Erectile dysfunction is a common disorder affecting many men worldwide. Drug treatments such as Viagra(Sildenafil) and Cialis(Tadalafil) have revolutionized the management of this condition, offering an effective and rapid solution in the majority of cases. However, sometimes these treatments are not effective, or lose their effectiveness over time. Faced with this situation, it’s essential to know what steps to take to regain a satisfying and fulfilling sex life.
In this article, inspired by the advice and expertise of Dr. Sébastien Beley, urological surgeon and andrologist, we explore in detail the possible reasons for Viagra and Cialis failure, the common mistakes to avoid, and the therapeutic alternatives available. Whether you’re a patient looking for solutions, or a loved one wanting to understand the problem, this guide will provide you with clear, precise answers.
Introduction: Understanding the failure of drug treatments for erectile dysfunction
Viagra and Cialis belong to a class of drugs known as phosphodiesterase type 5 (PDE5) inhibitors. They work by increasing blood flow to the penis, making it easier to achieve and maintain an erection sufficient for sexual intercourse. Although highly effective, these treatments do not work systematically in all patients. Several factors may account for initial failure or gradual loss of efficacy.
Before concluding that there has been a definitive failure, it is crucial to reassess the way these drugs are used, to examine the patient’s general state of health, and to consider other elements that may influence the response to treatment. Dr. Beley emphasizes that this process must be supervised by a healthcare professional, particularly a urologist, in order to adjust treatment and explore alternative options.
1. The importance of proper dosage: Why dose matters
One of the first things to check in the event of Viagra or Cialis failure is the dose administered. It’s common for some patients to receive a lower dose than recommended, which can significantly reduce the drug’s effectiveness. For example:
- Viagra is generally prescribed at a dose of 100 mg for optimum efficacy.
- Cialis is often prescribed at 20 mg for effective one-off doses.
However, some doctors or patients may reduce the dose as a precaution or out of ignorance, giving 50 mg or even 25 mg for Viagra, or 10 mg or even 5 mg for Cialis. These reduced doses are sometimes justified in specific cases, such asrenal or hepaticinsufficiency, but in the majority of cases, they fail to produce a satisfactory effect.
Dr. Beley therefore stresses the importance of using the recommended standard dose, unless medical advice dictates otherwise. An insufficient dose may explain the lack of response or an incomplete response, leading to the false impression of treatment failure.
2. Timing the shot: finding the right moment to maximize effectiveness
Another key factor often overlooked is the timing of the medication. Viagra and Cialis are not aphrodisiacs and require a certain time to take effect. This can vary from one man to another:
- Viagra usually takes between 30 minutes and an hour to take effect, but for some it can take several hours.
- Cialis can have a more prolonged effect, sometimes up to 36 hours, but a certain delay must also be observed after taking it.
It is therefore advisable to experiment with different doses at different times, in order to identify the ideal time for each individual’s physiology. For example, some patients find it more effective to take the drug several hours before the planned sexual activity, or even the evening before, which can lead to a spontaneous erection the following morning.
This experimental phase is essential to adjust the treatment and avoid prematurely concluding that it has failed. Dr Beley points out that it’s normal to need several trials before finding the right timing.
3. The influence of food and alcohol: a sometimes underestimated impact
Lifestyle and dietary habits play an important role in treatment efficacy. In particular, Viagra is sensitive to food intake:
- Eating fatty foods or foods rich in alcohol can considerably reduce the absorption of Viagra and therefore its effectiveness.
- It is therefore advisable to take Viagra on an empty stomach or at least after a light meal to optimize its action.
Conversely, Cialis is less affected by food, giving it a certain flexibility of use. However, alcohol moderation is still recommended to preserve erection quality and avoid other side effects.
4. The importance of hormone balance: the key role of testosterone
An often overlooked but crucial factor in the successful treatment of erectile dysfunction is hormonal balance, particularly levels of free or bioavailable testosterone. Testosterone is the main male sex hormone, essential not only for libido but also for erectile function.
If hormone assays reveal a testosterone deficiency, even the most effective drug treatments may prove ineffective. In this case, hormone replacement therapy may be necessary to restore a hormonal balance favorable tothe action of PDE5 inhibitors.
Dr. Beley therefore recommends a full hormonal check-up in the event of treatment failure, to ensure that the physiological conditions are ripe for improvement.
