ED Treatment Options in Canada

Written by: Rocky Health editorial team
Medically reviewed by: Mina Rizk, R.Ph., MPharm

Erectile dysfunction (ED) is far more common than many people realize, and talking about it openly is an important step toward finding effective solutions. In a Canadian study of 3,921 men aged 40 to 88 seen in primary care settings, nearly half, 49.4%, met the criteria for ED based on the International Index of Erectile Function (IIEF)[1], a validated questionnaire that assesses sexual function. 

Despite its prevalence, ED is often under-discussed, which can delay diagnosis and treatment. Understanding your options and seeking professional guidance can help you address ED in a way that’s safe, effective, and tailored to your needs.

This guide aims to give you a clear overview of ED treatment options in Canada, including key information on each, the risks and benefits, and how to book an appointment with a healthcare provider to access medication.

Note: Selecting the most appropriate ED treatment should involve careful research and a consultation with a qualified healthcare provider to ensure the option is medically safe and aligned with your health needs, goals, and lifestyle.

What Is ED: Defined by Medical Experts

According to the Canadian Urological Association Journal, ED is the preferred clinical term describing the persistent or recurrent inability to achieve and maintain a penile erection of sufficient rigidity to permit satisfactory sexual activity for at least 3 months [2].

Medical Causes of ED and Related Health Conditions

Erection, ejaculation, and orgasm are all controlled by different systems in the body. That’s why some men, especially those with diabetes or those who’ve undergone procedures like prostate removal, can still reach orgasm even if they struggle with getting or keeping an erection, or if they no longer ejaculate.

ED can be caused by poor blood flow to the penis, nerve damage, or issues with blood drainage from the penis. These problems may stem from low sexual desire, side effects from medications, or an underlying medical condition that affects sexual function.

Medical conditions that may cause ED include, but are not limited to, the following: 

• Diabetes
• Heart disease
• High blood pressure
• High cholesterol
• Obesity

Additionally, mental health plays a key role in sexual function because arousal starts in the brain. Stress, anxiety, depression, and certain medications can disrupt the signals needed for an erection. Addressing mental well-being is often just as important as treating the physical causes of ED.

Lifestyle Choices and ED

According to a study by the Canadian Urological Association [2], many of the same risk factors for heart disease, like lack of exercise, being overweight, smoking, high cholesterol, high blood pressure, and diabetes, can also contribute to ED.

The study shares that improving these factors through exercise, weight loss, or no longer smoking can help lower your risk, especially if you’re younger.

High Blood Pressure, High Cholesterol, Smoking, and ED

Healthy erections depend on a chemical process in the body called the nitric oxide (NO) pathway. The NO pathway is key to starting and sustaining the blood flow needed for a firm erection. When this process doesn’t work properly, it’s strongly linked to ED. Conditions like high blood pressure, high cholesterol, and smoking can damage those blood vessels, increasing the risk of ED. 

Neurological Conditions and ED

Neurological conditions like multiple sclerosis, Parkinson’s disease, or past surgeries (such as on the prostate or bladder) can also damage nerves and affect your ability to get an erection. Even with nerve-sparing surgical techniques, prostate surgery often leads to ED due to both nerve and blood flow disruption.

Symptoms of lower urinary tract issues may also contribute to ED due to shared underlying factors (like frequent urination or a weak stream). 

For men with diabetes, ED often results from a mix of nerve damage, blood vessel problems, and changes within the erectile tissue itself. Blood sugar control plays a big role. The better the control, the better the erectile function. Hormonal conditions like low thyroid (hypothyroidism) or low testosterone (hypogonadism) can also play a part.

Treatment Options for ED

1. Lifestyle Changes

A study shared on the International Journal of Impotence Research on physical activity and ED, found the following:

“Moderate and high physical activities were associated with a lower risk of ED [3].”

In hypertensive patients with ED, an 8-week exercise training for the duration of 45–60 minutes per day improved ED compared with controls who remained sedentary during the same period.

Moreover, physical exercise showed beneficial effects on self-esteem and mental health with a positive impact on psychological issues associated with sexual dysfunction.

Weight Loss

Both short-term and long-term weight-loss studies, including only caloric modifications or restrictions, demonstrated improvement in ED [4].

Diet

Studies show that diets rich in whole grains, legumes, fruits, and vegetables, and that limit red meat, full-fat dairy products, and food and beverages high in added sugars are associated with a reduced risk of ED [5]. The greater adherence to a Mediterranean-style diet, in particular, has been associated with a lower prevalence of ED in both diabetic and nondiabetic men [5].

Smoking

Both the direct use of tobacco and second-hand exposure are well-established risk factors for ED.

A study [6] on the association between smoking cessation and sexual health in men looked at how quitting smoking affects men’s sexual health. The study found that men who stopped smoking showed clear improvements in both how their bodies functioned during sex and how they felt about their sexual health. This was true even for men who had problems with erections before they quit. 

Alcohol

Heavy alcohol use is strongly linked to ED, with over half of alcohol-dependent men reporting sexual dysfunction and about 25% specifically citing ED, while light to moderate drinking may not increase risk and could even show a protective effect in some studies [7]. 

Cannabis In contrast, cannabis use shows a clear association with ED: a meta-analysis found users were almost four times more likely to experience ED than non-users (69% vs. 35%), with frequency of use correlating with higher risk. Overall, frequent marijuana use and heavy drinking significantly increase ED risk, whereas moderation in alcohol may have less impact [8].

2. ED Medication Options

Phosphodiesterase type 5 inhibitors (PDE5 inhibitors) for ED therapy have been available in Canada for over 26 years. 

