Stendra – the newest drug for ED + Tips on sexual health

Stendra – the newest drug for ED. And what to do.


Yesterday, a pharmaceutical rep for Vivus Inc. introduced me to a relatively new erectile dysfunction (ED) drug,  Avanafil (Stendra is the trade name). Stendra passed FDA approval in April 2012.
This is now the fourth oral drug for ED. The others include:  tadalafil (Cialis), vardenafil (Levitra), and sildenafil (Viagra ). Viagra is still the king of ED drugs as it was the first one FDA approved for this category in 1998 and still holds a majority of the market share.  Cialis is second most popular.

How does Stendra stack up with the rest?
Stendra, is also a PDE-5 inhibitor – so how it works biologically similarly to its competitors. Supposedly, however, Stendra works faster than its competitors. It’s also tiny i size (about the size of a grain of rice) which can be useful to those preferring smaller pills. So which works best? The reality is that there is no conclusive answer without a head-to-head human trial, which is unlikely to happen.

Comparison table among PDE-5 inhibiting drugs


Time it takes to work

Amt of time half of the drug stays in your system


15 to 30 minutes

5.5 to 10.5 hours


30 minutes to 2 hours

3 to 5 hours


30 minutes to 12 hours

17.5 hours


30 minutes to 2 hours

4 to 5 hours

*Table is obtained from a research paper by Uckert et al. 2013.

Side effects of Stendra are similar to the other PDE-5 inhibitors: headaches, redness (flushing) of the face, flu-like symptoms, nasal congestion and back pain.


My Take On This
Do we need another ED drug? Probably not.
As a natural medicine first type of doctor, I don’t have a problem with PDE-5 inhibitors. I think they bring great psychological benefit to men who have sexual problems. That’s right. I personally think the psychological benefits are greater than the physical ones.
Many men experience intolerable headaches from PDE-5 inhibitors, however. Also, many patients have complained of erections feeling “unnatural” – almost like if their penis is detached from their body’s.  So what is one to do?

7 ways to improve your sexual health
1.    Always address the cause of ED. Viagara, Cialis, Stendra and Levitra are “Band-Aids” – not a cure.
2.    The top two causes of ED are stress and fatigue. Another top on the list is bad circulation often due to other conditions like heart disease and diabetes.
3.     Take action. Exercise and eat sensibly. This will help lose weight (if necessary) and improve circulation.
4.     *Take the herb Rhodiola. This is an herb that has been shown to fight stress, lower stress fatigue and provide gradual energy.
5.    Think penile health first. Feed the pelvic arteries (and those of the heart as well) with nutrients and antioxidants. *The best studied are pomegranate and resveratrol.
6.    Arginine is a good supplement for sexual health. *L-Citrulline is better. Arginine is a necessary to produce Nitric Oxide (NO), a chemical produced in your arteries to help open blood vessels for proper circulation. Open arteries in the penis is what produces an erection. The problem with arginine supplementation is that;
A. It takes a lot of arginine to work, about 5000mg a day.
B. It’s metabolized too quickly by the body so you need to take it often. L-Citrulline continually     makes     arginine     in the kidney. In fact, you get more arginine in the blood from oral intake of L-Citrulline than from Arginine itself.
7.    Try the herb *Epimedium, AKA “Hornygoat weed.”

Here’s a secret – don’t tell anyone: Epimedium contains a chemical called Icarrin which works as     a PDE-5 inhibitor but because   it’s an herb with hundreds of other components,  it does not produce the same side effects as PDE-5’s.

What if I want to try a dietary supplement  with Rhodiola, L-Citrulline, Resveratrol, Pomegranate and Epimedium?
Individually, these nutritional agents can be found in any reputable health food store.

** They can be found in THIS formula. This product has clinically shown to be effective in steadily helping men build their sexual health. It’s not an event driven product. Another words, if you are looking to take a substance only on an “as needed” basis this product is not for you. Instead THIS product builds with time when taken daily and nourishes key tissues of penile tissues along with the rest of the body. In about 8 days men have reported to see a significant sexual difference.

Lastly, as it relates to sexual supplements the buyer should be cautious. Most “natural” sexual supplements are not natural and often contain PDE-5 inhibiting drugs in them. If a “natural” supplement works in an “as needed” basis or a company advertises it doing so, then you should assume it has a drug in it until proven otherwise. THIS is an example of such occurrence where the FDA stepped in and removed a sexual enhancement supplement from the market for containing Tadanafil.

Dietary supplements are not event driven. If it sounds too good to be true….

Do you have any experiences in improving your sexual health? Let me know.


** As frequent readers of this blog know, is a platform for unbiased information to help men (and women with bladder problems) find options to rebuilding and reclaiming their health. However, sometimes I write a timely blog post where I am financially associated with a product I suggest. The recommended male product I suggested above is a product that I have formulated and tested clinically. As a result, I am financially associated with that product. I ( and we) are big on transparency.

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