What is Sildenafil and How Does It Work

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Written By Julie Ingram
what is sildenafil

Males face many challenges in their sexual lives that can affect their confidence and self-esteem. 

Erectile Dysfunction (ED) is one of those sexual challenges. It is the difficulty in getting or maintaining an erection during sexual activity. 

Sildenafil is a popular medication for treating Erectile Dysfunction (ED) in men or Assigned Males at Birth (AMAB).

This article aims to give you a brief overview of Sildenafil. It will discuss what is Sildenafil, how it works, and its history.

History of Sildenafil

Sildenafil is a medication that belongs to a group of drugs called  Phosphodiesterase Type 5 (PDE5) inhibitors.

In 1989, Sildenafil for ED was discovered by mistake by scientists at Pfizer. They were looking for a drug to treat Angina, a type of chest pain due to reduced blood flow to the heart. 

However, during clinical trials, they found that Sildenafil had a more significant effect on improving erectile function than on improving Angina.

As a result, the FDA approved Sildenafil as the first oral medication for treating ED in 1998.

This makes Sildenafil the oldest and most extensively researched medication for ED treatment

For an in-depth exploration of how Sildenafil turned into a revolutionary ED medicine, refer to this articleThe History of Sildenafil and its Development

Why is Sildenafil Prescribed

Sildenafil is a medication primarily prescribed when:

  • You can get an erection, but not at the time you want
  • You can get an erection, but it does not last long enough for satisfactory sex
  • You can not get an erection at all

You may suffer from these symptoms occasionally. However, if it becomes a regular issue, it may indicate a condition of Erectile Dysfunction. 

Sildenafil is not just for treating ED—it is prescribed for various medical issues. Explore the Versatile Uses of Sildenafil in Medical Treatments

Understanding Erectile Dysfunction

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Erectile Dysfunction (ED) is a condition in men or AMAB that makes it challenging to get or maintain an erection.

It is a common condition, affecting 30 million males in the US alone.

At the time of sexual arousal, the brain sends a signal to the nerves of the penis to release cyclic Guanosine Monophosphate (cGMP).

The release of cGMP causes the blood vessel in the penis to relax. This relaxation allows blood to flow freely into the penis, filling the two chambers, namely, corpora cavernosa and corpus spongiosum. 

As the blood fills the chambers, the penis becomes hard and erect.

Erectile Dysfunction occurs when something blocks or disrupts the blood flow to the penis. 

Penile blood flow can be impeded due to various causes. 

These causes include physical, psychological, and lifestyle factors. 

  • Physical causes of ED – Physical conditions like heart disease, Diabetes, high blood pressure, Obesity, and neurological disorders can contribute to ED.
  • Psychological causes of EDSome common problems like Anxiety, Depression, and relationship problems can affect sexual health and cause ED.
  • ED due to lifestyle factors – Some bad lifestyle habits like smoking, excessive alcohol consumption, and drug use can also contribute to ED.
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  • How Sildenafil Works to Treat Erectile Dysfunction

    All PDE5 inhibitors, including Sildenafil, improves the blood flow to the penis by blocking PDE5.

    When a man gets sexually aroused, his body releases Nitric Oxide. 

    Nitric Oxide helps to produce cGMP. cGMP is important to get an erection. The main job of cGMP is to relax blood vessels and improve blood flow. 

    The PDE5 enzyme breaks down cGMP, which results in losing an erection.

    PDE5 inhibitors like Sildenafil block PDE5 enzymes from breaking down cGMP.

    As a result, the cGMP level increases. The increased cGMP level results in the relaxation of blood vessels and improved blood flow. 

    This increased blood flow to the penis helps men in getting or maintaining an erection.

    Does Sildenafil work the same for treating Female Sexual Dysfunction (FSD)? Find the answer in this articleSildenafil for Women: Can It Help With Sexual Dysfunction

    Why is Sildenafil Prescribed Over Other ED Medications

    Although other drugs are available for ED, Sildenafil is the most prescribed drug for ED treatment. 

    With more than 2 million prescriptions, in 2020, it was the 183rd most prescribed medication in the US.

    Some other drugs for ED are Tadalafil (Cialis), Vardenafil (Levitra), and Avanafil (Stendra).

    Sildenafil is prescribed over other drugs for many reasons:

    • Effectiveness – Sildenafil has been extensively studied and proven very effective in treating ED. It has a high success rate in improving ED and is well-tolerated by most people.
    • Fast action – Sildenafil typically starts working within 30 minutes to an hour. It is a good choice for people who want to have sex soon after taking the medication.
    • Cost – Sildenafil is less expensive than other PDE5 inhibitors. It is more accessible to people who may not have insurance coverage or who are on a tight budget.

    Delve into these articles for a comprehensive comparison of Sildenafil with other ED medications:

    Tadalafil vs Sildenafil – Which ED Pill Reigns Supreme

    Vardenafil vs Sildenafil: A Head-to-Head Comparison

    Sildenafil vs Avanafil: Which One to Choose

    Please note that only a doctor should determine which PDE5 inhibitor to use. Many factors like medical history, physical health, and other medication you are taking can cause side effects.You must talk to your doctor before taking Sildenafil to determine if it is safe and appropriate.


    Sildenafil is a medication used to treat Erectile Dysfunction (ED) in men. It belongs to a group of drugs called PDE5 inhibitors.

    Pfizer scientists discovered Sildenafil in 1989, and it became the first approved oral medicine for ED in 1998. This drug increases blood flow to the penis, making it easier for men to get and maintain an erection.

    It is prescribed over newer ED drugs because it is well-studied and is usually cheaper than other options.

    Different factors, such as physical health, mental health, or lifestyle choices, can cause ED.

    While Sildenafil treats ED, it does not address the root cause.

    Living a healthy lifestyle and addressing mental health issues can enhance the effectiveness of Sildenafil. 

    Frequently Asked Questions

    Can Sildenafil cure Erectile Dysfunction?

    Even though Sildenafil is a very effective treatment for ED, it does not cure its root cause. 
    Sildenafil can help a person temporarily achieve and maintain an erection. It is not a permanent solution for the treatment of ED.

    Are there any side effects of Sildenafil?

    While Sildenafil is generally considered safe and effective, it can cause side effects in some individuals. Some side effects of Sildenafil include headache, facial flushing, upset stomach, and nasal congestion.

    How effective is Sildenafil in treating ED?

    Sildenafil is highly effective in treating Erectile Dysfunction (ED), with up to 83% of men experiencing improved erections. 

    However, the effectiveness of Sildenafil may vary depending on individual factors, such as the severity of ED and underlying medical conditions.

    Is Sildenafil as strong as Viagra?

    Sildenafil and Viagra are essentially the same thing. Viagra contains Sildenafil as its active ingredient. Viagra is a brand name used by Pfizer to sell Sildenafil. 
    Other companies started generic Sildenafil after Pfizer’s patent on Viagra expired. All of them have the same strength and effectiveness in treating ED.

    Is it OK to take Sildenafil every day?

    You can take Sildenafil daily, but only if your doctor recommends doing so. The doctor can decide your Sildenafil doses based on your health conditions and age. 

    Do not change your Sildenafil dosing regimen without consulting a doctor first.

    Does Sildenafil increase time?

    No, it is not specifically designed to make you last longer. It can only help you to get and keep an erection.

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