Best Ed Medicine On The Market

staminasage

If you’ve tried more than one ED option, how did you figure out what “best” actually means for you? I’m new to this and overwhelmed by choices. Pills like sildenafil/tadalafil/vardenafil/avanafil all sound similar, then there’s topical or urethral alprostadil, injections, devices, even shockwave therapy. I’m not looking for medical advice here-just real‑world experience to help me ask smarter questions at my appointment.

A few things I’m curious about:

What trade‑offs mattered most: fastest onset, longest window, fewest side effects, spontaneity, or cost?
Did food, alcohol, or time of day noticeably change how the meds worked for you?
If you tried both daily low‑dose vs on‑demand, how did that impact spontaneity and side effects?
For anyone on blood pressure meds, antidepressants, or prostate meds, did interactions (managed with your doctor) push you toward a specific option or non‑pill route?
Anyone switch to avanafil for the “faster start” claim-worth it? Any experience with orodispersible tablets or the alprostadil cream vs MUSE?
Did pelvic floor training, weight loss, sleep, or stress changes noticeably reduce the dose you needed or make a certain med work better?
How many tries did you give a med before deciding it wasn’t a fit, and how did you track results/side effects with your partner?
Cost hacks your doctor suggested (generics, insurance coverage, pharmacy programs) that didn’t compromise safety?
Has anyone used wearables (heart rate, sleep, stress) to time doses or predict a “good night,” or is that overkill?

Also, if you could rewind to your first visit, what questions would you ask your doctor to leave with the right first choice and a backup plan?

StrongFoundation

A simple scorecard made “best” measurable: time taken, food/alcohol, onset (min), rigidity (EHS 1-4), duration, side effects same/next day, and partner feedback. Give each option 4-6 optimised tries; patterns emerge fast.
Food mattered: heavy meals blunted sildenafil/vardenafil; tadalafil was meal‑proof but gave next‑day backache at higher doses. Daily 5 mg improved spontaneity (and urinary symptoms); I still kept a small on‑demand boost for high‑stakes nights.
Avanafil’s “speed” felt like a 10-15 min gain at best; not game‑changing unless that window is critical. Alcohol reduced all of them for me more than time of day.
Interactions: spacing with alpha‑blockers cut dizziness; SSRIs didn’t change choice much, but fixing sleep apnea and losing some weight improved response more than swapping pills. If pills were inconsistent, VED + ring helped; injections were most reliable once trained. MUSE burned more than topical.
Cost: generics + tablet splitting, discount cards, and a reputable compounding pharmacy for injections kept costs down without sketchy sources.
First‑visit asks: baseline labs (A1c, lipids, morning testosterone), a stepwise plan with “optimal‑condition” PDE5 trials and clear endpoints, written interaction guidance (nitrates/alpha‑blockers), adjuncts if partial response (VED/pelvic floor), and hands‑on training for injections as a backup with a reassessment timeline.