r/erectiledysfunction • • 8d ago

Erectile Dysfunction Stendra Is Far Superior to Viagra/Cialis in terms of Side Effects: Lets make it affordable!

2 Upvotes

There’s a glaring absurdity in men’s health and generic drug pricing right now that perfectly illustrates why our pharmacy system is broken—and why Mark Cuban’s Cost Plus Drugs exists in the first place.

Most people only know about Sildenafil (Viagra) and Tadalafil (Cialis). They are 1st-generation PDE5 inhibitors developed in the 1990s and 2000s. While cheap, they have notorious off-target side effects:

  • PDE6 cross-reactivity: Causes retinal changes, cyanopsia ("blue-tinted vision"), and severe light sensitivity.
  • PDE1 cross-reactivity: Causes extreme facial flushing, dropping blood pressure, and throbbing headaches.
  • PDE11 cross-reactivity: Causes lower back and deep muscle aches (especially common with Cialis).

Enter Avanafil (Stendra). It’s a 2nd-generation molecule specifically engineered to fix those off-target bindings. It has >10,000x selectivity against PDE1 and >120x selectivity against retinal PDE6. In plain English: it kicks in within 15 minutes, has almost zero visual tinting, and doesn’t give you a splitting headache or a bright red face.

The Catch?

A generic version exists and has FDA approval (Camber/Hetero has an approved ANDA). The active pharmaceutical powder itself costs less than 50 cents a dose at wholesale.

Yet if you walk into Walgreens, CVS, or Safeway today:

  • Generic Sildenafil (Viagra): ~$0.30 to $1.00 / pill.
  • Generic Avanafil: $16.00 PER PILL ($480 for a 30-day supply) even with a GoodRx coupon.

Why? Because PBMs (CVS Caremark, Express Scripts, OptumRx) classify it as a low-volume "specialty tier" product. They intentionally maintain an artificially high Wholesale Acquisition Cost (WAC) to protect their rebate spreads, locking men out of a modern, cleaner molecule and forcing everyone back onto 30-year-old drugs with dirty side-effect profiles.

The Fix

Cost Plus Drugs already proved this model works. They took generic imatinib (Gleevec) from $2,500 down to $14. They sell generic sildenafil and tadalafil for pocket change.

Cost Plus does not need to manufacture avanafil from scratch. FDA-approved domestic generic ANDA holders (Camber / Hetero Labs) are already registered in the U.S. All Cost Plus needs to do is sign a direct purchasing contract with them. Under the Cost Plus formula (cost + 15% + $5 fee), a 30-count supply of Avanafil 200mg would drop from $480 down to ~$50 ($1.60/pill) overnight.

If you’re frustrated by PBM games or want access to modern generic medications without paying a $500/month ransom:

  1. Search "Avanafil" or "Stendra" on CostPlusDrugs.com/medications so it registers on their high-intent search analytics.
  2. Submit a quick medication request via their contact form asking them to contract with Camber/Hetero for generic Avanafil.

Let’s get this on Mark and Dr. Alex Oshmyansky’s radar.


r/erectiledysfunction • • 18h ago

Tadalafil/Cialis Amazon pharmacy is the way to go!

44 Upvotes

I recently started getting tadalafil from Amazon pharmacy. If you haven’t looked into it yet, do it. I got a 30 day supply of 5mg for $12 delivered to my door. Also this was with NO insurance, just using my prime membership.


r/erectiledysfunction • • 2h ago

Erectile Dysfunction Worsening ED when laying on back.

2 Upvotes

40m. I eat well, strength train 4-5 days a week. Testosterone is above mid range normal and labs are all in good levels. Don’t drink anymore.

I’ve been having worsening issues when if I’m on my back I can’t get nearly as hard, if I’m upright can get fully hard. My doc prescribed viagra which doesn’t seem to help.

Looking for recommendations with ways to improve. I’ve tried to do some readings but some says Kegels, others say they’ll make it worse to do reverse Kegels so I dunno. I do lift heavier but not crazy. Squats and deadlifts I usually only do 205 lbs.

