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You may prefer tadalafil or sildenafil, depending on your response to treatment. If the 20mg tablets are not effective, you should speak to your doctor or pharmacist. As is the case with all ED tablets, you should try taking these pills on 8 separate occasions, before trying another ED medication. 40mg of tadalafil is used in some situations to treat pulmonary arterial hypertension, but only under specialist supervision because of the risks. This depends - ED increases with age, affecting up to 40% of men by the age of 50. In many men there is no significant psychological cause and counselling is likely to be ineffective.
It is not known if tadalafil is effective in patients who have had pelvic surgery or removal of all or part of the prostate gland. Other causes include spinal injury or operations on the prostate or bowel. Regular cycling for 3 or more hours a day may also contribute to ED.
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