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Viagra is one of the most commonly known sexual enhancers and was the first PDE-5 inhibitor. This caused a huge change in how erectile dysfunction was treated. Although Viagra reigned supreme for many years, there are now alternatives that may work better for some people on an individual basis. In addition to medicinal alternatives such as generic Viagra, therapies like psychological counseling, mechanical aids, or surgery are also used. We will provide information about these various Viagra alternatives below so you can make an informed decision.
What Alternatives To Viagra Are There?
Viagra® alternatives include:
- Generic Viagra, contains the same active ingredient (sildenafil) as the original but are cheaper in price.
- Other PDE-5 inhibitors have the same principle of action but contain a different active ingredient than Viagra. They include Cialis (tadalafil), Sildenafil, Levitra (vardenafil), or Spedra (avanafil).
- Alternative treatment approaches such as psychological, mechanical, or surgical forms of therapy.
Viagra Alternatives in the UK: Price Comparison
Viagra alternatives in the UK come at a range of prices. But when it comes to making sure you get value for money, it pays to compare.
The cheapest Viagra-alternative option is Sildenafil, which usually costs around £20–£30 per packet. This generic treatment from a registered UK pharmacy works in the same way as branded Viagra and has been licensed by the MHRA since 2013.
For those who want an even cheaper alternative, there are also over-the-counter treatments that cost less than £10. These contain herbal ingredients such as ginseng or yohimbe and can be bought from pharmacies or online suppliers. However, these treatments have not been licensed by the MHRA and so their safety and efficacy are not guaranteed.
The most expensive Viagra alternative is Cialis, which usually costs around £40–£60 per packet. This branded treatment from Eli Lilly works in a similar way to Viagra but lasts for up to 36 hours, allowing you to take it at any time of day or night. It has been licensed by the MHRA since 2002 and remains one of the most popular treatments for erectile dysfunction in the UK.
At all prices, buying treatment online will generally be cheaper than buying it in person from a pharmacy. Whichever option you choose, the key thing is to make sure that whatever medicine you buy is licensed and safe to use.
Cialis
- Designed to be taken daily
- Brings sexual freedom
- Allows for spontaneous sex
- Designed to be taken daily
- Brings sexual freedom
- Allows for spontaneous sex
- Designed to be taken daily
- Brings sexual freedom
- Allows for spontaneous sex
Sildenafil
Tadalafil
- The effects can last for up to 36 hours
- Available in 5mg, 10mg and 20mg dosage
- Cheaper alternative to Cialis
Are These Viagra Alternatives Better For Treating Erectile Dysfunction?
This question cannot be answered in general, because the choice of sexual enhancer depends heavily on personal needs.
All PDE-5 inhibitors work in the same way: they increase blood flow to the penis, making it easier to get an erection. However, factors such as the time until the onset of action, duration of action, price, and used excipients play a role when choosing the right sexual enhancer, which is why a certain Viagra alternative may be more suitable individually.
Are there other treatment options instead of Viagra?
Drug alternatives
Injections
With this method, an erection-promoting drug is injected directly into the cavernous body using a thin needle. The effect occurs after about 15 minutes and lasts up to a maximum of 1 hour. The drug should therefore be injected just before sexual intercourse.
In the first sessions with the urologist, the dose necessary for a satisfactory erection is determined and the patient is trained in the correct application. The drug can then be injected independently at home.
It’s reassuring to know: Due to the very thin injection needles, the treatment is almost painless for most patients.
The biggest advantage of erectile tissue injections compared to Viagra & Co. is that this treatment method is also effective when the nerve tracts between the brain and penis are damaged or interrupted (e.g. after paraplegia or an operation in the pelvic area).
Urethral sticks
In this method, a rod containing an erection-enhancing substance is inserted directly into the urethra. The erection-enhancing effect starts about 10 minutes after inserting the stick and lasts for about 30-60 minutes.
Please note: Before the application can be carried out independently, the doctor must train the patient in the correct application.
Urethral rods, such as MUSE with the active ingredient alprostadil, are – just like cavernous injections – also effective if the erectile dysfunction is caused by nerve damage, for example by existing diabetes mellitus (diabetes).