I don’t masturbate much, maybe once a week.

Any help is greatly appreciated.


r/erectiledysfunction • • 12h ago

Erectile Dysfunction Any advice for first time Sildenafil user?

7 Upvotes

Any tips? Medication related issues, got it all legit from the doctor. Just looking for others experiences.


r/erectiledysfunction • • 1h ago

Morning Wood & Nocturnal Erections Not having morning wood please help pleaseeeeee

• Upvotes

I am 19 y old and I have noticed I am not getting morning wood in the usual way, before that I have not noticed got them or not. When I wake up I don't wake up with an erection but like if I keep laying down for a few minutes while half asleep ( which I usually do ) I get erect honestly it is some stimulation from bed but half asleep and with barest of stimulation I get hard in the morning after waking up nd being half asleep and erections while masturbation are perfectly fine. Please help. I am worried if I am having some sexual issue


r/erectiledysfunction • • 2h ago

Psychological ED Performance Anxiety ED

1 Upvotes

Hi, so I (29M) recently started to have some ED issues where I could not get hard when it came time to perform. It was fine before (sometimes I’d take a bit longer to get fully hard) but starting in 2025 and into this year, I had certain times where I couldn’t even get it up.

I used to be fine before and rarely struggled. However, as of recent, I started to struggle and let anxiety take over and I start thinking that I’m going to fail again like before. I’d still be to get hard from time to time but not the same percentage as before.

Due to the mental block, I checked with my doctor and they prescribed 5 mg tadafadil to get my confidence back up. It works well. I don’t get spontaneous erections but in the beginning, I did get harder from fantasizing (doesn’t happen as often now). However, I did notice I respond faster when time comes and am noticeably harder. All my recent encounters have gone well except for two for physiological reasons. Overall, my erection rate has been amazing since starting the pill.

However, I still get anxiety when I am about to have sex and fear that I’ll never get rid of this anxiety even though I’ve doing fine recently. Does anyone have any tips for this type of mental block? Recently, I just tried reframing my negative thoughts and that it’s fine for my erection to build up instead of going from 0 to 100 in an instant. I want to see if anyone has any other tips or experiences they can share to overcome this anxiety mental block.

For background, I excercise 3 days a week for 60-90 mins. I also walk ~8k steps per day. I used to watch porn but cut that out in March 2026. I do masturbate somewhat but I mainly do it when fanatasizing a former scenario. I mainly just stroke and don’t really stroke to completion. I normally stay hard until I stop stroking and then it fully goes down in a few seconds to a min.


r/erectiledysfunction • • 13h ago

Tadalafil/Cialis Tadalafil tolerance : less effective ?

5 Upvotes

I’ve been taking 2.5 mg of tadalafil daily for the past two weeks. From the very first day, and for the next 10 days, I felt a tremendous benefit. I had nighttime erections as soon as I went to bed and upon waking up. My libido got a boost. During the day, I sometimes had spontaneous erections.

But for the past four days, I’ve noticed these effects have diminished. No more erections during the day or at bedtime, fewer erections upon waking. Lower libido.

Is it possible to develop a tolerance? Is it advisable to take breaks? Maybe you have some tips, like taking the pill on an empty stomach rather than with meals? Combining it with L-citrulline (<1 or 2 g) and monitoring blood pressure?


r/erectiledysfunction • • 18h ago

Erectile Dysfunction Worst experience ever (Viagra 50mg + 4 Sprays of Stud100)

11 Upvotes

Hey just had sex and i hate myself. I had a full meal and after 3 hrs of that i had 50mg viagra and after 75 minutes of that i started sex. But i only got hard when she was blowing me, the moment she stopped sucking and the moment i tried to put it inside her it went soft. And then we tried everything but it didn’t go proper hard. It again went hard when she sucked and then again went soft when was about to penetrate.

