When seeking treatment for erectile dysfunction (ED), you want to know all the facts. And you might be put off by rumours of neverending erections in inconvenient places.
Scrambling for cover for hours on end isn’t ideal, but will this actually happen?
Let’s separate fact from fiction.
Understanding erectile dysfunction
Erectile dysfunction is a prevalent issue. Approximately 42% of men in the UK reported ED in an online survey, with severe cases reported by 8% of participants.
One study found that over 152 million men worldwide had ED in 1995 whilst projections for 2025 show a prevalence of approximately 322 million, an increase of nearly 170 million.
Misinformation about ED and its treatments only adds fuel to the stigma. This prevents men from seeking the treatment they need to prevent ED and enhance their sex lives.
How ED medications really work
Firstly, let's get the facts straight. ED medications, such as sildenafil and tadalafil, are designed to induce erections in response to sexual stimulation. This is how they work:
Nitric oxide release: When a man is sexually stimulated, the release of nitric oxide (NO) occurs in the penis. Nitric oxide stimulates an enzyme called guanylate cyclase, which increases levels of cGMP.
Mechanism of action: Sildenafil and tadalafil belong to a class of medications called PDE5 inhibitors. PDE5 is an enzyme found in various tissues in the body, including the smooth muscles of the penis. This enzyme breaks down cGMP. By inhibiting the action PDE5, there’s more cGMP in the body.
Muscle relaxation: Increased levels of cGMP cause relaxation of the smooth muscles in the penis, leading to widening of blood vessels. This allows increased blood flow into the penis, resulting in an erection.
To put it simply, sexual arousal triggers the set of events which enable medications such as sildenafil and tadalafil to take effect. They do not work by inducing an instant erection.
The time a treatment works for (say 4 hours) refers to the time it will be effective, not the time you’ll be erect for.
But can ED medications cause constant erections?
A rare side effect of the medication, priapism, is a disorder in which the penis maintains a prolonged erection in the absence of appropriate stimulation. Definitions vary regarding duration, but any erection lasting four hours or longer is generally considered priapism.
However, this only happens in incredibly rare cases, with 1-5 in 100,000 incidences reported per year.
Managing expectations with ED treatments
Many people expect immediate results from ED treatments. An NHS hospital study found that if these expectations weren't met, it not only undermined confidence in the medication but also increased distress about erectile dysfunction.
While these treatments are designed to help the process of achieving an erection, it’s important to be realistic - ED treatments aren’t the cure for everything. It’s crucial to know what the medications can and cannot do.
For instance, sildenafil usually begins to work within 60 minutes of ingestion and can last up to 4 hours. Tadalafil, on the other hand, can take 30 minutes to kick in and stays active in the body for up to 36 hours, offering a longer window for spontaneity.
If you're not seeing results, it might not just be about the medication. Factors like low testosterone, stress, or depression could also be at play. Sometimes, incorporating mental health or relationship support can help solve the root of the problem.
Numan talks: Jonny & James
We spoke to Jonny and James, who shared their journeys with ED treatment:
Jonny: I always thought that ED treatment would give me an erection that would never stop. That’s not the case at all. Only when I spend intimate time with my partner do the effects kick in.
James: The way the treatment works where I’m ready at any time works so well for me. It doesn’t matter if I take it and then my partner isn’t in the mood. I just know that I’ll be ready if the moment arises.
The numan take
ED medications do not cause constant erections. This myth isn’t only untrue but also harmful - it prevents men from seeking the treatment they need and from addressing the health issues that ED may signify. Cut through the misinformation and make informed decisions about your health based on scientific understanding and medical advice.