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Why Is Viagra Not Working for Me?

Mike Bohl, MD, MPH, ALM

Reviewed by Mike Bohl, MD

Written by Vanessa Gibbs

Published 07/14/2019

Updated 01/18/2024

You’ve been prescribed Viagra®, or the generic version sildenafil, and finally your erectile dysfunction (ED) problems are over. But then…it doesn’t work. Ugh.

It’s important to remember that Viagra — or any other ED drug, for that matter — isn’t 100 percent effective. 

So what if Viagra doesn’t work for you? Here are the potential reasons why: 

  • You’re not using Viagra correctly.  

  • You’re using a low dose of Viagra. 

  • You’re giving up on Viagra too early. 

  • Your ED is caused by an underlying health condition. 

  • Porn is affecting your sexual performance.

  • Your ED is psychological. 

  • Viagra isn’t the right medication for you. 

Below, we dive into these reasons in more detail — including how to fix them — and cover why Viagra might stop working after being successful for you in the past.

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How Viagra Works for Erectile Dysfunction

ED occurs when you can’t get or keep an erection firm enough for satisfactory sex. 

You might: 

  • Get an erection sometimes, but not every time you want to have sex 

  • Get an erection, but it doesn’t last long enough for good sex 

  • Never get an erection 

Viagra is one treatment for ED. It belongs to a class of medications called phosphodiesterase type 5 inhibitors, or PDE5 inhibitors

You might have heard of other PDE5 inhibitors like: 

  • Levitra® (vardenafil)

  • Cialis® (tadalafil)

  • Stendra® (avanafil) 

If you don’t have ED, your nervous system sends a signal to the corpora cavernosa — bodies of erectile tissue in your penis — when you get sexually stimulated. This signal causes the production of nitric oxide, which diffuses into the smooth muscle cells in the arteries that supply blood to your penis and stimulates the formation of a cellular messenger called cGMP. 

Then, cGMP causes your blood vessels to dilate and more blood to flow into your penis. And voila — an erection. 

Viagra acts on the enzyme PDE5, which is found in the smooth muscle cells of your penis. 

As the name suggests, PDE5 inhibitors inhibit PDE5, which degrades cGMP. So when you take Viagra, cGMP builds up in the smooth muscle and is free to do its thing — which is to dilate blood vessels and increase blood flow to promote an erection.  

Or, in simple terms, Viagra works by increasing blood flow to your penis, resulting in better erections. Bye-bye, ED.

It’s worth noting that Viagra only affects blood flow. It doesn’t increase sexual arousal or desire, and you’ll still need some sexual stimulation to get hard.

Viagra is an effective treatment for ED, though. Research shows that the drug has a 70 percent to 80 percent success rate. 

You can learn more in our guide to Viagra uses

Why Is Viagra Not Working for Me? 

Viagra is an effective treatment for ED for many men, but it’s not a guarantee. 

Here’s why you may find Viagra is not working for you. 

You’re Not Using Viagra Correctly

We don’t want to point any fingers, but one reason Viagra may not work for you is because you’re not taking it correctly. 

Here’s where you could be going wrong: 

  • You’re trying to have sex too soon. You should take Viagra at least 30 minutes to one hour before having sex. If you pop a pill and try to get it on straight away, the medication won’t have had enough time to work. 

  • You’re waiting too long to have sex. On the flip side, you might be waiting too long to have sex after taking Viagra. Viagra can give you ED relief for up to four hours. So if you take it in the morning and try to have sex that evening, it won’t work.  

  • You’re taking Viagra and eating a high-fat meal. We’re all for a burger and fries, but if you take Viagra alongside a high-fat meal, you might find the drug takes longer to kick in. Try avoiding fat-heavy meals before Viagra or try taking it on an empty stomach to see if that makes a difference.

  • You’re not sexually aroused. As we mentioned above, Viagra doesn’t just give you a spontaneous erection. You’ll need sexual stimulation for that. If you’re not aroused, Viagra can’t help. 

