From the Guidelines
To achieve and maintain rigid erections and prolong sexual intercourse, a multifaceted approach is recommended.
Pharmacological Interventions
Pharmacological interventions such as phosphodiesterase type 5 inhibitors (PDE5Is) like sildenafil (50-100mg, 30 minutes to 1 hour prior to intercourse) or tadalafil (10-20mg, 30 minutes to 2 hours prior to intercourse) may be effective 1.
Supplements
Additionally, supplements like L-arginine (2-3 grams daily) and L-citrulline (1-2 grams daily) may enhance nitric oxide production, promoting improved erectile function.
Key Points
- PDE5Is are effective in improving successful sexual intercourse and erections in men with erectile dysfunction (ED).
- Sildenafil and tadalafil are two commonly used PDE5Is with different dosing regimens.
- L-arginine and L-citrulline supplements may also be beneficial in improving erectile function.
- A multifaceted approach that includes pharmacological interventions, supplements, and lifestyle modifications may be necessary to achieve and maintain rigid erections and prolong sexual intercourse.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Protocols for Achieving and Maintaining Rigid Erections
- Oral L-citrulline supplementation has been shown to improve erection hardness in men with mild erectile dysfunction, with 50% of men achieving a normal erectile function score after taking 1.5g/d of L-citrulline for a month 2.
- Phosphodiesterase type 5 (PDE5) inhibitors, such as sildenafil, vardenafil, and tadalafil, have been found to be effective in improving erectile function in men with erectile dysfunction, with sildenafil 50mg and 100mg being considered the most effective compounds in the general population 3, 4.
- The duration of action of sildenafil has been found to be longer than previously reported, with a mean duration of erections with ≥60% rigidity of 26,11, and 8 minutes at 1,8, and 12 hours after dosing, respectively 5.
Supplements for Prolonging Sexual Intercourse
- L-citrulline supplementation has been found to increase the mean number of intercourses per month from 1.37 to 2.3 in men with mild erectile dysfunction 2.
- PDE5 inhibitors, such as tadalafil, have been found to have a longer duration of action than sildenafil and vardenafil, making them a potential option for prolonging sexual intercourse 3, 4.
- Nitric oxide (NO) donors, such as L-citrulline, may also have a role in prolonging sexual intercourse by increasing NO bioactivity and improving erectile function 6.
Safety and Efficacy of Protocols and Supplements
- L-citrulline supplementation has been found to be safe and well-tolerated in men with mild erectile dysfunction, with no adverse events reported in a study of 24 men taking 1.5g/d of L-citrulline for a month 2.
- PDE5 inhibitors, such as sildenafil, vardenafil, and tadalafil, have been found to be generally safe and effective in improving erectile function in men with erectile dysfunction, although they can cause adverse events such as headache, flushing, and dyspepsia 3, 4.
- The efficacy and safety of PDE5 inhibitors can vary depending on the specific compound and dosage, with sildenafil 100mg being associated with more treatment-related adverse events and dropouts than lower doses 4.