Erectile dysfunction is an upsetting and life-changing condition that affects many men around the world. Specifically, ED prevents men from being able to achieve erections, which in turn means they are unable to enjoy intercourse. While there are many treatments for the condition, the most popular interventions involve the use of drugs. Two of those drugs are Cialis vs Viagra.
If you are currently struggling from erectile dysfunction and are looking for an effective treatment, then you will likely have been pointed in the direction of these drugs. So what is the difference, and which one will provide the best solution?
Difference between Cialis and Viagra
To make it simple, these are the main differences in a generalized way:
Effect: Same
Onset off effect:
Cialis: after ~1-3 hours
Viagra: after ~20-60 minutes
Duration:
Cialis: ~36 hours
Viagra: ~4-6 hours
Side effects:
Cialis: milder than Viagra
Viagra: stronger than Cialis
Mechanism of Action
Cialis and Viagra are classified as PDE5 inhibitors. A PDE5 inhibitor is a drug that is used to block phosphodiesterase type 5 in smooth muscle tissue. PDE5 is an enzyme that breaks down another substance called cGMP. This controls the dilation and the contraction of blood vessels that direct blood to the penis. By destroying cGMP, PDE5 can prevent an erection from occurring. Therefore, both Cialis and Viagra are able to increase the likelihood, length, and firmness of an erection.
Increasing PDE5 this way on the other hand will elevate levels of nitric oxide. Nitric oxide (NO) has a vasodilatory effect, meaning that it will widen the blood vessels and thereby increase blood flow.
What is important to remember, is that erections are the result of increased blood flow to the penis. This blood will fill the area, causing it to become harder and more sensitive to touch. Specifically, PDE5 inhibitors deliver increased blood to the corpora cavernosa (cavernous bodies), which contain most of the blood in the penis.
There are two corpora cavernosa and one corpus spongiosum. These extend along the length of the penis, with the cavernosa lying along the shaft from the public bones to the tip (where they join). They are made from a “sponge-like” tissue, which has the ability to expand and contract. After the erection, the excess blood is drained away, and the penis returns to its normal size and strength.
It’s worth noting that PDE5 inhibitors will only work during arousal. This is because arousal increases the production of NO, and it is NO that “actives” the action of these drugs.
Cialis vs Viagra – Differences Explained
Cialis is actually the brand name for a substance called Tadalafil, whereas Viagra is really called Sildenafil. Both substances are PDE5 inhibitors, though they do have some differences.
History and Release
Of the two, Viagra was the first to market. This was actually the first PDE5 inhibitor that was approved by the FDA for ED. It was also the first oral pill that could offer these benefits. This all happened in 1998, though a generic for Viagra was approved in 2016 and released in 2017. Cialis was meanwhile approved 5 years later in 2003. This was the third PDE5 inhibitor to hit the market, following the release of Levitra.
Half-Life
In terms of functionality, one key difference between the two, is that Cialis has a longer half-life of 18 hours vs 2-2.5 hours for Viagra. That means that Cialis will remain active for 36 hours, as compared with just 4-6 hours for Viagra. Remember: PDE5 inhibitors only work when there is nitric oxide present, usually as a result of arousal. That means that the user is not going to be walking around with an erection for the following 36 hours! Rather, they should simply find that it is easier to achieve and maintain an erection as needed.
Speed of Action
Another difference is how quickly the two drugs begin to work. Whereas Cialis will work in 1-3 hours (depending on the person and body), Viagra is more consistently likely to kick-in at the 30 minute mark. One mitigating factor in all this, is that Viagra can be negatively affected by food. If you should eat a high-fat meal, then you may find that Viagra does not work as well as it otherwise would. It may also take longer to have an effect. This means that it is generally best to take Viagra on an empty stomach.
Effectiveness
Perhaps the most important consideration however is the effective. In general, it has been found that both Cialis and Viagra are similarly effective. That said, Viagra is mildly more effective: 84% versus 81% for Cialis.
Dosage and Administration
Cialis is used on an “as needed” basis. That means you will use it as frequently as you need and will increase the dose in order to achieve the desired effect. It is generally recommended that you start with a dosage of 10mg. This should be taken prior to sexual activity. If this is ineffective, then you may increase the amount to 20mg. If the effects are felt too strongly, then you may wish to reduce the quantity to 5mg. It is important that patients only take a single dose in 24 hours. Likewise, it is not recommended that users take 10-20mg doses daily.
Viagra is conversely taken in larger doses, again as needed. Generally this will be limited to 50mg, taken one hour before sexual activity. Dosage can be increased to 100mg or decreased to 25mg if a stronger or more modest effect is desired. Viagra may be used daily, though should not be taken more than once inside 24 hours. It is important to be careful when using Viagra or Cialis in combination with other drugs or medicines. Vasodilators such as Aspirin or blood pressure medication in particular may cause the blood vessels to widen even further, exaggerating the side effects.
Cialis vs Viagra – Side Effects
The primary side effects of Viagra are headache, flushing, and indigestion. These side effects are the same for Cialis. Viagra may also cause changes in color perception for a few patients, but this effect is not present with Cialis.These side effects are a result of the increased blood flow and vasodilation. As blood vessels widen, this causes the blood pressure to drop. Imagine trying to suck water through a very wide straw for an idea of how this might work. This in turn means that blood may not reach the brain as readily due to the effect of gravity.
Note as well, that as more blood flow is delivered to the penis, this can also cause less blood to reach other areas. This is how PDE5 inhibitors are able to cause indigestion. As blood flow is directed toward the penis, it is taken away from the digestive system. That in turn means that the digestion will be impaired and that can lead to acid reflux and similar symptoms. These symptoms are generally not dangerous, though you should consult with your GP if you are concerned.
Limitations and Alternatives
Although Viagra and Cialis are considered effective and work well for many people, they are far from perfect. Many people have a sense of dissatisfaction and 50% of users will stop using them after one year. As such, many alternatives are available that are racing to become the go-to ED treatment. These include the likes of gels that are applied topically to the area. However, one of the most effective treatments for ED is psychotherapeutic intervention – the “talking cure.”
While erectile dysfunction is often the result of illness, physical impairment, or other biological cause, it is also important to recognize that there is a large psychological element. In particular, erectile dysfunction is closely related to stress, with the release of stress hormones actually causing a vasoconstriction effect.
CBT for Erectile Dysfunction
When we are stressed, this elevates our heartrate, strengthens our muscle tone, and increases our energy levels. This response is intended to help us overcome physical threats and dangers and redirects blood from functions such as digestion and bowel movements over to the muscles and brain.
This can also rob the genital region of blood flow, causing the area to constrict as more blood supply is directed to the muscle. In fact, blood flow to muscles can increase by as much as 20 times!
The unfortunate fact is that many people feel stressed during intercourse precisely because they are concerned about erectile dysfunction. This can result in a vicious cycle, as the sufferer talks themselves into a panic and thereby causes themselves to lose their erection. Interventions like Cognitive Behavioural Therapy (CBT) can teach patients to control their autonomic nervous system with breathing exercises and mental techniques. Likewise, it will teach them to recognize destructive thoughts and to replace them with more helpful strategies via a process called “cognitive restructuring.” This can prove highly effective, especially when combined with a PDE5 inhibitor.
Closing Comments
Cialis vs Viagra – what to use? The answer is that either drug should provide positive benefits, with the main difference being the half-life and speed of effect. For that reason, many prefer Cialis over Viagra. However, for the best results and long-term effects, it is advisable to address the psychological root causes of the issue at the same time. This way, many can overcome ED quickly and end their reliance on drugs.
Home »
