Quick Answer
Yes, it is possible to take Viagra and not get an erection. There are several reasons why Viagra may not work as expected:
- Taking Viagra after a heavy, high-fat meal, which can delay absorption.
- Drinking too much alcohol, which can make it more difficult to get an erection.
- Taking certain other medications that interact with Viagra.
- Having nerve damage or circulation problems that affect erections.
- Having low testosterone levels.
- Experiencing high levels of anxiety or depression.
- Having diabetes, heart disease, or other medical conditions that make erections difficult.
If Viagra doesn’t work, it’s important to follow up with your doctor to discuss adjusting the dose or trying another ED medication. Make sure to take Viagra as directed on an empty stomach and avoid alcohol. Give the medication time to work – it takes effect in 30-60 minutes.
How Viagra works
Viagra, also known by its generic name sildenafil, belongs to a class of medications called PDE5 inhibitors. It works by relaxing the smooth muscle tissue in the penis and enhancing blood flow. When a man is sexually aroused, erections normally occur when the smooth muscle allows increased blood flow into the penis. Viagra helps facilitate this process.
Specifically, Viagra prevents an enzyme called phosphodiesterase type 5 (PDE5) from working too rapidly. PDE5 breaks down a substance called cyclic guanosine monophosphate (cGMP), which controls blood flow to the penis. By slowing the action of PDE5, Viagra boosts levels of cGMP, allowing more blood to flow to the penis and making it easier to get and sustain an erection when sexually stimulated.
However, Viagra does not have a direct impact on sexual desire or sensation. It only facilitates erections in the presence of arousal. The medication takes 30-60 minutes to start working and the effects may persist for several hours.
Why Viagra may not work
There are several reasons why Viagra may not work as expected:
1. Incorrect use
Viagra needs to be taken properly for maximum effect. Here are some common usage mistakes:
- Taking it after a heavy, high-fat meal – This delays absorption and reduces effectiveness.
- Not allowing enough time for it to work – It takes effect in 30-60 minutes.
- Drinking too much alcohol – Alcohol is dehydrating and can make erections more difficult.
- Taking it inconsistently or stopping use abruptly – Viagra works best with consistent use over time.
- Chewing or crushing the tablet – It should be swallowed whole about 30-60 minutes before sex.
Following dosage guidelines, allowing enough time for absorption, and taking it on an empty stomach can help Viagra work optimally.
2. Underlying health conditions
Various health conditions that restrict blood flow or damage nerves can make it more difficult to get an erection. Viagra may be less effective if underlying issues are not resolved. Medical conditions that can reduce Viagra’s effectiveness include:
- Diabetes – Diabetic nerve damage can make achieving an erection difficult.
- Heart disease – Atherosclerosis can restrict blood flow.
- Obesity – Excess weight contributes to circulation problems.
- Metabolic syndrome – Impacts blood vessel and nerve function.
- Multiple sclerosis – Damages nervous system signals.
- Parkinson’s disease – Impairs nervous system signaling related to arousal and erections.
- Spinal cord injuries – Interrupts nerve signals from the brain to the penis.
- Prostate surgery – Can damage nerves and change anatomy.
Treating any underlying conditions may improve erectile dysfunction and allow Viagra to work better.
3. Certain medications
Some medications can interact with Viagra and affect its metabolism and absorption, resulting in reduced effectiveness. Medications that may decrease Viagra’s effectiveness include:
- Alpha-blockers for high blood pressure – Doxazosin, terazosin, etc.
- Antibiotics – Erythromycin, clarithromycin, telithromycin.
- Antifungals – Itraconazole, ketoconazole, voriconazole.
- HIV protease inhibitors – Ritonavir, saquinavir, atazanavir, etc.
- Nitrates for chest pain – Isosorbide mononitrate, nitroglycerin, etc.
- Blood pressure medications – Minoxidil, guanethidine, etc.
- Seizure medications – Phenobarbital, phenytoin, carbamazepine.
Checking for drug interactions and timing doses appropriately can help prevent issues. Do not take Viagra with nitrates or “poppers” as this poses serious health risks. Inform your doctor of all current medications.