I also had 4 sprays of Stud100 for PE. Idk if that really made my cock so numb that i didn’t get any feelings and that’s why Viagra didn’t work.

Last time i had Viagra 75mg on empty stomach and also had 3 sprays of stud100 and my cock wasn’t even going soft after i released cum. Sometimes it’s really good experience and sometimes worst. I don’t understand this all really


r/erectiledysfunction • • 12h ago

Erectile Dysfunction So I am a 71 years old man retired and living in my Sprinter van RV.

3 Upvotes

I don’t maintain an erection as well as I used to. I’m looking for an online ED source for Viagra or similar that can I can receive in various addresses and who won’t bug me constantly on my phone like the Indian telemarketers used to…
Somebody mentioned Amazon Pharmacy.
Anybody have experience with them?
Or any other suggestions…?


r/erectiledysfunction • • 1d ago

Tadalafil/Cialis Tadalafil vs sildenafil

12 Upvotes

I’m 30 years old and my ED is from anxiety and panic disorder . 12.5 mg of sildenafil does the trick for me every time, no issues there. But I absolutely hate the side effects I get from it , sometimes it makes my anxiety worse. And my face feels like it’s burning most times I take it. Also headaches . I like to relax after sex and I get so uncomfortable from these effects. Is tadalafil gentler when It comes to side effects?


r/erectiledysfunction • • 17h ago

Erectile Dysfunction 22m, need help with erection quality

2 Upvotes

I’m 22m, 70kg and 5’8.5. Over the past few years I have struggled getting firm erections. Over the last few months I’ve tried kegels and reverse kegels, pelvic stretches and working out. Also tried supplements like beetroot and whatnot, also cialis and sildenafil which don’t appear to do much. I would say over the last 2-3 months I’ve been waking up with morning wood about 3-4 times a week which I never use to, and my erections have probably gone from 50/60% to 70/75%. However when I have sex with my GF it most of the time ends up going soft. I have stopped masturbating as often and watching porn over the last 4/5 months. Will masturbate 2/3 times a week without porn. Any help/ideas?


r/erectiledysfunction • • 23h ago

Erectile Dysfunction help your bro out is it a sign

3 Upvotes

21, I workout also and I masturbate a lot

so when I was fucking this girl I was hard for some time then Didn't ejaculate but dick goes soft and mood turns off it was not erecting it was my first time but i masturbate a lot so what should I do

cause i don't get girls much to fuck so how will i know it improved.

please help please


r/erectiledysfunction • • 1d ago

Anxiety Do any of you have any experience with hypertonic pelvic floor dysfunction?

5 Upvotes

Is it possible to do too many kegels?

Is it possible that my ED is caused by this constant state of fight or flight where my body is always anxious and tensed up? Is that's what's causing me to not get hard when I'm with somebody but still get morning wood when I'm alone and relaxed?


r/erectiledysfunction • • 1d ago

Erectile Dysfunction Trying to find the root cause of ED

6 Upvotes

This sub has provided great information and hopefully I can also get some useful answers. I am 39, work out 4 times and am generally healthy. BP is always checked at the GP and comes as normal. Due to certain hereditary factors, I have slightly elevated cholesterol and blood sugar which I am working hard to reduce further. Gp has stated both of these aren't high enough to cause ED

-experienced first episode of ED last year. Went to my GP and he prescribed me tadalfil 5 mg to take a few hours before when sexual activity is planned. This worked pretty well and I even found 2.5 mg (5 cut in half) would do the job. I didn't always need the pill as well so all was good.

- few months back I experienced 2 episodes of ED and took 5 mg as usual but this time it didn't resolve the issue. I then took 5 mg daily for 4 days as I understand it's a daily dose but while I could get erect, I couldn't maintain it.

- GP has now referred me to a urologist and also made me shift to 5 mg branded cialis to check until I can get a urologist appointment which can take ages in Canada. I haven't tried the branded one yet.

