and maintain an erection. As well as this, the man is required to be sexually stimulated in order for the drug to work.

Most ED medications take around 30-60 minutes to work, except Spedra which fast acting as it usually takes between 15-30 minutes. The duration of each drug will also vary.

  • Sildenafil or Viagra is effective for up to 4 hours.
  • Tadalafil or Cialis is effective for up to 36 hours. This is also the longest lasting ED medication.

Generally, you are meant to allow time for the medication to work, so it is best to take it an hour before you plan to have sexual intercourse.

Common Mistakes

Before you decide to seek alternative treatment, ask yourself whether you are taking the medication as prescribed. Many men fail to achieve results they expect because they have either not read the instructions or ignored their doctor’s advice.

Here are some common mistakes men make when they take ED medication:

  1. Expecting a miracle - For the drugs to work, you also need to be sexually stimulated as well. The drugs are meant to increase the blood flow to the penis and are not aphrodisiacs so without proper arousal, the drug will not work effectively.
  2. Taking the wrong dose – Not all men prefer taking medication, so it may be tempting to start at the lowest dose. The reality of this is that if you are not taking the right dose then the medication won’t work properly. You should speak with your doctor to find the right dosage for you.
  3. Eating a heavy meal - If you have just eaten a large and heavy meal containing fat, this will delay the absorption of the ED medication, so it is advised that the ED drugs, such as sildenafil, tadalafil, vardenafil and avanafil are taken on an empty stomach. Wait at least 2 to 3 hours after eating before taking any ED medication.
  4. Not waiting – These aren’t magical pills which will give you an erection instantly, it takes time for it to work. Generally, it is best to wait around 60 minutes before engaging in sexual activity, but for tadalafil it is best to wait 2-3 hours after consumption.
  5. Giving up too quickly – Many men think that if it doesn’t work the first time, it won’t work at all. Don’t feel discouraged if it doesn’t work the first time as it is advised that you use any ED medication at least six times before consulting with your doctor to change the dosage or use a completely different treatment.
  6. Not trying alternatives – All individual responds differently to medications and it’s no different with ED medications. What might work for one individual may not for the other. If one has not worked for you, try another one.

Are you making any of these mistakes? If you aren’t and you are still not experiencing a suitable erection then it might be worth consulting with your doctor to find a treatment that is suitable for you.

Other ED Options

  • Penis Pump
    A penis pump, or vacuum pump is used as a non-medical treatment for ED. The pump is placed over the penis and the pump sucks air out of the cylinder, creating pressure which increases the blood flow to the penis. Once an erection has formed, a ring is placed at the base of the penis to help maintain the erection for sexual activity and the pump is removed.
  • Alprostadil Self-Injection
    Another option is to inject the drug into the penis when oral medications don’t work. Alprostadil (brand names Caverject and Edex) is injected into the base of the penis, allowing blood flow to increase as the blood vessels and penile muscles have relaxed, causing an erection. It works in 5-10 minutes after it has been injected and can maintain an erection for up to an hour. The injection should only be used 3 times per week and no more than one injection should be used in a day.
  • Alprostadil Urethra Suppository
    The alprostadil suppository is another option if you don’t prefer needles. The suppository is placed inside the penis in the urethra using a special applicator and the drug is absorbed within the urethral wall. The erection will take approximately 10 minutes to occur and the effects can last up to one hour. It can be used twice a day, but no more than 7 times per week.
  • Penis Implants
    Penis implants are usually recommended if all other erectile dysfunction treatments have failed or if you weren’t eligible for treatment using the other methods. It is a surgical treatment where the implants are inserted inside the penis to allow men to achieve an erection. There are three different type of implants, which work differently and have different benefits and risks.
  • Pleasure enhancement
    Some research suggests that erectile dysfunction can be a function of not being in the right mindset for sex. Arousal levels can be impacted by work-related stress, relationship issues, and similar psychological causes of erectile dysfunction. One way to address this is by using ED toys to enhance pleasure in the bedroom, which researchers have found to increase sexual satisfaction among some men. Additionally, if you're looking to explore new ways to please your partner, we found some options here that can add an exciting dimension to your intimate moments.


Your lifestyle could actually be the underlying cause of your ED. Some of the physical causes of ED include, high blood pressure, high cholesterol, obesity, smoking and alcohol. Small changes in your lifestyle could help with your ED.

  • Eating healthy – Incorporating a diet made up of fruit and vegetables, lean proteins, grains and healthy fats is likely to improve erectile problems. Circulation will improve, which is key for the ability to achieve and maintain an erection and the risk of developing high blood pressure, high cholesterol or being overweight and obese will lower.
  • Exercising – Regular exercise will improve your overall cardiovascular health and it is good for the circulatory system as it keeps the blood flowing smoothly throughout the body which is important for achieving an erection. Not only does exercising help with circulation, it also keeps weight under control, reducing the risk of being overweight or obese, a common cause for ED. Try exercising 30 minutes, 5 times a week to start off with.
  • Quit smoking – The nicotine in cigarettes restricts the blood flow in the body which also means less blood flow into the penis. Quitting smoking is likely to improve your ED and overall health.
  • Reduce your alcohol consumption – Limiting or stopping drinking altogether will improve your ED. Alcohol is known to reduce libido and long-term alcohol abuse can cause damage to the nerves in the penis.

Toby Watson

Written by: Toby Watson

Pharmica Medical Writer

Toby (BSc) is an experienced medical writer, producing educational articles on many areas of health including sexual health, fitness, nutrition and mental health.

He particularly enjoys debunking misconceptions around heath conditions and their treatments, researching each topic in detail and writing easily-accessible content.

Find out more about how we ensure the accuracy of our content with our content guidelines.

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