  • You’re drinking too much alcohol. We hate to be the buzzkill, but your drinking habits may be the reason Viagra isn’t working. Alcohol can cause ED (popularly known as “whiskey dick”). Try sticking to alcohol-free drinks on nights you use Viagra or limiting your alcohol consumption to one or two servings. Learn more in our guide on Viagra and alcohol

  • You’re taking recreational drugs. If you’re taking recreational drugs you may have trouble getting hard and Viagra might be less effective. Avoid using recreational drugs (even if they’re legal) while using Viagra to treat ED. 

Learn more in our guide to how to take Viagra for the best results

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You’re Using a Low Dose of Viagra 

Viagra is available in 25mg, 50mg and 100mg doses. If you’re taking a lower Viagra dosage, this may be the reason the drug isn’t working for you. 

A 2013 study used data from two studies to compare sildenafil in 50mg and 100mg doses. Men with ED were given the 50mg sildenafil dose to be taken as needed before sex. After two weeks, those with no issues with the drug were moved up to the 100mg dose.

While the 50mg dose did help to treat ED, the 100mg dose was even more effective.

But this doesn’t mean that you should double up on your dose of Viagra in an attempt to get better results — it could cause dangerous side effects. If you think you need a higher dosage of sildenafil, get medical advice.

And what if 100mg Viagra doesn’t work? Don’t panic. Other ED drugs may work for you instead.

You’re Giving Up on Viagra Too Early 

We know it can be disheartening if Viagra or sildenafil isn’t working. And when you’re suffering from ED, you want a fix — fast! But you may need to be patient with Viagra. 

It’s quite common for Viagra not to work the first time you try it.  

You might be nervous about Viagra side effects or worrying, “what if Viagra doesn’t work?” These worries can up your odds of sexual performance anxiety, which can get in the way of an erection. 

Give Viagra a few tries before you write it off. As you become more comfortable with the medication, you might find it starts working for you. 

Sildenafil has been shown to lead to successful intercourse for 63 percent of men with general ED. We like those odds. 

If Viagra still doesn’t work for you, speak to a healthcare provider. You might need a higher dose or a different ED treatment. 

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Your ED is Caused by an Underlying Health Condition 

If your ED is caused by an underlying health condition, Viagra may not be effective. 

ED can be caused by health conditions such as: 

  • Hypertension (high blood pressure) 

  • Type 2 diabetes 

  • Blood vessel and heart disease 

  • Atherosclerosis 

  • Neurological diseases like multiple sclerosis 

  • Peyronie’s disease

  • Chronic kidney disease 

  • Injury to the penis, spinal cord, prostate, bladder or pelvis 

  • Injury from treatments for prostate cancer 

  • Surgery for bladder cancer 

Hormonal issues like low testosterone are also linked with ED. 

This is an easy one to figure out. You can get your testosterone levels checked and, if yours are low, a healthcare provider may prescribe testosterone therapy to help.

Testosterone therapy has been shown to help men with mild ED, particularly those who are unresponsive to PDE5 inhibitors like Viagra. It can also boost your libido, which can be affected by low testosterone levels. 

Speak to a healthcare provider if you’ve got a medical condition. They can give you the best advice on whether this condition could get in the way of Viagra and suggest different ED treatments that might work better.

ED can also be caused by lifestyle factors like smoking, drinking, drugs, not being physically active, and having overweight and obesity. 

The good news here is lifestyle changes can help. There’s some research showing that quitting smoking can improve erectile function. 

And if your ED is caused by physical inactivity, obesity, high blood pressure, metabolic syndrome or cardiovascular disease, research shows that getting at least 40 minutes of exercise, four times a week for six months can help.  

ED may also improve after weight loss, with eating a Mediterranean diet and eating more fruits and veggies. 

Finally, ED can be a side effect of medications like: 

  • Antidepressants

  • Appetite suppressants

  • Blood pressure treatments

  • Antiandrogens, which are used for prostate cancer therapy 

  • Ulcer meds 

  • Tranquilizers or prescription sedatives 

Speak to your healthcare provider about your meds, as they may be able to recommend a different Viagra dose or a different ED medication. 

Porn is Affecting Your Sexual Performance 

Who knew a seemingly innocent bit of porn could wreak havoc on your erections? 

