Erectile Dysfunction FAQ

Very common. Roughly 40 percent of men over 40 report some degree of ED. Around 25 percent of men under 40 also experience it. The total number of SA men affected is in the millions. You are not unusual.

Yes. Both are Schedule 4 prescription only medicines under SAHPRA. A registered doctor must issue the prescription. Selling or buying without a prescription is illegal.

Sildenafil is the active ingredient in Viagra. Viagra is the original brand name. Generic sildenafil contains the same active ingredient and works the same way. The main difference is price.

Yes. Tadalafil is the active ingredient. Cialis is the original brand. Generic tadalafil is the same medication at a lower price.

For sildenafil and vardenafil, 30 to 60 minutes. For tadalafil, similar onset but the effect lasts up to 36 hours. None of them is instant.

Tadalafil has a licensed low daily dose option (2.5 to 5 mg daily). Sildenafil and vardenafil are not licensed for daily dosing, although they can be taken on most days if needed. No more than one dose in 24 hours.

Sildenafil and vardenafil last around four to five hours. Tadalafil lasts up to 36 hours. After the medication wears off, your erections return to baseline.

Only if you tell them. There is no obvious external sign of having taken ED medication. Many men prefer to discuss it with their partner anyway. We have a separate article on how to do that.

Light drinking is fine. Heavy drinking reduces effectiveness and increases side effects. Heavy alcohol is one of the main reasons men think their medication has failed.

One or two drinks usually fine. The aim is to be relaxed but not impaired. Excess alcohol works against you both directly and indirectly.

Tadalafil yes, no problem. Sildenafil and vardenafil are slowed by fatty meals. If you eat a heavy meal, expect a delay or a weaker effect.

In most cases yes, if the blood pressure is reasonably controlled. The doctor will check this at consultation. Never combine PDE5 inhibitors with nitrate medication.

Generally yes. Men with diabetes often need higher doses to achieve a good response because the underlying vascular and nerve damage is greater.

Stable controlled cardiovascular disease is usually fine. Active angina, recent heart attack, or severe heart failure may rule it out. The doctor assesses at consultation. Nitrates are an absolute contraindication.

Side effects are more likely and more intense. Headache, flushing, indigestion, low blood pressure. If you have taken significantly more than prescribed, contact a doctor or pharmacist.

Some tablets are scored and can be split. Some are not designed to be split because of the coating or release pattern. The doctor will let you know the safe way to dose down.

No. It restores normal erectile function. Erections may feel firmer than recent attempts because the underlying issue is treated, but the medication does not produce supernormal results.

Not physically. PDE5 inhibitors are not addictive. Some men develop a psychological reliance, particularly after using medication to overcome a performance anxiety cycle. This can be worked through with a doctor.

No. PDE5 inhibitors do not affect sperm count, sperm quality, or fertility.

For most men, yes, if taken correctly. About one in three men needs a dose adjustment or a different medication to find what works for them. A second consultation handles this.

Common reasons: dose too low, taken with too much food, taken too soon or too late, heavy alcohol, lack of sexual stimulation, or the medication is genuinely not enough for your level of ED. The doctor will troubleshoot.

Yes, when delivered by registered SA doctors and dispensed through SAPC registered pharmacies. Buying ED medication from overseas websites without a prescription is illegal and risky.

Yes, when they are SAHPRA registered. Generic sildenafil and tadalafil contain the same active ingredients and are subject to the same quality controls as branded versions.

Through Online Doctor SA, R250 for the consultation. Medication is purchased separately at your pharmacy.

Varies by pharmacy and quantity. Generic sildenafil is the cheapest option, available at all major SA pharmacies. Tadalafil is somewhat more expensive but still affordable. Both are commonly bought in quantities of four to thirty tablets at a time.

Some medical aids reimburse consultations for ED. The medication itself is sometimes covered depending on the plan. Check with your scheme.

Yes. Follow up consultations are available for repeats once the treating doctor is satisfied the medication remains appropriate.

The doctor will troubleshoot. Common steps: increase the dose, switch to a different PDE5 inhibitor, address contributing lifestyle factors, or refer to a urologist if oral medication is not sufficient. Most men find something that works.

Some have weak supporting evidence (L arginine, panax ginseng). None come close to PDE5 inhibitors for effectiveness. Be cautious with unregulated herbal products as they sometimes contain undisclosed prescription drugs in unknown doses.

Yes. Particularly if you see them for cardiovascular care or for any chronic condition. It is just useful for them to know everything you are on.

No. PDE5 inhibitors are not for partners. There are different medications for female sexual concerns that need their own assessment.

Yes, particularly in the early stages or in men where psychological factors are major contributors. Bad weeks and better weeks are common.

Yes. Caffeine has no significant interaction. In fact some research suggests moderate caffeine may slightly help erections.

A painful erection lasting more than four hours is called priapism and is a medical emergency. Go to the nearest emergency department immediately. Permanent damage can occur if untreated.