Erectile dysfunction

Does ED always need treatment?

No. Sometimes making lifestyle adjustments can make it go away. If you drink a lot of alcohol, smoke cigarettes, or take recreational drugs, curbing these habits can help with erections.

Being overweight can be a factor in ED too, so eating a healthy diet and exercising more is a good solution as well.

You might get erectile dysfunction if you’re anxious about sex. And talking to someone about it, whether it’s your partner, a friend or a therapist, can make all the difference. If you find that having conversations about it doesn’t help though, medication may be recommended.

Which erectile dysfunction pills are best?

It’s down to personal choice on your part really, and your health background.

Viagra is a household name and has been around the longest, and some would argue it’s the most successful treatment for ED.

The generic, Sildenafil, is less expensive, but has the same active ingredient in it, and functions in the same way in the body.

The benefit of Cialis is that you only have to take one and it stays active for up to 36 hours (other ED drugs average about 4 or 5 hours).

There’s also a smaller dose version of this designed to be taken every day, called Cialis Daily. With the everyday version, you’re ‘ready to go’ all the time, and you don’t have to wait around for the drug to take effect (it takes half an hour to an hour for most others). Tadalafil (generic Cialis), is cheaper and works in exactly the same way.

As well as being a licensed treatment for ED, Tadalafil is an approved option for BPH (or benign prostatic hyperplasia) which is when you have an enlarged prostate. So if you experience BPH and ED, Tadalafil can treat both conditions.^[1]

Spedra is an on-demand treatment that starts to work from 15 minutes after you take it. It’s a good option for men who want a quick-acting drug, but don’t want to take something every day.

And then there’s Levitra, which is said to be better for older men or men with pre-existing conditions, like high blood pressure or diabetes.

Erectile dysfunction creams

If you can’t take ED tablets because of their side effects or due to an existing health condition, or if you’d just prefer not to use them, there is a prescription cream available too called Vitaros.

You apply this cream to the opening of your urethra (the opening at the tip of your penis) and the active ingredient in it, alprostadil, helps to widen the blood vessels in your penis. Once the blood vessels are more dilated, more blood can flow into your penis, and this allows you to get an erection.

So using ED creams is a bit different to taking ED tablets. But Vitaros is faster acting than ED tablets (effective within 5-10 minutes of use, rather than between quarter of an hour and an hour). From a spontaneity point of view then, it’s a pretty strong option.

What about MUSE?

MUSE is a ‘urethral suppository’ – basically a very small pellet you insert into the opening at the end. You can use MUSE up to seven times in seven days, so there’s quite a lot of flexibility with it.

On that basis, if you’re looking to have sex frequently, MUSE might be one of the better options for you.

Applying the pellet takes a bit of getting used to. But because it’s a locally acting treatment, it works faster than pills – usually within 10 minutes of application.

Injections for erectile dysfunction

Another prescription medication for ED is injections. You may find that tablets or creams aren’t the right treatments for you, or that your body doesn’t tolerate them. Like Vitaros and MUSE, ED injections such as Alprostadil and Viridal Duo kick in very quickly (within five minutes) and they contain the same active ingredient (alprostadil) so if you’re looking for fast results, injections can give you that. Alprostadil injections used to be available under the brand Caverject, but Caverject was discontinued in 2025 and replaced with generic Alprostadil.

You inject these medications into the penis directly, and you don’t need to be aroused in the first place for them to take effect. If you’ve not used them before though, you should see your clinician or a pharmacist prescriber in the first instance, as they will need to show you how to do it.

You shouldn’t use injections any more than three times a week (and not more than once over any 24 hour period). If you find that the dose you’re on isn’t working the way you want it to, drop our clinician a message, and they can look into adjusting your dose with you.

Can you get erectile dysfunction pills over the counter?

Most are prescription only. The only licensed prescription-free ED treatments are Viagra Connect, Aronix and Liberize – all of which contain 50mg of sildenafil (then drug found in Viagra). As pharmacy medicines though, you’ll still need to have a consultation with a pharmacist before they can be given to you.