The ultimate erectile dysfunction treatment guide: Which is right for you?

Tuesday, July 28, 2026

When it comes to treating erectile dysfunction (ED), most people have heard of Viagra, the blue pill containing the active ingredient Sildenafil. But this tablet is far from your only option.

Men with erectile dysfunction can choose from longer-lasting tablets such as Tadalafil, topical gels and creams, oral sprays, penile injections, and even devices designed to improve erectile function over time. Only with so many options available, it's not always obvious which treatment to choose.

In this guide, we'll compare the main erectile dysfunction treatments available in the UK and translate what these differences actually mean in real life, so you can choose the treatment that’s right for you.

Complete an online consultation or browse our erectile dysfunction range to get started.

In this article:

What erectile dysfunction treatments are available?
What tablets are there for erectile dysfunction?
What about other treatment options?
What is the best treatment for erectile dysfunction?
What treatment best fits your lifestyle?
Are you ready to explore your options?

What erectile dysfunction treatments are available?

There are four main categories of erectile dysfunction treatments: PDE5 inhibitor tablets, topical treatments, penile injections, and devices. Each option has its own advantages and disadvantages, and the right choice depends on what you’re looking for from treatment.

Below is a quick summary of all the medicines available at Oxford Online Pharmacy:

TREATMENT	BRAND NAMES	TYPE	SPEED	DURATION	PRESCRIPTION
Sildenafil	Generic Sildenafil, Viagra, Viagra Connect, Eropid	Tablet	30–60 minutes	Up to 36 hours	Yes*
Tadalafil	Generic Tadalafil, Cialis, Cialis Together	Tablet	30–60 minutes	Up to 36 hours	Yes*
Avanafil	Generic Avanafil, Spedra	Tablet	Around 15 minutes	Up to 6 hours	Yes
Vardenafil	Generic Vardenafil, Levitra	Tablet	30–60 minutes	4–5 hours	Yes
Eroxon Stimgel	Eroxon Stimgel	Gel	Around 10 minutes	0–60 minutes	No
Vitaros	Vitaros	Cream	5–30 minutes	1–2 hours	Yes
Hezkue Spray	Hezkue Spray	Oral Spray	Around 15–30 minutes	4–5 hours	Yes
Alprostadil	Generic Alprostadil, Caverject, Viridal	Injection	5–20 minutes	Around 1 hour	Yes
Vertica	Vertica	Device	Gradual improvement	Long-term use	No

*Viagra Connect (50mg Sildenafil) and Cialis Together (10mg Tadalafil) are available from pharmacies without a prescription following a suitability assessment.

What tablets are available for erectile dysfunction?

Tablets are usually the first treatment men try. They work by increasing blood flow to the penis, making it easier to get and maintain an erection when you're sexually aroused (1).

Because they work in a similar way, they share many of the same side effects, including headaches, facial flushing, indigestion, nasal congestion and dizziness. But not all ED tablets are the same. Some work faster than others, some last much longer, and some may fit better with your lifestyle.

Complete an online consultation or browse our erectile dysfunction range to get started.

Sildenafil (Viagra)

Sildenafil is the active ingredient in Viagra, the first tablet licensed for erectile dysfunction. Today, it is also available as generic Sildenafil for cheaper.

The medicine comes in strengths of 25mg, 50mg and 100mg. Most men start with 50mg, which can also be purchased over-the-counter, and adjust their dose if needed. The tablet is usually taken 30 to 60 minutes before sex, and the effects typically last for around 4 to 6 hours (2).

Best for: Men looking for a well-established treatment that can be used as needed.

Tadalafil (Cialis)

Like Sildenafil, Tadalafil (brand name Cialis) typically starts working within 30 to 60 minutes, but it remains in the body for much longer. Its effects can last up to 36 hours, earning itself the nickname “the weekend pill” (3). This longer window of effectiveness allows for more spontaneous sex.

Rather than taking it before sex, some men take a lower dose daily to provide continuous support. This makes it a good option for men who have regular sex and prefer not to think about taking medication before intimacy.

Best for: Men who want longer-lasting effects or a daily treatment option.

Avanafil (Spedra)

Avanafil is available in strengths of 50mg, 100mg and 200mg and is taken as needed before sex (4).

Its main advantage is speed. While response times vary between individuals, some men may find Avanafil starts working in as little as 15 minutes, making it one of the fastest-acting ED tablets available. The effects typically last for up to 6 hours.

Best for: Men looking for the fastest-acting erectile dysfunction tablets

Vardenafil (Levitra)

Vardenafil is very similar to Sildenafil. It’s a prescription-only medicine usually taken 1 hour before sex, with effects typically lasting for around 4 to 5 hours (5).

While it is more expensive than Sildenafil, it has some advantages. First, its absorption is less affected by food, meaning it may still work well if taken after a meal. Some studies have also suggested it may be particularly effective for men whose erectile dysfunction is linked to diabetes.

Best for: Men who haven't achieved the desired results with sildenafil.

What about other treatment options?

While tablets are often the first treatment recommended for ED, they're not always suitable. Some men can’t take tablets because of other medications or health conditions. Others prefer not to take tablets at all, or simply don't see the results they were hoping for.

