The global erectile dysfunction drugs market was valued at USD 2.30 billion in 2021 and is expected to expand at a compounded annual growth rate (CAGR) of 8.5% from 2022 to 2030. 

Viagra is one of the most popular medications when it comes to addressing penile erection issues. In the year 2019 alone, Pfizer’s world-famous erectile dysfunction medication Viagra generated around 500 million U.S. dollars in revenue.  

Yet, there are patients, for whom Viagra does not work. In some men, it might cause bad headaches; while others simply do not get any penile erections. Some men may even have trouble in identifying blue and green colors apart when they start taking the drug.

Viagra Not Working – What Does it Mean? 

There are several reasons Viagra and other ED drugs might not work effectively as treatments for erectile dysfunction. These include: 

• Using Viagra incorrectly
• Taking a low dose of Viagra
• Using Viagra to treat ED that’s caused by something other than poor blood flow 
• Interventions with other drugs 

Some studies published in the International Journal of General Medicine in 2013 found that men with ED who used a 100 mg dose of Viagra (Sildenafil) showed better results than men who used a 50 mg dose of Viagra (Sildenafil). 

As Viagra works in a way that is quite similar to that of the drugs containing nitrates, it cannot be recommended for men who take nitrates for heart disease or those with certain other heart conditions. 

Also, in addition to medical interventions, it’s important to address lifestyle factors that play a role in ED. Some common factors that can lead to conditions affecting blood circulation include:

• Lack of daily exercise 
• Smoking addiction 
• Excessive mental stress
• Drinking alcohol
• Substance abuse 

What to do when Viagra doesn’t work? 

Basically, in order to improve your overall health and improve ED symptoms such as circulation, you need to reconsider your lifestyle habits and try to include these changes:

• Quit smoking.
• Minimize daily stress.
• Manage your weight through a healthy diet and regular activities.
• Participate in daily exercise and physical activity.
• Reduce or eliminate alcohol intake.

One needs to consult with a urologist. There are several options to treat erectile dysfunction aside from oral medications like Viagra, including:

• erectile dysfunction pump (penis or vacuum pump)
• penile injections
• surgery for an inflatable penile prosthesis
• therapy for emotional, psychological, and relationship issues related to ED
• suppositories (Alprostadil)

Alprostadil is a medication that either alone or sometimes in combination with others such as papaverine and/or phentolamine, can be injected directly into the penis to dilate the arteries. This drug produces an erection in about 10 minutes, lasting up to an hour. 

But there are several disadvantages, as some patients are averse to using a needle, which is why many men tend to avoid this therapy, and many of those who try it may experience pain at the injection site or priapism (a painful erection lasting too long).