Erectile dysfunction is when men are unable to get or keep an erection suitable for sex. Dr Fox provides advice and confidential treatment for erectile dysfunction posted direct.
Erectile dysfunction (ED) is common. It is not usually caused by low hormone levels. Most men with erectile dysfunction are in reasonable health, although erectile dysfunction may be a symptom of poor circulation or early diabetes. Erectile dysfunction is more common in smokers and men who are overweight. Some medicines including herbal medicines can contribute to ED. Some men with ED have low testosterone levels. Cycling more than 3 hours a day can cause ED.
All men with ED should tell their GPs about it.
Over the last decade medications have revolutionised the treatment of erectile dysfunction. These medications work by enhancing the natural reaction to stimulation, opening up the blood flow needed for erections. Other treatments for ED include topical applications, injections into the penis, surgical devices and counselling.
Types of treatment
Seven different medications are available to buy online from Dr Fox:
- Viagra tablets (25mg, 50mg, 100mg)
- Viagra Connect tablets (50mg only)
- Sildenafil tablets: low cost generic Viagra (25mg, 50mg, 100mg)
- Cialis tablets (2.5mg, 5mg, 10mg, 20mg)
- Tadalafil tablets: low cost generic Cialis (2.5mg, 5mg, 10mg, 20mg)
- Levitra tablets (5mg, 10mg, 20mg)
- Levitra orodispersible tablets (10mg)
- Vardenafil tablets (5mg, 10mg, 20mg)
- Spedra tablets (50mg, 100mg, 200mg)
Each tablet has a different duration of action and side effects – see tablet differences below.
No combination of Viagra/sildenafil, Cialis/tadalafil, Levitra/vardenafil, Spedra or other ED treatment should be used at the same time – a break of up to 24 hours (36 hours for Cialis/tadalafil) should be left.
Investigating erectile dysfunction
You should always tell your regular doctor if you are having problems with erections.
Erectile dysfunction can be a symptom of conditions such as diabetes, high blood pressure, high cholesterol or narrowing of the arteries. Some simple tests may be required. A face-to-face assessment with a doctor is particularly important if symptoms develop over a period of weeks or months, or even suddenly, without an emotional event to set them off. Erectile dysfunction can be a complication of previous operations or a side effect of some prescribed medication.
Lifestyle and risk factors
Improving lifestyle factors such as diet, exercise, smoking, excessive alcohol, and maintaining an active lifestyle has shown improvement in ED in men of all ages. Apart from the general benefits of a healthy lifestyle, studies show improvement in erectile dysfunction symptoms and a reduced need for tablets. ED also shares risk factors with a range of other medical conditions including diabetes, heart disease, and circulatory problems, all of which are also likely to benefit from lifestyle modification.
It is best to start with a lower strength tablet and build up as needed (see how to start treatment). One type of tablet sometimes works better than another. You may like to try out different tablets to see which ones suit you best.
Sexual stimulation is required for tablets to work. Without it tablets will have no effect.
You can request more than one type of tablet at a time. A first trial of treatment starts at £6.90.
Erectile dysfunction can be distressing and lead to relationship difficulties, anxiety, and depression. Your regular doctor may recommend counselling. This may help resolve the cause of erectile dysfunction. In some cases a problem of performance anxiety can be overcome by breaking the cycle of failure with tablet treatments.Buy treatment
Dr Fox supplies treatment for erectile dysfunction (impotence) on prescription – you are required to answer a short medical questionnaire before your order can be completed.
|Brand names||Viagra, Viagra Connect||Cialis||Levitra||Spedra|
|Time taken to start working||30-60 minutes||30-60 minutes (2.5mg and 5mg tablets can be taken daily)||25-60 minutes – faster for orodispersible tablets||15-30 mins on empty stomach, 1.5 hours on full stomach|
|How long effects last||4 hours||36 hours||4-5 hours||4 hours|
|Warnings and cautions|
|Do not take||Allergic to ingredients, low or high blood pressure, severe heart or liver problems, loss of vision due to NAION, recent stroke or heart attack|
|Rare inherited eye diseases||Kidney dialysis, rare inherited eye diseases||Liver or kidney problems, rare inherited eye diseases|
|Exclusions - talk to your doctor first||Sickle cell anaemia, multiple myeloma, leukaemia, deformity of the penis, problems with your heart, stomach ulcer or bleeding problems|
|Drug interactions||Any nitrate-based medication, usually to treat angina (important); 'poppers'; nitric oxide donors, medicines for HIV, AIDS, or fungal infections; riociguat; alpha-blockers; other ED medicines|
|Common side effects (% occurrence)|
|Abnormal vision||1.9%||< 2%||none|
|Back pain||6.5%||< 2%|
|Myalgia (muscle pains)||5.7%||< 2%|
|Medical emergencies (very rare)|
|Urgent medical attention required||Sudden decrease or loss of vision, Priapism (painful erection lasting 4 hours or more), allergic reaction, chest pains, heart attack|
Notes: Sexual stimulation is required before erection will take place. See the patient information leaflet links above for full details of cautions and interactions. You may get no side effects. If side effects are severe stop the medication and see your doctor.