4. Nerve damage
Nerves in the penis must be working properly for Viagra to work. Nerve damage from diabetes, cardiovascular disease, prostate surgery, spinal cord injuries, and other conditions can disrupt the chemical signals needed for an erection. Even with Viagra, nerve signals may struggle to reach the penis. Treating underlying nerve damage, if possible, can improve results.
5. Circulatory problems
Healthy blood vessels are essential for good erections. Atherosclerosis or blood vessel plaque buildup from high cholesterol can restrict blood flow to the penis. This circulatory damage can make achieving an erection difficult even with Viagra. Improving cardiovascular health through diet, exercise, quitting smoking, and medication can potentially help.
6. Low testosterone
Erections depend on adequate testosterone levels. Viagra may have more difficulty working if testosterone levels are low. Low testosterone, or “low T,” is more common in older men but can occur at any age due to injury, chronic disease, or other disruptions to hormone production. Blood testing can determine if testosterone supplementation could help.
7. Psychological issues
For Viagra to work, the brain needs to be in a state of arousal. Anxiety, stress, depression, relationship trouble, lack of attraction, fear of failure, and other psychological issues can make arousal difficult. Viagra does not resolve these underlying issues. Counseling, therapy, antidepressants, and other measures to improve mental health could potentially improve responsiveness to Viagra in these cases.
8. Anatomic defects
Rare congenital anatomic defects of the penis, such as angulation, cavernosal fibrosis, or Peyronie’s disease, can make erections difficult to achieve. Viagra may help minimally, if at all, when significant anatomic deformities are present. In some cases, surgery can correct such issues.
Risks and warnings
Viagra is generally safe when used responsibly under medical supervision. However, there are some warnings to keep in mind:
- Cardiovascular risks: Viagra can lower blood pressure and should not be used by some men with heart conditions. It could be dangerous to take Viagra with nitrates.
- Priapism risk: Unwanted, painful erections lasting more than 4 hours may require medical intervention.
- Vision issues: In rare cases, Viagra may cause sudden vision loss or impairment. Seek immediate care if this occurs.
- Hearing problems: Sudden decrease or loss of hearing has occurred in a small number of Viagra users. Discontinue use if this happens.
- Drug interactions: Viagra should not be mixed with certain medications due to serious interactions.
Always consult a doctor before taking Viagra, especially if taking other medications or have an underlying health condition. Never take more than the recommended dose of Viagra. Seek emergency care for any serious side effects. Viagra requires a prescription for good reason – work closely with your doctor for maximum safety.
When to see a doctor
If Viagra does not seem to be working, it’s important to follow up with your doctor for guidance. Do not simply increase the dosage on your own without medical supervision. Be prepared to discuss details like:
- How often you are attempting to use Viagra
- How long you wait after taking Viagra before attempting sex
- Foreplay and arousal levels prior to intercourse
- Any difficulty obtaining or maintaining erections
- Current medications, vitamins, supplements, and doses
- Any changes in health since starting Viagra
Based on this information, your doctor may:
- Adjust your Viagra dosage or frequency
- Try a different ED medication, such as Cialis or Levitra
- Check for underlying health issues impeding effectiveness
- Ensure you are taking Viagra correctly
- Address psychological factors involved
- Update your list of medications to prevent interactions
- Order diagnostics tests – lab work, imaging, etc.
Do not hesitate to talk to your doctor if Viagra does not seem to be working. Various adjustments can help get Viagra functioning optimally for your situation.
Lifestyle changes and home remedies
While Viagra works for most men with ED, making positive lifestyle changes and using certain home remedies in conjunction can also help improve sexual functioning in some cases:
Exercise and lose weight
Being overweight and physically inactive contributes to erectile dysfunction. Regular exercise for 20-30 minutes per day can reduce weight, improve cardiovascular health, and help circulation needed for better erections.
Eat heart healthy
A diet high in fresh fruits, vegetables, whole grains, fish, and healthy fats promotes circulation. Limit sugary foods, trans fats, processed items, and excessive alcohol. Proper nutrition supports sexual health.
Stop smoking
Smoking is a major risk factor for erectile dysfunction as it damages blood vessels. Quitting improves blood flow.