The first PDE5 inhibitor approved for ED therapy in Canada was Viagra®, also available as generic Sildenafil approved in March 1999.

Other PDE5 inhibitors, such as Cialis®, also available as generic Tadalafil, and Levitra, available as generic Vardenafil, were approved in Canada in 2003. These ED medications remain widely prescribed today. 

Viagra® (Sildenafil)

Viagra® was the first oral medication approved in Canada for the treatment of ED and remains one of the most well-known options. It works by increasing blood flow to the penis, helping men achieve and maintain an erection in response to sexual stimulation. 

Viagra typically starts working within 30 to 60 minutes and lasts for about 4 hours. It’s available in both brand-name and generic (sildenafil) forms, which are equally effective but often differ in price.

Cialis® (Tadalafil) 

Cialis® is another popular PDE5 inhibitor.  It’s known for its longer duration of action—up to 36 hours—earning it the nickname “the weekend pill.” Cialis can be taken as needed before sexual activity or in a lower daily dose for more spontaneous intimacy. Like Viagra®, it’s available as a brand-name medication or as a generic (tadalafil) at a lower cost.

Levitra® (Vardenafil)

Levitra® was approved in Canada in 2003 as another PDE5 inhibitor option. It works similarly to Viagra but may be slightly more effective for some men, especially those with diabetes-related ED. It usually takes effect within 30 to 60 minutes and lasts about 4 to 5 hours. Levitra is available in generic form vardenafil as well.

Take our online assessment to see which ED medication might be right for you.

Risks and Benefits of ED Medication

While ED medications, primarily PDE5 inhibitors like Viagra® (sildenafil), Cialis® (tadalafil), and Levitra®(vardenafil) can improve erectile function and may also reduce cardiovascular risk in certain patients, there are also risks associated with the medications. 

Common ED side effects can include headaches, digestive upset, heartburn, body aches, dizziness, blurry vision, congestion, shortness of breath, and more. As such, it’s important to speak to a healthcare professional before starting ED medication use. 

Does Insurance Cover ED Medication?

In most cases, insurance in Canada does not cover ED medication. Drugs like Viagra®, Cialis®, and Levitra—along with their generic versions—are generally considered lifestyle medications rather than essential treatments. 

This means patients usually need to pay out-of-pocket for prescriptions, whether purchased at a local pharmacy or through a licensed online telehealth provider.

Some extended health benefit plans may offer partial coverage if ED medication is prescribed for another condition, such as pulmonary hypertension, but this is the exception rather than the rule.

How Much Does ED Medication in Canada Cost?

The cost of ED medication in Canada can vary depending on whether you choose a brand-name drug or a generic version, as well as where you fill your prescription.

On average, brand-name options like Viagra® (sildenafil) and Cialis® (tadalafil) cost more, while generic options are typically more affordable.

It’s important to remember that ED medications are usually not covered by insurance in Canada, meaning most patients pay out-of-pocket.

How to Buy ED Medication Online, Discreetly

In Canada, ED medications can be legally obtained discreetly online through licensed telehealth services such as Rocky Health.

At Rocky Health, potential patients undergo a clinical assessment conducted by a qualified healthcare professional who determines the appropriate ED treatment. 

Prescribed medications are dispensed by Rocky’s licensed pharmacy and delivered directly to the patient in discreet packaging. Patients also have the option to pick up their medication from a pharmacy of their choice. All personal health information at Rocky Health is securely stored in compliance with Personal Information Protection and Electronic Documents Act (PIPEDA) regulations to ensure patient confidentiality and privacy.

Talk to a doctor to see if ED medication is right for you. Get started today.

References

1. Grover, Steven A., et al. “The Prevalence of Erectile Dysfunction in the Primary Care Setting: Importance of Risk Factors for Diabetes and Vascular Disease.” Archives of Internal Medicine, vol. 166, no. 2, 2006, pp. 213–219.
2. Domes, Trustin, et al. “Canadian Urological Association Guideline: Erectile Dysfunction.” Canadian Urological Association Journal, vol. 15, no. 10, 17 Aug. 2021, pp. 310–322
3. Cheng, J. Y., et al. “Physical Activity and Erectile Dysfunction: Meta-Analysis of Population-Based Studies.” International Journal of Impotence Research, vol. 19, 2007, pp. 245–52
4. Kolotkin, R. L., et al. “Assessing Impact of Weight on Quality of Life.” Obesity Research, vol. 3, 1995, pp. 49–56.
5. Bauer, Scott R., et al. “Association of Diet With Erectile Dysfunction Among Men in the Health Professionals Follow-up Study.” JAMA Network Open, vol. 3, no. 11, 2020, e2021701.
6. Polsky, J. Y., et al. “Smoking and Other Lifestyle Factors in Relation to Erectile Dysfunction.” BJU International, vol. 96, 2005, pp. 1355–1359.
7. Hou, Hai-Jun, et al. “Early Prediction of Sepsis-Induced Acute Kidney Injury.” Journal of Critical Care, vol. 48, Dec. 2018, pp. 475–76. Epub, 2 Aug. 2018. Elsevier, PubMed, PMID 30097259.
8. Sandesara, Pratik B., et al. “Clinical Significance of Zero Coronary Artery Calcium in Individuals with LDL Cholesterol ≥ 190 mg/dL: The Multi-Ethnic Study of Atherosclerosis.” Atherosclerosis, vol. 292, Jan. 2020, pp. 224–229. Epub 27 Sept. 2019. Elsevier. PubMed, PMID 31604582.

Disclaimer: This article is intended for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult your healthcare provider with any questions about a medical condition or treatment, including dosage, risks, benefits, and other considerations.

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