Q: I’ve tried Viagra for erectile difficulty, but it gives me headaches. I’ve heard there are other sexual enhancers available or in testing. What can you tell me about these?
A: Headache is a common side effect of sildenafil (Viagra). The good news is that “sexual enhancers” today include several evidence-based options with different dosing schedules and side-effect profiles. Rather than pushing through headaches, it’s reasonable to consider alternatives and complementary strategies with your clinician.
Modern Oral Options (beyond Viagra)
- Tadalafil (Cialis): Longer-acting; can be taken as needed (onset ~30–60 minutes, duration up to 36 hours) or as a low daily dose, which some men find gentler with fewer peaks in side effects.
- Vardenafil (Levitra): Similar to sildenafil but may be better tolerated by some. Avoid taking with large, high-fat meals (can delay effect).
- Avanafil (Stendra): Faster onset in many men (as little as ~15–30 minutes) and a side-effect profile some find milder.
If your primary concern is side effects, discuss starting doses, timing, food/alcohol interactions, and potential drug interactions (especially nitrates and certain alpha-blockers) with your prescriber. For more background on expected reactions, see our guide to the Side Effects of Viagra.
Non-oral Therapies
When pills aren’t a fit, urology-guided options can reliably trigger erections by increasing penile blood flow directly:
- Alprostadil (intraurethral suppository or injection): A prostaglandin E1 that dilates penile blood vessels. Your clinician can teach proper technique and dosing to minimize discomfort.
- Vacuum erection device (VED): A medication-free option that draws blood into the penis, with a tension ring to maintain firmness. Learn how it works in Vacuum Pump for Erection Problems.
- Penile implant: A surgical solution for men who don’t respond to other therapies; satisfaction rates are high in the right candidates. See Penile Implants for an overview.
Lifestyle, Health Check, and Counseling
Erections reflect overall vascular, hormonal, and psychological health. Addressing the basics can boost every treatment:
- Cardiometabolic tune-up: Manage blood pressure, blood sugar, cholesterol, weight, and sleep apnea.
- Habits: Limit alcohol; avoid smoking and recreational drugs. Regular activity improves nitric-oxide signaling and blood flow (see our tips in Improving Man’s Sex Drive).
- Mental health: Performance anxiety, stress, and depression can blunt response to meds; brief sex therapy or CBT often helps even when ED has a physical basis.
- Medication review: Some prescriptions (e.g., certain antidepressants, antihypertensives) can worsen ED; your clinician may have alternatives.
What about “new” experimental enhancers?
Over the years, agents like oral phentolamine (Vasomax) and apomorphine (Uprima) were explored but did not become widely used. Today’s standard of care centers on the PDE5 inhibitors above, alprostadil formulations, VEDs, and—when appropriate—implants. Be cautious with over-the-counter “boosters”; many are unregulated and can contain undisclosed drugs.
Bottom Line
If sildenafil causes headaches, don’t give up—many men do well by switching to a different PDE5 inhibitor, changing dose or timing, or using a non-oral therapy. A brief health check to optimize cardiovascular risk factors, plus support for anxiety or mood, often improves results across the board.
Authoritative resource: For a clear, patient-friendly overview of erectile dysfunction causes and treatments, see MedlinePlus: Erectile Dysfunction.