Reduce stress
High stress negatively impacts sexual functioning and arousal. Try relaxing activities – yoga, meditation, massage, listening to music. Make time to unwind.
Get enough sleep
Not getting 7-9 hours of quality sleep per night can reduce testosterone levels needed for sexual functioning. Stick to consistent bedtimes and avoid screen time before bed.
Acupuncture
Some studies suggest acupuncture may help improve ED by increasing blood flow. Getting frequently treated by an experienced practitioner may enhance arousal.
Pelvic exercises
Kegel exercises to strengthen pelvic floor muscles may heighten sensation and improve erectile strength. Stop urination intermittently to locate these muscles.
While not magic cures, lifestyle changes and home remedies can support improved arousal, circulation, and sexual health when combined with Viagra treatment.
Alternative ED medications
If Viagra is not working optimally, other erectile dysfunction medications can be considered. Popular alternatives include:
Cialis (tadalafil)
- Works similarly to Viagra but can be effective for up to 36 hours instead of 4-5 hours.
- More expensive but allows for more spontaneous rather than planned sex.
- May cause muscle aches and back pain.
Levitra (vardenafil)
- Functions like Viagra with a moderately longer duration of action.
- Less affected by food intake than Viagra.
- Higher doses can increase risk of side effects.
Stendra (avanafil)
- Newer PDE5 inhibitor that starts working in 15-30 minutes.
- Less impacted by food and alcohol.
- More expensive than Viagra and some other options.
Injections
- Alprostadil injected into the penis can relax smooth muscle and improve blood flow.
- Often effective but can be uncomfortable and cause painful erections.
- Must be shown how to properly inject by a doctor.
Discuss the pros and cons of other ED medications with your doctor. Switching prescriptions may produce better results in some men. Combination therapy is also an option.
Natural and herbal supplements
Many dietary supplements claim to improve erectile function, but most lack rigorous scientific research. Popular options include:
L-arginine
An amino acid that may support nitric oxide production and blood vessel dilation. Large doses can cause GI upset.
Panax ginseng
Used in traditional Chinese medicine to boost energy and vitality. Potential modest benefit for ED.
Rhodiola rosea
An adaptogen herb thought to help reduce fatigue and improve sexual functioning. Requires more study.
Ginkgo biloba
Primarily used for memory and focus. May have some effectiveness for ED symptoms.
Maca root
A Peruvian plant traditionally used to enhance sex drive. Some preliminary evidence it may help with ED.
DHEA
A hormone that may help improve sexual performance in men with low DHEA levels. However, long-term safety is unknown.
Always consult your doctor before trying supplements. They have potential side effects and risks. While a few show some promise for ED, more research is needed. They are not as proven or regulated as prescription ED medications.
When to see a specialist
If adjusting Viagra, trying other oral medications, and making lifestyle changes does not improve ED, seeing a specialist may be the next step. Doctors who specialize in sexual dysfunction include:
- Urologist – Focuses on the urinary tract and male genital systems. Can assess medical and surgical solutions.
- Endocrinologist – Treats hormonal imbalances that may contribute to sexual problems.
- Cardiologist – Manages heart and vascular disorders impacting sexual function.
- Neurologist – Addresses nervous system issues causing erectile difficulties.
- Psychiatrist or Sex Therapist – Helps resolve emotional and relationship problems.
After a thorough evaluation, specialists may recommend:
- Advanced medications and injections
- Testosterone or other hormone therapies
- A penile implant
- Counseling for psychological ED contributors
- Vascular surgery (rare)
Do not hesitate to see a specialist if you are not getting sufficient results from primary care ED treatment. There are many options to explore.
Conclusion
Yes, it is possible for Viagra to not work as expected. A number of factors from incorrect usage to underlying health problems can prevent Viagra from being fully effective. Make sure to take Viagra correctly and allow adequate time for it to work. Inform your doctor if the medication is not producing the desired results – there are many potential adjustments and alternatives to improve efficacy. Combining Viagra with healthy lifestyle changes also supports better overall sexual functioning. With some troubleshooting and patience, Viagra can successfully treat ED for most men.
