When Viagra was released in 1998, erectile dysfunction (ED) was a condition that few men would dare mention. Thankfully in the years after, ED is now known to be a pretty common affliction, and the taboos the surround it have largely been dispelled.

Mild and moderate ED affects about 10 per cent of men per decade of life—that’s roughly 40 per cent of guys in their 40s, 50 per cent in their 50s, and so on. And as men age, they require more stimulation, more time between erections, and in many cases, a little help from the pharmacy. However, it does affect many younger men too.

The active ingredient in Viagra is sildenafil, which was developed in the early 1990s to treat cardiovascular disease, but dilating the heart’s blood vessels by blocking a protein called phosphodiesterase type 5, or PDE-5.

But in human trials, sildenafil caused an unexpected side effect: Dilating the blood vessels in the penis, not the hearts, and so the ‘little blue pill’ was born.

Following Viagra were three other PDE-5 inhibitors: Cialis, Levitra, and Stendra. While all three pills work in the same way, men often respond differently to the pills in different ways. Choosing between one or the otxher can be a matter of trials and error, so here is a guide to help you make the right choice for you.

Viagra (generic name Sildenafil)

Possibly the most well known ED brand name, Viagra, or sildenafil if you buy the generic version, should be taken an hour before sex, and on an empty stomach. It is known to include some side effects, which include blurry vision, altered colour perception, rashes, flushing, and headaches.

Viagra/sildenafil provides strong erections for up to four hours, and studied have shown positive results for men with diabetes or who have recently had prostate surgery or spinal cord injuries.

Cialis (generic name Tadalafil)

Whereas Viagra is available in 50 or 100mg pills, Cialis, or tadalafil if you buy the generic version, comes in lower doses, the smallest of which is 2.5mg, meaning it can be used on a daily basis and ensures the drug is in your bloodstream (for up to 36 hours) for when the need arises.

Cialis/tadalafil can cause limb, back and muscle pain, but if your ED is connected to an enlarged prostate, it is a great choice as it can treat both conditions.

Levitra (generic name Vardenafil)

Levitra, or vardenafil if you buy the generic version, is closest to Viagra/sildenafil. It will take a good hour to kick in, and can last for up to 4 hours. It is as effective as sildenafil, but is more potent, meaning it does a better job at moving blood to the penis rather than other parts of the body.

Levitra/vardenafil does not have the same side effects as sildenafil and doesn’t cause any vision problems or limb pain. It is available in doses ranging from 5 to 20mg.

The generic versions of all these drugs mean you can now get treatments at a much lower cost. They’re the same drugs but without the fancy packaging and branding.

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