Porn use may be linked to less sexual satisfaction, but more studies are needed.

A 2014 survey of almost 500 men found that the more porn a man watched, the more likely he was to have concerns over his sexual performance and body image. Higher porn use was also linked to less enjoyment when having sex with a partner. 

These things could lead to less-than-ideal erections that Viagra might not be able to fix.

If you watch porn often, try giving it up for a few weeks to see if that makes a difference. 

You can learn more in our guide on porn-induced ED

Your ED is Psychological 

ED can also be caused by psychological issues, such as: 

  • Fear of sexual failure 

  • Anxiety

  • Depression 

  • Guilt about sexual performance or certain activities 

  • Low self-esteem

  • Stress — about ED or from daily life 

If you’re under 40, psychological causes are probably to blame. Research shows that in men under 40, more than 85 percent have ED caused by psychological factors. 

These causes of ED are still common in men over 40, just less so. About 41 percent of men over 40 have ED caused by psychological factors. In the over-40 club? You’re more likely to have organic ED, which is ED caused by factors like medical conditions or an unhealthy lifestyle. 

Viagra can increase blood flow to your penis, but it can’t help reduce sexual performance anxiety or depression. Unfortunately, it’s not a miracle worker. 

Treating psychological issues can help your ED, though. Couples therapy and behavioral therapy can also help. 

We offer online psychiatry for conditions like depression and anxiety, as well as online therapy, so you can chat with a pro from home. 

You can learn more in our guide to psychological ED

Viagra Isn’t the Right Medication for You 

Viagra is an effective ED medication, but it’s not right for everyone. 

Luckily, it’s not your only option. 

Other ED medications include: 

  • Cialis (tadalafil)

  • Levitra (vardenafil)

  • Stendra (avanafil)

  • Our hard mints, which contain the active ingredients in Cialis, Levitra and Staxyn® at different dosages

ED is almost always treatable, so if Viagra isn’t doing the trick, it’s worth trying a different treatment. 

Some of these medications may work better for you than Viagra — and they even come with their own advantages. 

For example, Stendra may have fewer side effects and can be taken 15 minutes before sexual activity. Cialis — known as the “weekend pill” — can provide relief from ED for a whopping 36 hours! Now we’re talking. 

Speak to a healthcare provider about switching to a different type of ED medication. 

Viagra who?

What if Viagra Stops Working After Successful Use? 

You know what’s confusing? When Viagra works for you for weeks, months or even years and then just…stops. Urgh. 

Viagra doesn’t always work, which might happen if you:

  • Develop a physical health condition 

  • Develop a mental health condition

  • Change something in your lifestyle 

As we mentioned above, ED can be caused by physical and mental health conditions. You might be fighting fit when you start taking Viagra, so it works well for you. But then you might develop a health condition — like high blood pressure or type 2 diabetes. You might also undergo surgery or treatment for prostate cancer. All this can suddenly get in the way of Viagra doing its job. 

The same goes for mental health conditions. Anxiety and depression can crop up, making Viagra less effective. You might also develop sexual performance anxiety or relationship problems. All this, yet again, can cause Viagra to not work. 

And if you’ve started a new type of medication for any of these conditions, it could be making your ED worse.

Your stress levels can also fluctuate over time. If a new relationship problem has come up, Viagra might stop working for you.

As for your lifestyle, you might have more alcoholic drinks than you usually did before popping the little blue pill or maybe you’ve taken up smoking recently. Once again, these can affect how Viagra works for you.

Your best bet is to talk to a healthcare provider. They can recommend treatments for any physical or mental health conditions that have come up, increase your dosage of Viagra or switch you to a different ED medication. 

If your ED is severe, a pro may even recommend a different ED management option altogether, like:

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Why Is Viagra Not Working? The Bottom Line

Viagra not working can definitely be a drag. But it doesn’t have to be a disaster for your sex life.

Here’s a quick recap of what we’ve covered:  

  • Viagra might not work for you for several reasons. You might be using it wrong, need a higher dose or simply need to give it a few more tries. Remember to avoid high-fat meals, too much alcohol and recreational drugs when taking Viagra to see if that helps the ED med work its magic. 