I've read so many posts where tadalfil 5 mg resolved the issue for so many people but the majority are taking the dose daily. Any information would be appreciated and also how long does it take for the daily dose to start doing its job as intended.


r/erectiledysfunction • • 1d ago

Erectile Dysfunction Is low libido & ED permanent especially if you're older & have been dealing with it for awhile?

4 Upvotes

I'm 39. I'm not old but I'm definitely not 20 anymore. I've been dealing with a lack of sex drive and ED for 5 plus years now. My doctor said I'm perfectly healthy and I've done blood tests to prove so. I don't expect to be who I was when I was 20 but I don't expect to not be a sexual being. I'm just not sure what to do or where I go from here. I feel like this is who I am now. I feel like someone castrated me.


r/erectiledysfunction • • 1d ago

Erectile Dysfunction 37M, Fit With High Testosterone but Struggling With ED. Could Blood Pressure Be the Cause?

8 Upvotes

I’ve been trying to get to the root cause of my erectile dysfunction, and one thing I’m starting to question is whether my blood pressure has been contributing to it all along.

This morning, my blood pressure was 151/102. About three weeks ago, I had readings of 150/94 and 156/97, and I’ve had several other elevated readings in between.
I’m 37, physically active, and in relatively good shape. My testosterone recently came back at 1,050, and I’ve had extensive bloodwork done trying to figure out what’s going on.

I’ve been dealing with difficulty getting and maintaining erections, and neither Cialis 5 mg daily nor sildenafil 25 mg as needed has been consistently effective.

So far, a lot of the discussion has centered around psychological factors, stress, or anxiety. While I understand those can play a role, I’m starting to wonder whether there’s a physical or vascular issue that’s being overlooked.

What’s frustrating is that I sometimes feel dismissed by doctors, possibly because I’m younger, active, and appear healthy. But clearly, looking healthy doesn’t necessarily mean everything is functioning properly.

I’m not saying my blood pressure is definitely the cause, but I’m wondering if I’ve been living with elevated blood pressure without realizing how much it could be affecting my sexual health.

Has anyone here experienced erectile dysfunction related to high blood pressure? If so, did getting your blood pressure under control improve your erections? And did blood pressure medication help or make things worse?

I’d really appreciate hearing firsthand experiences because I’m trying to understand what might be going on rather than automatically assuming it’s all psychological.


r/erectiledysfunction • • 1d ago

Erectile Dysfunction Does Cialis work even if I have Nitric oxide issues?

4 Upvotes

I think i have Nitric oxide issues. if i take Cialis 10 or 20mg.. will it work and make up for the Nitric oxide/blood flow issues?


r/erectiledysfunction • • 1d ago

Erectile Dysfunction I have a downward curve dick

3 Upvotes

Anybody has same?


r/erectiledysfunction • • 1d ago

Tadalafil/Cialis i am 24 years old taking tadalafil 10mg

3 Upvotes

it will be my first time taking tadalafil 10mg because i want my dick super hard with only light romance and i will take this tadalafil only on some dates not much.So taking this tadalafil will be good for me or not?any side effects on my sexual health?


r/erectiledysfunction • • 1d ago

Erectile Dysfunction I Tend To Stop Ejaculation In Sleep

2 Upvotes

I (m25) have been porn addict for more than 13 years straight. I've quit porn after going through a gradually-induced process of quitting for time-specific intervals through a larger time frame.
As of today, I haven't fapped for about 35 days. I have experienced erections in sleep 2 or three times. This has always been the case. Whenever I quit, I tend to experience them when I'm asleep. And it happens a few times in one week and then they disappeared completely just like as they were in this period of abstinance.
Last night when I was in the final stage of sleep, (2-3 hours before waking up) I was about to ejaculate but then whilst being asleep, I stopped myself by squeezing the muscle as hard as I could.
Why does it keep happening with me? That has stopped myself every time? I mean, I'm someone who hasn't been really having night falls since childhood (with my given porn history). But thefew times that they have happened, I've ended up stopping myself in sleep.
So what I want to ask here is, is this an improvement? Why is it that always when I quit both porn & fap, this happens, (few erections in a week) & then everything goes back to zero again


r/erectiledysfunction • • 1d ago

Anxiety No will to live help!!!!

