Erectile Dysfunction Medication 101

First things first: Erectile dysfunction (ED) is a really common experience.

January 7, 2021

Most of the info we know about Erectile Dysfunction comes from studying cisgender men. Erectile dysfunction can start about age 20 and becomes more common with age. Diet, medications, medical conditions, and even stress are all factors that can contribute to ED. But, in our community, another common cause is the use of estrogen HRT and testosterone blockers.

Although ED is common, it can also be frustrating & upsetting to some people.

But fortunately, medical treatment is available and prescribed often - almost 2.8 million Viagra prescriptions were written in 2018. Currently, there are four pills available to help make sure bodies are ready at just the right time. These common ED prescription medications are called PDE-5 inhibitors. Not to get too deep into the science: but basically PDE-5 inhibitors stop the chemical that is responsible for stopping an erection. When this happens, certain muscles and blood vessels relax, which leads to a good erection that lasts longer. Of course, these medications alone don’t produce an erection -- sexual arousal is still part of the process! Right now, ED meds are used only in those who are born with and still have a penis.

Here's a quick look at the medications available:

MedicationAlso known as...When to takeHow long it lastsHow often to takeWhat else is good


Viagra30-60 minutes before sex4-6 hours, and 12 hours maxas needed

Has been around a long time, and is the best on an empty stomach

Available directly through FOLX


Cialis30 minutes before sex12-36 hoursas needed

Can be prescribed as a daily dose for continuous action

Available directly through FOLX

Daily Tadalafil

Daily CialisOnce a day24-36 hoursdaily as a low dose

Can allow for spontaneity if you take it daily, no need to pre-plan

Available directly through FOLX


Stendra15-30 minutes before sexup to 6 hoursas needed

Very quick onset & can be taken with or without food

FOLX can send Rx to a pharmacy


Levitra or Staxyn30-60 minutes before sex (but often works faster)5-7 hoursas needed

Quick onset, can be taken with or without food & Staxyn dissolved under the tongue!

FOLX can send Rx to a pharmacy

Although ED medications have side effects like all medications do, the side effects are almost never bad enough to stop using them. The most common side effects are:

  • Back pain and muscle aches
  • Mild headache
  • Flushing (happens more with Sildenafil)
  • Temporary blue-tinged vision (happens more with Sildenafil)
  • Nasal congestion
  • Dizziness
  • Low blood pressure
  • Indigestion

As with all medications, there will be a few people who have serious but very rare side effects, and there will also be some who cannot take pills for ED because of medical conditions or other medications that have a dangerous interaction with ED pills. Those who take nitrates or nitroglycerin for heart problems will have to discuss with their clinicians other ways of helping with ED, instead of using pills. Those who have had a heart attack, a stroke, or other serious heart problems may be able to use ED pills, but will also have to talk to their clinicians about the risks. 

And that’s a little 101 on ED medications! It’s up to every person to decide what sexual lifestyle is right for them, and FOLX clinicians can help. If you are ready to get started with FOLX for ED treatment, check out our sexual health offerings. If you have questions about ED and estrogen HRT, read more here. If you are an existing FOLX member, don't hesitate to schedule time with a clinician or to reach out to your clinician on your portal. And for those wanting to know more, feel free to reach out to us via the Help Center.

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