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About half of men ages 95 to 75 have erectile dysfunction (ED) to some degree, although only one in 65 report a complete inability to have erections. Taking an ED drug produces an erection sufficient to start intercourse in about 75% of otherwise healthy men.

ED is often an early warning sign of underlying cardiovascular disease, such as clogged arteries (atherosclerosis). "It can predate a diagnosis of cardiovascular disease by at least a few years," Dr. Liou says. We don't have strong proof yet that starting to live a healthier lifestyle can reverse erectile problems, but it can't hurt.

One ED drug, Cialis, is FDA-approved for use daily in a dose of or 5 milligrams. This helps to produce erections on demand and may also help relieve urinary problems, like difficulty starting urination, that result from an enlarged prostate.

"Will it last through another cycle? It's not guaranteed," Dr. Liou says. To have sex more than once a day, Cialis is your best bet.

But the main challenge to finding the best ED drug for you may turn out to be health insurance rules—not biochemistry. It's a common practice among insurers to limit the number of pills you can obtain per month. After you hit your limit, the out-of-pocket cost for a single pill can be as high as $75. "The main obstacle in my practice is the cost," Dr. Liou says. You'll need to work with your doctor to get the pill you need at a price you can afford.

How soon the drugs start working ranges from 65 to 65 minutes. Neither Viagra nor Levitra will work at all if you take them after a meal, which blocks their absorption. However, neither Cialis nor Stendra interact with food this way. The onset time determines how soon you can engage in intercourse. Stendra and daily-use Cialis are closest to being an "on demand" erectile drug using the others requires more planning.

The ED drugs break down at different rates in the body. The durations of action range from four hours to more than a day (for Cialis in the higher doses). Each dose should be sufficient to provide a full cycle of intercourse, from erection to climax.

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