5. When to move on to second-line treatments: Intracavernosal injections
If, despite correct dosage, appropriate timing, controlled diet and normal hormonal balance, oral treatment fails, it’s time to consider more effective alternatives. Among these, intracavernosal injections represent a powerful and often under-utilized treatment option.
These injections involve injecting a vasoactive drug, such as Vitaros, directly into the corpus cavernosum of the penis, causing blood vessels to dilate and an almost immediate erection to take place. This treatment is particularly effective for patients with severe erectile dysfunction or erectile dysfunction resistant to oral treatments.
However, before resorting to this method, a thorough examination of the arteries and veins of the penis is recommended, often performed by Doppler ultrasound. This examination enables us to assess the quality of the vascularization and detect any venous or arterial disorders responsible for the dysfunction.
6. Penile Doppler ultrasonography: An essential tool for understanding treatment failure
PenileDoppler ultrasonography is an essential diagnostic step when oral treatments fail. It provides a detailed analysis of :
- The quality of arterial blood flow to the penis.
- Venous function and the ability to retain blood in the penis.
This precise assessment helps the doctor to identify the vascular causes of erectile dysfunction, which may be arterial, venous or mixed. Depending on the results, treatment can be adapted, for example by combining several approaches or referring to surgical solutions if necessary.
7. Combination therapies: optimizing results by combining treatments
In some cases, Dr. Beley recommends the combined use of several treatments to increase the chances of success. For example:
- Daily treatment with low-dose Cialis (5 mg) to maintain good vascularization.
- Occasional use of full-dose Viagra or Cialis during intercourse.
This strategy enables patients to benefit from the improved physiological basis of daily treatment, while retaining the potency of a higher dose at key moments. This combination may prove particularly effective in certain patients, especially those with moderate to severe erectile dysfunction.
8. The importance of specialized medical care: Consult a urologist
When oral treatment fails, it’s vital not to be left alone with your questions or doubts. Follow-up by a urologist specialized in andrology is essential for :
- Accurately assess the clinical situation.
- Perform any additional tests required.
- Adapt or change treatment according to results.
- Suggest suitable therapeutic alternatives.
Dr. Beley points out that, in many cases, it is possible to regain good erectile function through personalized, step-by-step treatment. Sometimes, all that’s needed is a break in treatment, a change of medication and then a return to good efficacy.
9. Practical advice for patients : How to optimize your treatment
To maximize the chances of success with Viagra, Cialis or other treatments, here are some practical tips to follow:
- Do not reduce the dose without medical advice.
- Taking the right medicine at the right time: Experiment with different timings to find the one that suits you best.
- Avoid fatty meals and alcohol: especially with Viagra, prefer a light stomach.
- Hormonal check-up: Check testosterone levels and request treatment if necessary.
- Consult a specialist: In the event of failure, seek urological advice for appropriate follow-up.
- Be patient: It may take several tries before satisfactory results are obtained.
10. Perspectives and innovations : Towards new treatments and approaches
The treatment of erectile dysfunction is constantly evolving thanks to medical and technological advances. In addition to oral treatments and injections, other options exist or are being developed:
- Focused shockwave therapy: Used to stimulate local vascularization.
- Penile implants: Surgical solution for severe and resistant cases.
- Personalized hormone therapy: restoring optimal endocrine balance.
- New molecules in research: Expanding pharmacological options.
These prospects offer hope to patients who have difficulty with conventional treatments, and demonstrate the importance of regular follow-up and comprehensive management.
Conclusion: Never give up hope in the face of erectile dysfunction
Viagra and Cialis have transformed the lives of millions of men, but their effectiveness is not guaranteed for everyone. In the event of failure, it’s essential not to give up and to consult a specialized healthcare professional. A thorough assessment, treatment adaptation and, sometimes, a combination of several approaches can often lead to a return to satisfactory sexuality.
Dr. Sébastien Beley reminds us that every patient is unique, and that successful treatment depends on a detailed understanding of the underlying causes, as well as close collaboration with the patient’s doctor. Erectile dysfunction is not inevitable, and solutions exist to improve the quality of sexual life at any age.
Don’t hesitate to consult an andrologist for a personalized assessment and support tailored to your situation.