  • Physical and mental health issues can get in the way of Viagra. Whether that’s depression, high blood pressure or stress over ED itself, a lot of health conditions can make erections harder to come by.

  • Other erectile dysfunction medications may work better. Viagra isn’t your only option. Phew. Other ED drugs include Cialis, Levitra and Stendra. 

We offer erectile dysfunction treatments online so you can treat ED quickly and conveniently. If Viagra doesn’t work for you, no biggie. We offer Cialis and Stendra alongside other ED treatments.

24 Sources

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  2. Dhaliwal, A., Gupta, M. (2023, April 10). PDE5 Inhibitors - StatPearls. NCBI. https://www.ncbi.nlm.nih.gov/books/NBK549843/
  3. Viagra (sildenafil citrate) tablets. (n.d.). https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/20895s039s042lbl.pdf
  4. McCullough A. R. (2002). Four-year review of sildenafil citrate. Reviews in urology, 4 Suppl 3(Suppl 3), S26–S38. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1476025/
  5. Jiann, B. (2010). Effect of Alcohol Consumption on the Risk of Erectile Dysfunction. Urological Science, 21(4), 163-168. https://www.sciencedirect.com/science/article/pii/S1879522610600371
  6. Symptoms & Causes of Erectile Dysfunction. (n.d.). https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/symptoms-causes
  7. Mulhall, J. P., Creanga, D. L., & Stecher, V. J. (2013). Improvement in erection hardness and intercourse success with first dose of sildenafil citrate 100 mg. International journal of general medicine, 6, 849–854. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3836683/
  8. Yafi, F. A., Jenkins, L., Albersen, M., Corona, G., Isidori, A. M., Goldfarb, S., Maggi, M., Nelson, C. J., Parish, S., Salonia, A., Tan, R., Mulhall, J. P., & Hellstrom, W. J. (2016). Erectile dysfunction. Nature reviews. Disease primers, 2, 16003. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5027992/
  9. Sooriyamoorthy, T., Leslie, S. W. (2023, May 30). Erectile Dysfunction - StatPearls. NCBI. https://www.ncbi.nlm.nih.gov/books/NBK562253/
  10. Rizk, P. J., Kohn, T. P., Pastuszak, A. W., & Khera, M. (2017). Testosterone therapy improves erectile function and libido in hypogonadal men. Current opinion in urology, 27(6), 511–515. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5649360/
  11. Mollaioli, D., Ciocca, G., Limoncin, E., Di Sante, S., Gravina, G. L., Carosa, E., Lenzi, A., & Jannini, E. A. F. (2020). Lifestyles and sexuality in men and women: the gender perspective in sexual medicine. Reproductive biology and endocrinology : RB&E, 18(1), 10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7025405/
  12. Kovac, J. R., Labbate, C., Ramasamy, R., Tang, D., & Lipshultz, L. I. (2015). Effects of cigarette smoking on erectile dysfunction. Andrologia, 47(10), 1087–1092. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4485976/
  13. Gerbild, H., Larsen, C. M., Graugaard, C., & Areskoug Josefsson, K. (2018). Physical Activity to Improve Erectile Function: A Systematic Review of Intervention Studies. Sexual medicine, 6(2), 75–89. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5960035/
  14. Ostfeld, R. J. et al. (2021). Vasculogenic Erectile Dysfunction: The Impact of Diet and Lifestyle. The American journal of medicine, 134(3), 310–316. https://www.binasss.sa.cr/marzo/1.pdf
  15. Treatment for Erectile Dysfunction. (n.d.). https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/treatment
  16. Dwulit, A. D., & Rzymski, P. (2019). The Potential Associations of Pornography Use with Sexual Dysfunctions: An Integrative Literature Review of Observational Studies. Journal of clinical medicine, 8(7), 914. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6679165/
  17. Sun, C., Bridges, A., Johnson, J. A., & Ezzell, M. B. (2016). Pornography and the Male Sexual Script: An Analysis of Consumption and Sexual Relations. Archives of sexual behavior, 45(4), 983–994. https://www.researchgate.net/publication/269173515_Pornography_and_the_Male_Sexual_Script_An_Analysis_of_Consumption_and_Sexual_Relations
  18. Ciaccio, V., & Di Giacomo, D. (2022). Psychological Factors Related to Impotence as a Sexual Dysfunction in Young Men: A Literature Scan for Noteworthy Research Frameworks. Clinics and practice, 12(4), 501–512. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9326597/
  19. Vaishnav, M., Saha, G., Mukherji, A., & Vaishnav, P. (2020). Principles of Marital Therapies and Behavior Therapy of Sexual Dysfunction. Indian journal of psychiatry, 62(Suppl 2), S213–S222. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7001355/
  20. Katz, E. G., Tan, R. B., Rittenberg, D., & Hellstrom, W. J. (2014). Avanafil for erectile dysfunction in elderly and younger adults: differential pharmacology and clinical utility. Therapeutics and clinical risk management, 10, 701–711. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4155803/
  21. Highlights of Prescribing Information. (n.d.). https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/202276s018lbl.pdf
  22. Huang, S. A., & Lie, J. D. (2013). Phosphodiesterase-5 (PDE5) Inhibitors In the Management of Erectile Dysfunction. P & T : a peer-reviewed journal for formulary management, 38(7), 407–419. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3776492/
  23. Highlights of Prescribing Information. (n.d.). https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/021368s030lbl.pdf
  24. Bodenmann, G., Atkins, D. C., Schär, M., & Poffet, V. (2010). The association between daily stress and sexual activity. Journal of family psychology : JFP : journal of the Division of Family Psychology of the American Psychological Association (Division 43), 24(3), 271–279. https://www.researchgate.net/publication/44670652_The_Association_Between_Daily_Stress_and_Sexual_Activity
Editorial Standards

