ERECTIONS ∙ 4 minute read

Erectile dysfunction medication isn’t working? Here’s why.

By Kirsty Mason | Medically reviewed by Mo Dekmak

Backed by years of research and scientific development, erectile dysfunction (ED) treatments have become a crucial element for male sexual health. There are several different medications to choose from - all of which have proven results. But what happens when ED medication isn’t working for you?

We caught up with our prescriber, Mo, to find out about the most common reasons why ED medication doesn’t work and what you can do to resolve the issue.

But first, let’s take a look at the mechanics behind ED medication.

How does erectile dysfunction treatment work?

At Numan, we provide five different erectile dysfunction medications:

All of these treatments are PDE5 inhibitors. They work by preventing the degradation of cGMP. Essentially, this means that the medication opens up the blood vessels and encourages blood flow to the penis. Blood flow is a critical element in the physiological process of getting an erection

And clinical trials have proven the effectiveness of this method of treatment…

In a large study on more than 8000 patients, 82% reported improvements in their erections after taking 100mg sildenafil.

Although this demonstrates a very high success rate, it shows how the treatment doesn’t always work for everyone. The question is: why?

Our prescriber, Mo, talks us through the 6 most common reasons why your ED medication isn’t working…

1. You’re taking it incorrectly

Each ED treatment should be taken in a specific way with certain expectations about the effect of the medication, as follows:

  • Sildenafil: Sildenafil is a tablet that should be taken one hour before you plan on having sex. The effects last for around four hours. This is your window of arousal. Sildenafil does not affect libido so you still need to be sexually aroused for the treatment to be effective. 
  • Effortless Erection Spray: To use Effortless Erection Spray, shake the bottle and spray on the back of your mouth, then swallow. Follow the clinician’s advice on how many times you should spray. The active ingredient in Effortless Erection Spray is sildenafil. It should take around an hour to become effective and should last for around four hours.
  • Tadalafil Daily: Tadalafil is a PDE5 inhibitor, which encourages more blood flow to the penis. This specific medication should be taken daily so that the effects are continuous. Many people choose Tadalafil Daily because it eliminates the need to plan sex within a specific time frame. The medication’s well suited to people who have sex regularly and prefer it to be less regimented. It takes around three to five days for the medication to build up and become effective. After this, the effects will be continuous.
  • Tadalafil: Tadalafil is effective in just 30 minutes and can last for up to 36 hours. The medication is much more tolerable with food when compared to sildenafil. 
  • Viagra Connect: Viagra Connect contains the active ingredient, sildenafil, and works as described above.

2. You’re eating a big meal beforehand

If you’re taking sildenafil (this is the active ingredient in Viagra Connect), you’re advised to wait a couple of hours after a large meal before taking the medication. Having a lot of food in your stomach will significantly increase the time that it takes for the medication to be absorbed. The delayed absorption could mean that the medication is ineffective at the desired time.

When it comes to food and ED medications, you should also be wary of grapefruit. The fruit contains a group of chemicals called furanocoumarins that affect the absorption of the medication. As a result, you might experience heightened side effects.

Tadalafil works slightly differently from sildenafil and can be taken with food. Tadalafil Daily is a low-dose medication that’s taken every day and is more suitable for people who prefer less regimented sex.

3. You’re drinking too much alcohol

Alcohol is infamous for the harm it does to erections. Cutting down on alcoholic drinks means that your body will be more naturally inclined to become erect when sexually aroused. Combined with ED medication, you have a better chance of success.

4. You’ve got a physical issue

Most ED treatments work by increasing blood flow to the penis, resulting in a stronger erection. But if you’re getting sexually aroused and taking the medication as directed, then you may have a physical condition that can’t be treated using a PDE5 inhibitor (such as sildenafil). 

Examples of physical conditions that cause ED include:

  • Nerve damage: Damage to the nerves can prevent the arteries around the penis from relaxing properly, inhibiting the ability to get an erection. Often, men who’ve had an invasive procedure such as prostate surgery find they experience ED as a result of damage to the nerves.
  • Hormonal imbalances: Low levels of testosterone (which is increasingly common as you age) can lead to erectile dysfunction as the hormone is associated with libido. ED medications do not act on arousal so if you’re not sexually aroused, medication won’t help an erection. Your thyroid function can also interfere with the hormones that support a healthy erection. To check your testosterone levels and thyroid function, you can take a blood test.

5. You’re not sexually aroused

Many people think that taking ED medication will instantaneously result in an erection. This is not the case. There’s a window of time where the medication will be effective. During this time, you must be sexually stimulated for the treatment to work. Without sexual arousal, you won’t achieve an erection, even while taking the medication.

When a man’s sexually aroused, the brain sends nerve signals that trigger the blood vessels surrounding the penis to relax and fill with blood. This stage (where the blood vessels relax and fill with blood), is where PDE5 inhibitors can help. Without any sexual stimulation, the first step for achieving an erection, where the brain sends nerve signals, isn’t triggered. As a result, the medication won’t encourage the physiological response in the body that leads to an erection.

There are various psychological reasons why you might be struggling to get an erection. For example, body image issues, relationship problems, anxiety, or depression.

If you’re having relationship problems, it’s important to speak to your partner. You can go to Relate for advice on sex and relationships. Charities such as Mind provide support for anyone struggling with anxiety or depression. You can also visit your local GP. For advice on how to approach sex with a happy, healthy mindset, head to Sexwise.

6. You need a higher dosage or different medication

If you’re not seeing results on your current ED medication, there are alternative treatments and dosages that may work better for you. Speak to our clinical team about increasing your dosage or trying an alternative medication. If you’re still not seeing results, you might be advised to take a blood test. This will help you to get to the bottom of what’s causing your ED and could help you find a treatment that works for you.

Fear Nothing Blood Test

Fear Nothing Blood Test

Know what your blood knows.

The numan take

Most ED medications are PDE5 inhibitors, although there are several alternatives. PDE5 inhibitors, such as sildenafil, prevent the breakdown of cGMP. This molecule plays an important role in stimulating an erection. With more cGMP in the body, the blood vessels surrounding the penis will be more relaxed, encouraging greater blood flow. ED medications don’t increase libido and you need to be sexually stimulated during the window in which the medication is effective to see results. If you’re taking the medication correctly and still not getting an erection after sexual arousal, then you may have a physical issue. Other common issues include eating a big meal beforehand or drinking too much alcohol.