Mechanical alternatives
Penis pump
Penis pumps are based on a purely mechanical mechanism to treat erectile dysfunction. By creating negative pressure, the blood flowing into the penis is promoted. When the penis is erect, the pump is removed and an elastic cock ring is fitted to help maintain an erection throughout intercourse.
Since penis pumps work in a purely mechanical way, side effects are not to be expected if used properly.
Please note: However, if the pump is used incorrectly, for too long, or too often, painful side effects or even injuries can occur.
Penile prostheses
Penile prostheses are cavernous implants that are surgically inserted into the penis and allow the penis to be artificially stiffened.
During the operation, the cavernous bodies in the penis are removed and replaced with a hydraulic silicone prosthesis. This consists of a pump, 2 cylinders and a liquid container. By pressing the pump several times, the liquid runs from the container into the cylinders and an erection is created. The erection ends when the pump is pressed continuously, causing the liquid to drain back into the reservoir.
Penile prostheses can remain in the body for a lifetime – provided they are well tolerated by the patient and no technical defects occur. In addition, sex is possible as often and as long as you want. Because even after an orgasm, the penis remains erect.
Psychological therapies
Psychological therapy approaches are particularly effective when erectile dysfunction is based on emotional causes – such as stress, pressure to perform, or problems in the partnership. However, this does not mean that you have to lie on the “couch” for years. Depending on the underlying cause, a clarifying conversation with your partner, a job change or a few sessions with a coach or psychologist is enough to remedy erectile dysfunction. Because especially in the case of mental potency problems, a single positive experience is often enough to find your way back to the “old form”.
It is relatively easy to determine whether mental or physical factors are the cause of erectile dysfunction: if masturbation and spontaneous nocturnal/morning erections are still possible without any problems, the erectile dysfunction is very likely to be psychological.
However, physical and mental factors can also occur together or influence each other. A targeted therapy should therefore always be based on the personal circumstances of the patient and can certainly include the simultaneous use of psychological and drug treatment approaches.
Are there over-the-counter alternatives to Viagra?
Yes, but it is not advisable to use it, especially without medical advice.
Despite the fantastic sounding promises, many over-the-counter remedies lack scientific evidence of their effectiveness in treating erectile dysfunction. Also, “over-the-counter,” “herbal,” or “natural” does not always mean “safe.” Interactions can occur, especially in combination with other drugs taken at the same time. So it is quite possible that although the desired potency-enhancing effect does not occur, you experience a number of undesirable effects from the therapy.
Source List:
- Instructions for use (VIAGRA®): Information for patients (as of: November 2021)
- Information for professionals (VIAGRA®): Summary of the characteristics of the medicinal product (as of: November 2020)
- Instructions for use (Cialis®): Information for users (as of: March 2019)
- Yuan-Shan C et al. Avanafil for male erectile dysfunction: a systematic review and meta-analysis. Asian Journal of Andrology 2014; 16:472-477.
- Instructions for use (Levitra): Information for users (as of: March 2022)
- Erectile dysfunction (impotence) NHS (as of: March 2022)
- Package leaflet (Spedra): Information for patients (as of: April 2019)
- Hautmann, R., & Gschwend, JE (Eds.). (2015). Urology. Springer-Verlag.
- Ning H, Xin ZC, Lin G, Banie L, Lue TF, & Lin CS (2006). Effects of icariin on phosphodiesterase-5 activity in vitro and cyclic guanosine monophosphate level in cavernous smooth muscle cells. Urology, 68(6), 1350-1354.
- Treating erectile dysfunction – NHS Scotland (as of: November 2021)
- Pharmaceutical Newspaper (2011). Vardenafil. Sexual potency for the first time as an orodispersible tablet.
Isabel D White
Isabel led the Royal Marsden Hospital (London) psychosexual therapy service until 2019. She works in partnership with individuals & couples to explore physical, emotional & relationship factors that contribute to sexual difficulties after cancer. These include: low desire, erection, arousal or orgasmic difficulties, sexual pain & sexual avoidance. She adopts an integrative approach to personalized therapy using psychosexual therapy (sensate focus framework), biomedical management (erectile dysfunction medication & devices, menopause & vaginal health strategies, sexual aids) & psychoeducation.