Authored 18 February 2010 Dr Tony Steeleby
Last updated 18 June 2019
References & bibliography
NICE, 2017, Erectile dysfunction - Assessment, accessed 31 August 2018
NICE, 2017, Erectile dysfunction - Phosphodiesterase-5 (PDE-5) inhibitors, accessed 31 August 2018
Ralph, McNicholas, 2000, BMJ: UK management guidelines for erectile dysfunction, accessed 31 August 2018
Gupta, Murad, Clifton, 2011, JAMA: The Effect of Lifestyle Modification and Cardiovascular Risk Factor Reduction on Erectile Dysfunction, accessed 31 August 2018
Yafi, Jenkins, Albersen, Corona, Isidori, Goldfarb, Maggi, Nelson, Parish, Salonia, Tan, Mulhall, Hellstrom, 2016, Nature Reviews Disease Primers: Erectile dysfunction, accessed 31 August 2018
Raheem, Su, Wilson, Hsieh, 2017, American Journal of Men's Health: The Association of Erectile Dysfunction and Cardiovascular Disease: A Systematic Critical Review, accessed 31 August 2018
Maiorino, Bellastella, Esposito, 2015, AJA: Lifestyle modifications and erectile dysfunction: what can be expected?, accessed 31 August 2018
Rajkumar RP, Kumaran AK, 2015, Comprehensive Psychiatry: Depression and anxiety in men with sexual dysfunction: a retrospective study, accessed 31 August 2018
|Quantity of tablets||x4||x8||x16||x32||x64|
|Viagra Connect 50mg||£19.99||£34.99||n/a||n/a||n/a|
|Levitra Orodispersible 10mg||£29.00||£51.00||n/a||n/a||n/a|
|Medicine||28 tablets||56 tablets|
|Daily Tadalafil 2.5mg||£22.50||£41.10|
|Daily Tadalafil 5mg||£24.10||£46.40|
|Daily Cialis 2.5mg||£66.50||£128.30|
|Daily Cialis 5mg||£67.60||£132.20|
Dr Fox supplies medicine on prescription and charges a small prescription fee based on the order value of each prescription.
Prescriptions are issued by our doctors online and sent electronically to our pharmacy.
If you have your own private or NHS paper prescription please post to our pharmacy (details).
Dr Fox prices are 25%–50% lower than other UK online clinics.
|Order value||Prescription fee|
|up to £10||£1.00|
|up to £20||£2.00|
|up to £40||£3.00|
|Generic/Branded||Dr Fox*||Express Pharmacy||Zavamed||Pharmacy 2U||Med Express|
|Sildenafil 25mg x 4||£6.90||£19.99||£15.00||£15.00||£9.99|
|Sildenafil 25mg x 8||£13.70||£29.99||£25.00||£23.00||£19.99|
|Sildenafil 25mg x 16||£24.80||£49.99||£45.00||£40.00||£39.99|
|Sildenafil 25mg x 32||£43.20||n/a||n/a||£60.00||£79.99|
|Sildenafil 50mg x 4||£8.90||£19.99||£20.00||£23.00||£17.99|
|Sildenafil 50mg x 8||£15.60||£29.99||£30.00||£38.00||£29.99|
|Sildenafil 50mg x 16||£26.80||£49.99||£50.00||£60.00||£49.99|
|Sildenafil 50mg x 32||£51.00||n/a||n/a||£86.00||£89.99|
|Sildenafil 100mg x 4||£9.80||£19.99||£25.00||£27.00||£19.99|
|Sildenafil 100mg x 8||£16.20||£29.99||£30.00||£56.00||£34.99|
|Sildenafil 100mg x 16||£28.40||£49.99||£50.00||£75.00||£59.99|
|Sildenafil 100mg x 32||£54.00||n/a||n/a||£130.00||£99.99|
|Viagra 25mg x 4||£24.20||£44.99||£32.00||£32.50||£29.99|
|Viagra 25mg x 8||£44.30||£69.99||£48.00||£50.00||£59.99|
|Viagra 25mg x 16||£82.00||£129.99||£82.00||£95.00||£119.99|
|Viagra 50mg x 4||£29.40||£44.99||£36.00||£30.00||£34.99|
|Viagra 50mg x 8||£59.50||£76.99||£58.00||£50.00||£69.99|
|Viagra 50mg x 16||£112.60||£149.99||£100.00||£85.00||£139.99|
|Viagra 100mg x 4||£33.80||£46.99||£39.00||£40.00||£34.99|
|Viagra 100mg x 8||£64.45||£79.99||£62.00||£60.00||£69.99|
|Viagra 100mg x 16||£124.50||£159.99||£109.00||£95.00||£139.99|
UK delivery only: £2.90 per consultation via Royal Mail 24 Signed For (1-3 working days with tracking).
Parcel forwarding services are not permitted. Use only UK home or work delivery address.
Returns and refunds - unwanted items can be returned within 14 working days for a full refund.
The order process
Answer short medical questionnaire
Choose treatment, register, and pay
Doctor issues prescription online
Medicine posted direct from pharmacy
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