Like many sex therapists, I’m used to seeing so many men walk into my session and state that the meds don’t work, and that they KNOW that they have a mental block somehow. It’s really unfortunate, and I truly empathise with them. The discouragement that they feel when this happens is staggering. There’s an idea that if the medication doesn’t work, it means that there’s really something bad happening somewhere.
Here’s what happens. Medications for erectile dysfunction, especially when there is no physical reason diagnosed by the physician, are given as a first line to help. However, the good doctors may not take the time to go into what you need to do to optimise the meds working. Or may have, but perhaps patients are bursting with enthusiasm to try this out. Here’s where sex therapy at Mindwise Counselling comes in useful.
Sildenafil is a widely used medication to support erectile function, but it doesn’t always work as expected on the first try. If you’re finding that Viagra or Sildenafil isn’t delivering the results you hoped for, don’t despair. There are several important factors to consider before concluding it truly doesn’t work for you.
1. Is Your Dosage Optimized?
There’s no shame in needing a dosage adjustment. Or perhaps they may try out another drug. Medical professionals are trained to refine and titrate medications based on your unique circumstances. If your current dose isn’t effective, consider discussing this with your doctor. They can assess your response, medical history, and other factors to determine if a dosage change is appropriate.
Many clients and patients stop and get discouraged when things don’t work out, but this is where support comes in most helpful. Working with real life challenges takes time, and patience.
Always consult your doctor before changing your dosage. Do not self-adjust as this can be dangerous to your health.
2. Watch What You Eat Beforehand
A heavy or high-fat meal can significantly delay the absorption of sildenafil. This can lead to the medication feeling ineffective or wearing off sooner than anticipated.
Many of us love to plan a date night, complete with a wonderful dinner, and schedule sexy time for 11 PM. You many need to ask if you’re setting yourselves up for success though? While you don’t need to take the medications on an empty stomach, opting for a lighter meal or taking the medication a bit earlier can help ensure optimal absorption.
Pro-Tip for Optimal Timing: Avoid scheduling intimacy for late at night when you’re already fatigued. Your body and mind are less likely to respond as well.
3. Are Other Substances Interfering?
Alcohol consumption before or while taking sildenafil can diminish its effectiveness.
Alcohol is a depressant that impacts your body’s ability to achieve and maintain erections. Furthermore, chronic heavy alcohol use can negatively affect hormone levels, blood flow, and nerve function. These are all crucial for healthy erectile function.
Many of my clients socialise and have drinks for work, and find it difficult to balance alcohol, and intimate time. Therapy can help to problem solve, or explore how you can best juggle the best of both worlds to prioritise your relationship or intimate life.
Important Note: This can apply to other mood-altering substances or medications. When in doubt, always discuss potential interactions with your doctor and never stop prescribed medications without professional guidance.
4. Explore Potential Underlying Causes
Erectile difficulties are often a symptom of other health conditions. Cardiovascular issues, high blood pressure, diabetes, and hormonal imbalances (like thyroid dysfunction) are commonly linked to impaired physical response. Have you recently had a comprehensive health check-up?
Beyond physical factors, psychological elements such as anxiety, performance pressure, stress, and depression contribute significantly to erectile challenges. It’s highly recommended to explore these underlying causes with a trained psychosexual therapist or mental health professional. They can work with you to address both your mental and sexual health.
5. Ensure Sufficient Sexual Stimulation
Sildenafil works by supporting the body’s natural arousal process, and it doesn’t create desire or arousal on its own. If you’re not feeling genuinely turned on, emotionally safe, or mentally engaged, the medication’s effects will be limited.
At Mindwise Counselling, our sex and couple therapists can provide guidance on optimizing sexual stimulation, enhancing arousal, and working through obstacles that may be disrupting your natural response.
6. Check Your Timing
Sildenafil is typically taken 30 minutes to 1 hour before sexual activity. Its effects usually peak around 1-2 hours after ingestion and can last for approximately 4-6 hours. Taking it too early or too late relative to when you plan to be intimate can reduce its effectiveness.
7. Embrace a Healthy Lifestyle
Supporting your overall health can significantly improve the efficacy of sildenafil. Regular exercise plays a crucial role in cardiovascular and sexual health.
Studies consistently show that physically inactive individuals are more prone to erectile difficulties. Consistent physical activity improves blood flow, boosts mood, and balances hormones, all of which complement the medication’s effects.
A healthy lifestyle is a natural treatment for sexual dysfunction and erectile dysfunction.
8. Address Potential Sleep Apnea
Sleep apnea, a condition where breathing repeatedly stops and starts during sleep, can significantly impact erectile function. Key signs include:
- Loud snoring
- Waking up gasping or choking
- Persistent daytime fatigue
- Difficulty concentrating
- Dry mouth in the morning
Sleep apnea is concerning because it can:
- Reduce testosterone levels
- Disrupt REM sleep (the phase when sexual arousal is highest)
- Increase fatigue, anxiety, and brain fog
- Impair blood flow to the pelvic area
If you suspect you have sleep apnea, consult your doctor for diagnosis and treatment.
9. Nurture Your Relationship Health
We are not robots, and our bodies don’t perform on demand without emotional context. Your emotions and the health of your relationship can profoundly impact sexual function. Consider if any of these factors are at play:
- Pressure and unspoken tension
- Emotional disconnection
- Unresolved conflict or resentment
- Mismatched needs or desire cycles
10. Give It Time: Try at Least 8 Times
It’s common for sildenafil to need up to 8 times before you can truly assess its effectiveness. Why? Because the very factors listed above (stress, timing, food, arousal, relationship dynamics) can all influence the outcome. A single “unsuccessful” experience doesn’t mean the medication won’t work for you. Be patient and consistent in your approach.
For great outcomes, medical as well as sex therapy support give the most effective treatment for erectile dysfunction.
Our psychosexual therapists at Mindwise Counselling offer therapy that integrates your mental, sexual, and relationship health, fostering a more fulfilling and responsive sexual experience.
We offer a complementary 15-minute exploratory call for you to see how you feel talking to us, and for you to ask your questions. We’re ready when you are.
To start working on yourself, call 6527 0526.