6 Upvotes

It has been 4 years now I am silently suffering numbness in my saddle area including groin and penis.

I m just 23 and i don't will to live anymore.

Seeing people enjoy through college life while I am living under huge shame and something i donot know how to fix.

How should I navigate this????


r/erectiledysfunction • • 1d ago

Erectile Dysfunction Hi dealing with erection

3 Upvotes

Hi everyone,
I’m 45 years old and dealing with an erection issue that is becoming very frustrating. I’m hoping to hear from anyone who has gone through something similar and found a solution.
My Situation:
Main Problem: I get hard enough to penetrate, but shortly after entering, my erection strength drops to around 70–80%. It loses its rigidity, making sex very difficult.
Medication: I take 5 mg Tadalafil (Cialis) daily.
Morning Erections: I still get morning erections, though not every day.
Health: I have some mild cardiovascular risk factors on certain days, but otherwise manageable.
My Questions:
1. Has anyone experienced this specific drop in hardness after penetration? Was it psychological (performance anxiety) or physical (venous leak / vascular)?
2. If you are on daily 5mg Tadalafil, did adding an extra dose before sex (on-demand) help?
3. Did pelvic floor therapy, cock rings, or other fixes help you maintain full rigidity?
Thanks in advance for sharing your experiences!


r/erectiledysfunction • • 1d ago

Erectile Dysfunction Blood flow issues & lack of sexual sensation?

5 Upvotes

I'm concerned that I have Post SSRI Sexual Dysfunction (PSSD), but I wanted to make this post just to see if anyone has had a similar experience and managed to fix it.

I've been completely sexually numb for the past several years. I've seen various specialists and had various tests. None have provided solid answers, leading me to believe the issue is PSSD and therefore unfixable.

I did see a urologist and got a Doppler ultrasound. They discovered signs of mild fibrosis and venocclusive insufficency (blood is flowing in to the penis but quickly leaking out).

Has anyone else had similar symptoms and experienced issues with numbness in the penis? I've heard lack of blood flow can prevent oxygen reaching your penis, which could potentially lead to sensation issues. If you've experienced anything like this, please let me know.


r/erectiledysfunction • • 1d ago

Erectile Dysfunction Cialis - how often is safe?

6 Upvotes

I’m a 60M and have taken the 10Mg dose of Cialis  occasionally and the results have been OK….. not as good as some have described, but definitely an improvement on using nothing, and for me a much better experience than using Viagra which I also previously tried. 

I feel lucky to be in good health at my age, and currently don’t take any daily medication so I’d rather not start to take the daily version of Cialis (5/2.5Mg?) even though the reports on here suggest the effects are good. Do you really need to wait a month or so for it to kick in?

So my question is how often would be safe to take the 10Mg version? I know more than 1 a day is not a good idea (2 x 10Mg pills is not the same as a single 20Mg pill apparently, and the 20Mg version seems hard to find in the UK) but can I take them daily for a short period of time or is that too often… every other day perhaps? I have a vacation approaching, hence the question. What are other guys experience in similar circumstance? 


r/erectiledysfunction • • 1d ago

Erectile Dysfunction Tadalafil 5mg had been the magic pill for me for a month until recently

3 Upvotes

32M. I have a very low libido followed by ED.

Tadalafil 5mg lit the spark in me and I could get spontaneous erections which was the phenomenon missing all these years. Although At the time of sex, the erection quality was not same as morning wood. It was relatively good for a month though.

Now morning wood has also gone missing. No spontaneous erections. The situation with tadalafil 5mg is same as before when I was not taking it. No difference whatsoever.

10 mg has never worked for me.

Do you guys have any clue ?

Thannks for your attention.