When the blue pills stop working

Sildenafil (Viagra) and tadalafil (Cialis) are PDE5 inhibitors. They relax the blood vessels in the penis so blood can flow in when you are aroused. Note the condition: when you are aroused. They do not create the arousal. They help the hardware respond to a signal that has to arrive first.

So when a man says the blue pills stopped working, the question is which half failed. Is the blood flow the problem, or is the wanting the problem?

When it is desire, not blood flow

Low desire has its own list of causes. Low testosterone, stress, poor sleep, alcohol, some antidepressants, and simple familiarity all turn it down. No amount of blood flow fixes a signal that never left the brain.

PT-141, also called bremelanotide, works further up. It switches on melanocortin receptors in the brain that are involved in sexual desire. It does not act on blood vessels at all.¹ It is approved in the US for low desire in premenopausal women. In men, the data comes from smaller studies, and it is used off-label.²

Viagra helps the body answer. PT-141 works on whether the question gets asked.

What it is like, honestly

It is taken about 45 minutes before sex, as needed. The most common side effect is nausea. In the women's trials, about 40% felt it, mostly on the first doses.¹ Flushing and headache are common too. It can push blood pressure up for a few hours, so it is not for men with uncontrolled hypertension or heart disease.

Do this first

Erection problems often show up years before a heart problem, because the vessels in the penis are smaller and narrow first.³ If they are new for you, get your blood pressure, blood sugar, cholesterol and testosterone checked before you buy anything, from us or anyone else.