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Mike Bohl, MD

Dr. Mike Bohl is a licensed physician and the Director of Scientific & Medical Content at a stealth biotech startup. Prior to joining Hims & Hers, Dr. Bohl spent several years in digital health focusing on patient education. He has also worked in medical journalism for The Dr. Oz Show and Sharecare and has served on the Medical Expert Board of Eat This, Not That!.

Dr. Bohl obtained his Bachelor of Arts and Doctor of Medicine from Brown University, his Master of Public Health from Columbia University, and his Master of Liberal Arts in Extension Studies—Journalism from Harvard University. He is currently pursuing a Master of Business Administration and Master of Science in Healthcare Leadership at Cornell University. Dr. Bohl trained in internal medicine with a focus on community health at NYU Langone Health.

Dr. Bohl is Certified in Public Health by the National Board of Public Health Examiners, Medical Writer Certified by the American Medical Writers Association, a certified Editor in the Life Sciences by the Board of Editors in the Life Sciences, a Certified Personal Trainer and Certified Nutrition Coach by the National Academy of Sports Medicine, and a Board Certified Medical Affairs Specialist by the Accreditation Council for Medical Affairs.

In addition to his written work, Dr. Bohl has experience creating medical segments for radio and producing patient education videos. You can find Dr. Bohl on LinkedIn for more information

Dr. Bohl lives in Manhattan and enjoys biking, resistance training, sailing, scuba diving, skiing, tennis, and traveling. You can find Dr. Bohl on LinkedIn for more information.

Education

  • Bachelor of Arts, Egyptian and Ancient Western Asian Archaeology. Brown University |

  • Doctor of Medicine. |

  • Master of Public Health, General Public Health. |

  • Master of Liberal Arts, Journalism. |

  • Master of Business Administration. | (anticipated 2024)

  • Master of Science, Healthcare Leadership. | (anticipated 2024)

Training

  • NYU Internal Medicine Residency—Brooklyn Community Health Track. |

Certifications

  • Certified in Public Health.

  • Medical Writer Certified.

  • Editor in the Life Sciences.

  • Certified Personal Trainer.

  • Certified Nutrition Coach.

  • Board Certified Medical Affairs Specialist. Accreditation Council for Medical Affairs

  • Digital Storytelling Graduate Certificate.

  • Marketing Management and Digital Strategy Graduate Certificate.

Publications

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