Erectile Dysfunction

Erections aren’t always easy for millions of men in the UK. It’s no big deal. Choose from highly effective, clinically proven solutions here.
View ed treatments
“Quick and discreet and saved me a trip to the GP.”
Zander, Trustpilot
UK licenced medication
Free, discreet delivery
Cancel any time
Ongoing clinician support

Sex Health Treatments

Choose from highly effective solutions to make erection worries a thing of the past.

Sildenafil

The generic unbranded form of Viagra
(344)
Cheapest
Best for first timers
Works in

60mins

Lasts for

4 hours

Dosages

50mg, 100mg

Price per pill

From £1.67

START FROM £15

Tadalafil

The generic unbranded form of Cialis
(83)
Lasts longer
Frequent sex
Works in

30 mins

Lasts for

36 hours

Dosages

2.5mg, 10mg, 20mg

Price per pill

From £2.57

START FROM £15

Viagra Connect

The over the counter classic
Works in

60 mins

Lasts for

4 hours

Dosages

50mg

Price per pill

From £8

START FROM £64

Viagra (Branded)

The classic
Works in

60 mins

Lasts for

4 hours

Dosages

50mg

Price per pill

From £12

START FROM £72
Not sure what the best treatment is for you?
Start our free online consultation for the best treatments specifically tailored to you.
Dr Earim Chaudry
Medical Director
Start consultation

HOW IT WORKS

Quick questionnaire

We’ll ask you a couple of quick medical questions. Tick the boxes and a clinician will review your answers and issue you a prescription.

Free next-day delivery

Your selected treatment will be delivered for free, with discreet packaging and instructions on how to use it.

Clinician support

Chat with a medical expert whenever you need. On the phone or via email. With support throughout your treatment.

Money Back Guarantee
If your treatment doesn’t work we will give you a full refund on your purchase. Orders of Sildenafil and Tadalafil only. See terms

Frequently asked

You can expect stronger, longer-lasting erections, if you are sexually aroused. Each ED treatment takes a certain time to take effect, and lasts for a different period of time.

Time to take effect Lasts for
Sildenafil (50mg) 1 hr 4 hours
Tadalafil (10mg) 30 mins 36 hours
Tadalafil Daily (2.5mg) 30 mins (3 days for full effect) Continuous effect

This depends on your sex life and preferences. All treatments we offer promote stronger erections, whilst working in slightly different ways - giving you the choice to find what suits you best.

Sildenafil or Viagra: Takes one hour to work and lasts for 4 hours. This is best for first-time users, and those who aren’t having regular sex - and will take it just when needed. Sildenafil is cheaper than Viagra.

Tadalafil: Works in 30 mins and lasts for 36 hours. This is best if you want harder erections over a longer period of time (for example over a weekend).

Tadalafil Daily: Works in 30 mins and lasts for 36 hours. This is best if you don’t want to plan sex around your treatments, as it keeps a baseline level of Tadalafil in your body all day every day. This means you can get erection whenever needed, without planning.

Yes, clinical studies show that it's safe and effective to use long-term. It won’t make your ED worse, and usually improves things.

ED can often be a symptom of health problems, such as low testosterone, high cholesterol or diabetes. We advise you to include blood tests in your order, to check for such underlying health problems.

Most men don’t experience side effects from ED treatments. The most common side effects when they occur are headache, indigestion, hot flushes, nausea, visual changes, nasal congestion and dizziness. A full list of possible side effects is available in the Patient Information Leaflet, included in your box. You should always read it carefully before taking your treatment. If you have further questions, you can book a call with our clinicians prior to an order.

Viagra and Sildenafil, both have the same active ingredient (Sildenafil) and are equally effective.

Sildenafil is the generic unbranded version of Viagra. Viagra was the brand name used by Pfizer: the first company to license the treatment Sildenafil (a process which costs pharmaceutical companies a significant amount).

Once the Viagra patent expired, other manufacturers could make it at a lower cost. This is a good thing for you, as now you can get a cheaper medication which is just as effective.