Fortunately, there are now several alternatives available that may be more suitable depending on your symptoms, lifestyle, and treatment goals.

Eroxon Stimgel

Eroxon is a topical gel massaged into the head of the penis before sex. Like tablets, it works by increasing blood flow to the penis, but it does this by creating a cooling and warming sensation that helps stimulate the nerves. This makes it easier to get an erection when aroused (6).

One of Eroxon's biggest advantages is that it starts working within 15 minutes and can be used as part of foreplay. It’s also available without a prescription.

Best for: Men looking for a fast-acting, non-prescription treatment.

Vitaros cream

Like Eroxon, Vitaros is a topical treatment applied to the tip of the penis before sex. But while Eroxon works through a cooling and warming effect, Vitaros contains a prescription-only medicine called Alprostadil, a vasodilator that increases blood flow to the penis by relaxing local blood vessels (7).

Vitaros can start working within as little as 5 to 10 minutes, although some men may not notice the full effects for up to 30 minutes. The effects typically last for around 1 to 2 hours.

Best for: Men who prefer topical treatment but want something prescription-strength.

Hezkue oral spray

Hezkue contains Sildenafil, the same active ingredient found in Viagra and generic Sildenafil tablets, but is delivered as an oral spray rather than a pill, which some men find more discreet and convenient (8). It’s also a good option if you don’t like taking tablets.

The effects last around 4 to 5 hours, the same as Sildenafil tablets. But Hezkue kicks in a little faster, in around 15 to 30 minutes, and can be bought without a prescription.

Best for: Men who don’t like taking tablets or find a spray more convenient.

Alprostadil injections (Caverject)

Alprostadil injections, such as Caverject, are injected directly into the side of the penis shortly before sex. This may sound intimidating, but they can be highly effective, and unlike all erectile dysfunction treatments discussed so far, sexual stimulation is not required for the treatment to work (9).

The most common side effects are mild and include pain, aching or burning sensations in the penis, as well as redness or bruising at the injection site.

Best for: Men who have not responded to other erectile dysfunction treatments.

Vertica

Vertica takes a different approach to treating ED. Rather than being a medication used immediately before sex, it’s a device that uses radiofrequency technology to improve erectile function over time. The device is used two or three times per week, with each treatment session lasting 30 minutes.

While not as well-studied as established treatments like Sildenafil, many men report stronger erections with long-term use (10). The main drawback is cost. It’s one of the most expensive treatments available, with the standard device costing £1,275.

Best for: Men looking for a drug-free treatment option.

What is the best treatment for erectile dysfunction?

When people ask about the "best" erectile dysfunction treatment, they are often asking which treatment is most effective. For most men, prescription tablets are the best place to start. These medicines have been studied extensively and work 60 to 70% of the time (11).

If you're unsure which tablet to try first, our Trial Pack can be a useful starting point. These packs contain four-pack boxes of Sildenafil, Vardenafil, and Tadalafil, allowing you to see which you get along with best. But tablets aren’t necessarily the right choice for every man.

If they don't work for you, cause side effects, or simply don't fit well into your lifestyle, it may be worth exploring some of the alternatives. Ultimately, the best ED treatment is the one that provides the results you're looking for and fits comfortably into your life.

Complete an online consultation or browse our erectile dysfunction range to get started.

Which treatment best fits your lifestyle?

To work out which treatment for erectile dysfunction might suit you best, ask yourself:

How often do I have sex? If you only have sex occasionally, an on-demand option like Sildenafil or Eroxon may work. If you have sex more frequently, longer-lasting options like Tadalafil or daily Tadalafil might suit you better.
How important is spontaneity? Sildenafil requires more planning and needs to be taken an hour before sex. Tadalafil can be effective for up to 36 hours, allowing for more spontaneity. Topical treatments and Hezkue work quickly, making them easier to fit into the moment.
Do I want a prescription? Most ED medicines require a prescription. If you prefer getting treatment over the counter, your options are Viagra Connect (50mg Sildenafil), Cialis Together (10mg Tadalafil), Eroxon, Hezkue, or the Vertica device.
What’s my budget? Cost varies dramatically between treatments. Generic Sildenafil is usually the cheapest option, while branded medicines like Viagra and Cialis cost more than their unbranded equivalents. Devices like Vertica sit at the other end of the scale.
Am I comfortable using the treatment? Many men are happy taking a tablet before sex. Others prefer applying a cream or gel, or find using a spray more convenient. If you decide to try treatments like Caverject, make sure you feel comfortable with injections.
Do I have any other health conditions? Certain medicines, particularly nitrates used for heart conditions, can affect whether treatments such as Sildenafil or Tadalafil are safe to use. Your medical history may also influence which option is most likely to work well for you.

Are you ready to explore your options?

Whether you're considering treatment for the first time or looking for an alternative to your current medication, understanding your options is the first step. But knowing which one to choose can feel overwhelming, especially if you don't feel comfortable discussing erectile dysfunction or aren't sure where to turn for advice.

At Oxford Online Pharmacy, our UK-registered prescribers can help. Complete a short medical questionnaire, and our doctors can assess your symptoms, lifestyle and medical history to help identify suitable treatment options, all without the need for an awkward face-to-face appointment.

Complete an online consultation or browse our erectile dysfunction range to get started.