Viagra Not Working? Here are Your Options

Medically approved by
Dr Earim Chaudry
Last updated
19th November 2020

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If Viagra isn’t working for you, the first thing to do is to check that you’re taking it correctly. It may take a few attempts to get all the conditions right, and for you to feel comfortable with the treatment.

Still no joy? It’s possible that an underlying health condition is responsible for your erection problems, and getting that sorted is the way forward. You can also talk to your health care provider about alternative erectile dysfunction treatments.

So you’ve dimmed the lights, slipped into something comfortable, and popped that little blue pill – looks like everything’s prepared for a great night. But hang on a minute… The Viagra doesn’t seem to be quite working as promised, and the erection you were hoping for hasn’t materialised.

If that situation sounds familiar – don’t worry. The conditions need to be right for Viagra to work optimally, so there may be something you can do differently to give it a fighting chance.

On the other hand, there’s a possibility that Viagra isn’t working because your erectile dysfunction (ED) is caused by an underlying health condition, which needs to be treated. If you treat the underlying cause, that may help treat your ED too.

Another option is to seek medical advice about alternative ED treatments that you could try. 

In this article, we explain how to take Viagra correctly for the best results, and what to do if the treatment doesn’t work for you.

Are You Taking Viagra (Sildenafil) Correctly?

As with any drug, Viagra (also known by its generic name, Sildenafil) needs to be taken in the right way at the right time in order to be effective. Here’s what you can do to give your Viagra treatment the best chance of success:

Take the Tablet at the Right Time

Your Viagra or Sildenafil tablet should be taken orally, with a glass of water, about an hour before you plan to have sex. If you try having sex too soon after swallowing the tablet, the drug may not have time to be absorbed into your body and help you produce an erection. 

Once you’ve taken Viagra, you usually have a window of 4–6 hours when it should be easier to get an erection hard enough for sex. If you want a drug that’s longer-lasting, you can try Tadalafil (brand name Cialis), which we describe in more detail below.

Take the Right Dose

Viagra is available in doses of 25mg, 50mg, and 100mg. The starting dose is usually 50mg but if you’re experiencing side effects your prescriber may move you to the lower dose of 25mg. In contrast, if 50mg doesn’t seem to be helping your erections you may be prescribed 100mg instead. You should never take a higher dose of Viagra than you’ve been prescribed.

Make Sure You’re Sexually Aroused

Viagra only works to give you an erection once you are aroused and receiving sexual stimulation, so take the time to give yourself some attention (or ask your partner nicely) before you try having penetrative sex.

Only Eat a Light Meal

Eating a heavy, fatty meal before taking Viagra will cause your body to absorb the drug more slowly. For faster results, take the tablet on an empty stomach or after a light meal.

Avoid Alcohol

Alcohol and Viagra don’t mix well. They work in opposing ways, with alcohol constricting blood flow in your body while Viagra aims to increase blood flow to your penis and cause an erection. Thus, saying “no” to that beer or glass of wine will help Viagra be much more effective for you.

Relax and Enjoy Yourself

Performance anxiety is the enemy of erections at the best of times, so try to relax and enjoy this intimate time with your partner, letting Viagra do its thing.

Does Your Erectile Dysfunction Have an Underlying Cause?

If you’ve tried taking Viagra under all the right conditions on several different occasions and it still hasn’t worked, there’s a possibility that your ED could be caused by an underlying health condition. Identifying this and getting the right treatment could make all the different to your erections.

Physical Causes of ED

Physical health conditions that affect your heart or blood circulation are common culprits behind ED. These include diabetes, heart disease, and high blood pressure (hypertension). It’s worth noting that some of the drugs used to treat these issues, such as beta-blockers for high blood pressure, can also contribute to ED.

Other diseases that can cause ED include Parkinson’s Disease and Multiple Sclerosis (MS), and it can also be a symptom of low testosterone levels (low-T). It’s common to experience it after surgery on your prostate, spinal cord, or pelvic region, too.

Psychological Causes of ED

The state of your mental health can have wide-ranging effects on your life – including your sex life. Conditions such as depression and anxiety can be behind ED, as well as work stress or bereavement. Of course, relationship conflict and breakdown can also have a huge impact on our confidence and fulfilment in the bedroom.

Getting the right help, whether that’s Cognitive Behavioural Therapy (CBT), counselling, or sex therapy, can improve your mental health and – as a result – improve your capacity to achieve erections and find new enjoyment in sex.

Should You Try Another Medical ED Treatment?

In some cases, you may have done everything you can to improve your health, but erections still aren’t coming easily. In that situation, if Viagra isn’t working for you, you can talk to your prescriber about alternative ED drugs you could try. Here are some of the options they might suggest:

Cialis (generic name Tadalafil): Cialis, like Viagra, is one of a family of drugs called Phosphodiesterase 5 or PDE5 inhibitors, which work to increase blood flow to your penis and help you achieve an erection. It’s often called the “weekend pill” because its effects can last up to 36 hours, allowing you more spontaneity regarding when you have sex. Another plus point is that you can take Cialis daily, whereas Viagra is only taken just before sexual activity.

Levitra (Vardenafil): Another PDE5 inhibitor, Levitra tablets work in a similar way to Viagra and Cialis. The downside of this drug is that you’re more likely to experience side effects, such as a blocked nose, headache, and nausea. 

Alprostadil: The ED drug Alprostadil is a synthetic version of the hormone prostaglandin E1 (PGE1). Like the PDE5 inhibitors, it acts as a vasodilator, widening blood vessels to allow more blood flow to the penis. 

Alprostadil is usually only prescribed once PDE5 inhibitors have proven ineffective. It’s available as a cream, injection, or a small pellet inserted into the urethra. Because the drug is administered directly to the penis, some men may experience penile pain with this treatment.

Viagra (Sildenafil)

The little blue pill

It’s the active ingredient in Viagra. MHRA approved and clinically proven to be highly effective by increasing blood flow into the penis.


Best for
One off use
Effective in
8 out of 10 men
Dosage
50 to 100mg

Key Takeaways: Viagra Not Working?

If Viagra (Sildenafil) doesn’t work the first time you take it, you might want to give it a chance on a few more occasions before seeking an alternative. After all, 80% of men find that Viagra is successful at treating their ED.

But don’t worry if you’re not one of them. Talk to your health care provider about other effective ED treatments, such as Tadalafil (Cialis). Your sexual health is important, and getting the right medical advice is the first step towards restored erections and more satisfying sex.

References

  1. The NICE British National Formulary (BNF) -BNF is only available in the UK: https://www.nice.org.uk/bnf-uk-only

  2. Reuters Health -Erectile dysfunction drugs vary in effectiveness, side effects: https://www.reuters.com/article/us-ed-drugs-profiles/erectile-dysfunction-drugs-vary-in-effectiveness-side-effects-idUSKBN0MY1TT20150407

  3. The NICE British National Formulary (BNF) -BNF is only available in the UK: https://www.nice.org.uk/bnf-uk-only

While we've ensured that everything you read on the Health Centre is medically reviewed and approved, information presented here is not intended to be a substitute for professional medical advice, diagnosis, or treatment. It should never be relied upon for specific medical advice. If you have any questions or concerns, please talk to your doctor.

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