Meet our medical team
Enabling the mission of revolutionising how men approach health, they are at the core of the men’s wellness platform. Meet our team.
Earim Chaudry, MD
Medical Director
Ryan Benbow
Pharmacist, Ind. Prescriber
Soheb Ganchi
Pharmacist, Ind. Prescriber
Get a free consultation
Speak with one of our clinicians and get personalised advice. Monday to Friday 9am-4:30pm
Book Consultation
Erectile Dysfunction: Everything You Need to Know
Curated by Dr. Earim Chaudry, Manual Medical Director
Erectile dysfunction (ED) is the inability to achieve and sustain an erection long enough to have sex. You may achieve an erection, but not be able to sustain long enough to reach ejaculation. You may develop an erection that isn’t firm enough for sexual activity. Or you may just not be able to get it up at all.
While it’s a hugely frustrating condition, you’re not the only person to have erections affect their sex life. As many as 4.3 million men across the UK experience this common sexual dysfunction. Luckily, there is a range of treatments available to combat ED.
What causes erectile dysfunction?
There are many potential causes of erectile dysfunction – from underlying medical conditions to unhealthy lifestyle habits, from psychological causes to hormonal changes. Alcohol abuse and smoking affect your erections, too. Erections are the result of complex internal processes – and your sensitive parts are not immune to any wider health problems that you may have.
The most common causes of ED are in your vascular system. When blood can’t flow easily around the body – due to high cholesterol, high blood pressure, cardiovascular disease, or heart disease – enough of it won’t get to where it’s needed. As a result, you won’t be able to achieve a fully firm erection.
However, other causes originate elsewhere. Diabetes, for example, can cause ED, with rates among diabetics potentially as high as 75%. It is thought to be caused by nerve and blood vessel damage, the result of chronic issues with high blood sugar levels.
Meanwhile, men who watch a lot of porn are at risk, too. It’s known as porn-induced erectile dysfunction. It’s thought that pornography can give men unrealistic expectations of what sex is – influencing their ideas of intimacy, sexual performance, and their partners’ bodies. As a result, those who habitually satisfy themselves through porn can struggle to get aroused in real sexual encounters.
ED can also be caused by low testosterone, prostate cancer, kidney disease, Parkinson’s disease, and Peyronie’s disease. Meanwhile, relationship problems, abuse of recreational drugs, and mental health problems including low self esteem can also contribute.
Is erectile dysfunction permanent?
There’s no reason to believe that your erectile dysfunction will become permanent – unless a serious health problem is the cause. In the majority of cases, ED can be stopped using a combination of immediate fixes (e.g. Viagra or Cialis), and long-term psychological and/or physical health improvements.
Studies have shown that if you stop smoking and reduce alcohol intake, the symptoms of ED can improve. If you’re overweight – a risk factor for ED – losing it can help you to regain erectile function. In the meantime, ED medications will usually help.
Can erectile dysfunction be treated?
ED can be treated in the short-term effectively, safely, and easily – in most cases, just by popping a pill. Treatments like Sildenafil and Tadalafil – the active ingredients in Viagra and Cialis respectively – have been shown to be effective in over 80% of cases, and side effects of these drugs are very uncommon.
Both drugs are PDE5 inhibitors. They target the enzyme, phosphodiesterase 5, which is responsible for smooth muscle contraction in the blood vessels supplying your penis. By inhibiting this enzyme, blood flow is improved – increasing the chances of achieving and maintaining a full erection.
Improving your lifestyle – through exercise, a healthy diet, and a reduction in your intake of alcohol and cigarettes – can be a longer-term cure for ED too. Psychological causes can be treated through counselling (CBT), self-talking therapies, and psychosexual counselling. It might also help to engage in mindfulness and relaxation therapies.
Which erectile dysfunction drug is best?
Sildenafil and Tadalafil – known by their common brand names, Viagra and Cialis – are the most effective erectile dysfunction drugs on the market. They work in over 80% of men, and studies have shown that they are less likely than Vardenafil and other PDE5 inhibitors to cause side effects.
So, both are effective. However, which is best for your specific needs is a different question. Whilst Sildenafil can take up to 30 minutes to an hour to take effect and lasts for 4-5 hours, Tadalafil can be effective within 30 minutes – and can last up to 36 hours.
Erectile dysfunction throughout your life
Erectile dysfunction is not something just for older men. Men as young as twenty can experience it, too.
That is in part because they are more likely to smoke, more likely to binge drink, and are less likely to be able to manage stress. That’s a cocktail of psychological and physical causes present in your early adulthood that can potentially cause ED – and that’s before we mention things like performance anxiety.
Studies show that over a third of men under 30 have experienced some degree of ED in their lives. That said, ED in your 20s or 30s shouldn’t be seen as “normal”. It may be a warning sign for an unhealthy lifestyle, and this should be addressed as soon as possible. There’s no shame in using Viagra or Cialis, though, if you need help to achieve and maintain an erection.
ED is not thought to be a natural part of ageing – even though it is a condition usually associated with older men. Rather, it is more likely to be the sign of an underlying health condition that would benefit from your attention. This includes general health and fitness, as well as diet.
About 50% of men in their 50s experience erectile dysfunction. As you age, it is more likely that ED is the result of atherosclerosis, or the narrowing of your arteries. It’s usually the sign of poor cardiovascular health, but could also indicate something more serious. In these instances, we recommend you see your GP for a health check to exclude underlying causes.
Join more than 50,000 happy customers who have used Manual
5 stars out of 5
They have helped me get my confidence back with my wife I lost for years. I feel like I am twenty years old again
Chris. Trustpilot

Further reading

Erections 101

A comprehensive guide to how erections work and what you can do when they don’t. Testosterone, stress, psychology and more.
READ ARTICLE

The doctor’s view

Hear what our experts have to say and their knowledge on E.D. Invaluable advice from medical professionals who’ve seen it all before.
READ ARTICLE