Getting Started on Medicine for Erectile Dysfunction (ED)

Written by Adrian Blackwell, MD

Common questions, answered!

I have erectile dysfunction (ED) and premature ejaculation (PE), will ED medicine help both?

There may be other medicines and non-medical treatments that will work better for premature ejaculation, aka, finishing too soon. However, some men find that these medications do help with PE as well. We encourage you to follow up with your local doctor if you would like different treatment for PE specifically.

How long should my erection last after taking ED medicine?

On average, when using a sufficient dose of ED medicine, men are able to have an erection lasting about 30 minutes after they are sexually stimulated. With any dose of ED medications it is normal for it to take an hour to work. You should then be able to achieve an erection that is satisfying for sex. Once you ejaculate, the erection should not continue.

keep calm

What is a refractory period?

The “refractory period” basically refers to the amount of time you must wait before you can achieve a second (or third, etc.) orgasm after an initial orgasm. After someone with a penis ejaculates via orgasm, the refractory period is like a ‘cooling off’ period. It typically lasts a few minutes (but can last up to a few days), and it is impossible for a man to have another orgasm during this time.

Generally, the younger you are, the shorter your refractory period will last. Eighteen-year-olds average about 15 minutes, and 70-year-olds can average up to 20 hours, and the overall average is about 30 minutes. Some people can get aroused again during this time, but still won’t be able to orgasm. However, for some, further stimulation of the penis does not result in arousal and is uncomfortable.

The bottom line: it’s totally normal if your body needs some time between orgasms. Whatever the refractory period means for you, don’t worry—it’s expected; whether it takes you hours to be ready for sexual activity again, or whether you’re ready to go again right away - it’s normal. As always, if you’re worried about your performance, don’t hesitate to talk to your doctor!

Should I eat something with my ED medicine? Can I drink alcohol with my ED medicine? What if my dose of ED medicine doesn't work?

It is important to take this medicine the right way. There are several things you can do to help ED medicines work better.

Always take this medicine on an empty stomach. Food blocks your body’s ability to absorb ED medicine - especially foods that have fat in them. If you have a fatty meal (think fried foods, ice creams, steaks, etc) then you can delay the absorption of this medicine for hours - which will make it seem like it is not working. If you are not having an erection that is satisfying for sex while taking this medicine, make sure to take the medicine on an empty stomach and without alcohol in your system. Alcohol makes ED problems worse. So try to cut back on alcohol and do not mix it with your ED medicines.

Try the dose you were prescribed on 4-5 different days/occasions. Take it 30 minutes to 1 hour prior to anticipated sexual activity. You should have a total of a 3-4 hour window for sexual activity before your body begins to break this medicine down. If the dose is still not working, contact your medical provider.

Should I get my testosterone and other hormones checked?

We recommend that you speak with your primary care provider about your issues with ED or PE. Although it is possible that your issues may be solely psychological, it is also possible that there are underlying medical issues as well. Medical conditions could include low testosterone, thyroid issues, diabetes, and/or blood flow issues. For this reason, we strongly encourage anyone who is having issues with ED or PE to speak with their personal physician to have a workup done. Often, correcting underlying medical conditions, will reverse the ED issues as well!

I like to have sex more than three times per week, should I be on ED medicine every day?

If you have intercourse more than 3 times per week, we could recommend Cialis/tadalafil for daily use. Viagra/sildenafil are medications that are not intended to be taken on an everyday basis. For this reason, you may want to consider daily Cialis/tadalafil. This pill can be taken once per day at any time. It allows for more spontaneity in sexual encounters as it doesn’t need to be taken 1 hour prior to intercourse.

Can I get addicted to ED medicine? Will I have to take this forever?

No, ED medications are not addictive medications. It is our hope that you will not need to take ED medications long term. We encourage you to speak with your local health care provider about your issues with ED as there may be an underlying medical condition causing the condition. Often, reversing the underlying medical condition can fix the issues with ED.

Will ED medicine cure my ED?

No , ED medications will not cure your ED - however, it will assist you in getting an erection. ED issues can sometimes be caused by medical conditions - which include but are not limited to low testosterone, thyroid problems, diabetes, and blood flow issues. If there is an underlying medical condition that is causing your ED, this needs to be investigated and corrected. Often correcting underlying medical conditions will resolve ED issues. For this reason, we strongly suggest that you speak with your local physician about your issues with ED.

Will ED medicine help me feel better about myself? Will I perform better with ED medicines?

Erectile dysfunction involves more than a problem with the blood flow in the penis. For most men this is a mental and emotional issue too. Erectile dysfunction can cause anxiety, depression, and difficulties in relationships over failed sexual encounters. The reverse is also true - having a lot of anxiety and concern about your ability to perform sexually and achieve an erection will often cause erectile dysfunction. It is important to discuss your concerns and these details with your health care provider. Sometimes you need to talk to a qualified therapist and/or doctor about this problem and work through some of these concerns and anxieties.

The views expressed in this article intend to highlight alternative studies and induce conversation. They are the views of the author and do not necessarily represent the views of HeyDoctor, and are for informational purposes only, even if and to the extent that this article features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice.

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