Erectile Dysfunction (ED) Treatment

Special Offer: Sildenafil is being discontinued once stock runs out, so it’s now available at a special price. Please contact us soon if you’re interested.

Sildenafil OD 50mg

¥660 per tablet (tax included)

Fast-acting, with an effect lasting about 5 hours. This is a generic version of Viagra. Being an OD tablet, it dissolves in the mouth and can be taken without water. Dosage: 1 tablet, take 1 hour before intercourse on an empty stomach (affected by food).

Erectile Dysfunction (ED)

Erectile dysfunction (ED) refers to the following condition that occurs repeatedly or persists:

“An inability to achieve or maintain an erection sufficient for satisfactory sexual activity.”

According to a study in Hirosaki City, Aomori Prefecture, more than 40% of men in their 20s and 30s report experiencing some degree of erectile dysfunction, and almost all men over 50 are aware of having ED. In a study conducted in Singapore, more than 50% of men over the age of 30 reported having ED, indicating that ED is a common health issue among men.

Causes and Risk Factors of ED

Several factors contribute to ED, including the following:

• Aging
• Diabetes
• Obesity or lack of exercise
• Cardiovascular disease and high blood pressure
• Smoking
• Decreased testosterone (male hormone)
• Chronic kidney disease and lower urinary tract symptoms
• Neurological disorders
• Surgery or trauma
• Psychological factors such as depression
• Medications
• Sleep apnea

ED Treatment

For individuals with ED risk factors, it’s important to treat underlying conditions and improve lifestyle habits such as diet, quitting smoking, and exercising.

The first line of treatment for ED is PDE5 inhibitors. cGMP synthesis in the smooth muscle cells of the penis is crucial for erections, but cGMP is broken down by PDE5, preventing the maintenance of an erection. PDE5 inhibitors work by blocking the breakdown of cGMP, helping to sustain erections.

ED Medications

At our clinic, we offer the following ED medications. Tadalafil is available in both 20mg and 5mg doses.

Medication	Price (incl. tax)	Features and Instructions
Vardenafil 20mg	¥1,650 per tablet	Fast-acting, strongest erection. Generic version of Levitra. Dosage: 1 tablet on an empty stomach 30 minutes before intercourse / 1 hour before after a meal. Start with half (10mg) for beginners. For those over 65, start with 1/4 (5mg) and increase up to 10mg.
Tadalafil OD 20mg	¥1,430 per tablet	Mild effect, long-lasting, fewer side effects. Generic version of Cialis. Dissolves in the mouth without water. Dosage: 1 tablet on an empty stomach 2 hours before intercourse / 3 hours before after a meal. Start with half (10mg) for beginners or those over 65.
Tadalafil OD 5mg	¥220 per tablet	Off-label for ED, not covered by medical compensation. Dissolves in the mouth without water. Dosage: 4 tablets on an empty stomach 2 hours before intercourse / 3 hours before after a meal. Start with 2 tablets (10mg) for beginners or those over 65.

• A consultation fee (¥3,850 for the first visit, ¥1,650 for follow-ups) applies.
• If you prefer to split your medication, we offer a pill cutter (¥880). Please use split pills within two weeks.
• Leave at least 24 hours between doses. Even if taking a half or quarter dose, only take one dose per day.
• Due to the nature of pharmaceuticals, we cannot accept returns or refunds after the medication has been dispensed, even in the case of side effects.

Recommended For

Medication	Recommended For
Vardenafil	Fast-acting: For those who want immediate results before intercourse, or want to enhance erection strength. Preventing “mid-erection drop”: For those who want to maintain an erection during intercourse.
Tadalafil	After meals: For those who frequently engage in intercourse after eating or drinking. Flexible schedule: For those whose intercourse timing is unpredictable. Travel or long-distance relationships: For those unsure of when intercourse will occur, such as during travel.

Those Who May Not Be Eligible for Treatment

Blood Tests

Conditions like diabetes, kidney disease, or LOH syndrome (Late-Onset Hypogonadism) can be hidden risk factors for ED. While a blood test is not always necessary during the first visit if you’re in good health, we recommend it if you haven’t had a check-up in over a year.

We also recommend a blood test every 6 months to a year to monitor liver function and check for side effects (a regular health check-up can be substituted).

Test (If necessary)	Price (incl. tax)	Details
Initial Test	¥5,148	Liver/kidney function, lipids, blood sugar, HbA1c, heart failure markers, blood count, etc.
Male Hormone Test	¥2,728	Free testosterone
Side Effects Check	¥2,948	Liver/kidney function, lipids, blood sugar, blood count, etc.

Side Effects

Common side effects include flushing, eye redness, blurred vision, headaches, heart palpitations, nasal congestion, back pain, muscle pain, limb pain, gastrointestinal issues (nausea, vomiting, diarrhea, constipation, abdominal pain, bloating), and liver function abnormalities.

More serious but rare side effects include heart attack, sudden cardiac death, and stroke, often in those with pre-existing cardiovascular risks. Low blood pressure, fainting, ischemic optic neuropathy (vision loss), and retinal artery occlusion have also been reported in rare cases.

If an erection lasts more than 4 hours, it can damage penile tissue and lead to permanent ED. Seek immediate medical attention.

In very rare cases, severe allergic reactions (anaphylaxis, Stevens-Johnson syndrome) can occur. If you experience high fever, low blood pressure, rashes, swelling of the face or lips, difficulty breathing, or seizures, call an ambulance immediately.

Drug Interactions (Contraindicated)

Drug Interactions (Caution)

Other Precautions