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You are responsible for maintaining the confidentiality of your password and for all activities that occur under your account. You are responsible for changing your password promptly if you think it has been compromised. You may not transfer or share your password with anyone, or create more than one account. Creating more than one account substantially limits our ability to provide appropriate care. Boston Medical Group explicitly disclaims liability for any and all losses and damages arising from your failure to comply with this section. The App is intended for use only on a mobile phone that runs an unmodified manufacturer approved operating system. Using the App on a mobile phone with a modified operating system may undermine security features that are intended to protect your protected health information from unauthorized or unintended disclosure. You may compromise your protected health information if you use the App on a mobile phone that has been modified. Use of the App on a mobile phone with a modified operating system is a material breach of these Terms of Use. We hereby grant to you a limited, non-exclusive, nontransferable right to access the App in the States Where We Operate and to use the Service solely for your personal non-commercial use and only as permitted under these Terms of Use, Consent to Online Health Services, and the Privacy Policy. We reserve the right, in our sole discretion, to deny or suspend use of the App to anyone for any reason. You agree that you will not, and will not attempt to: (a) impersonate any person or entity or otherwise misrepresent your affiliation with a person or entity; (b) use the App to violate any local, state, ... More

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Also, men with liver diseases or a disease of the retina, such as macular degeneration or retinitis pigmentosa, may not be able to take these medications, or may need to take the lowest dosage. These medical goodrx coupon for sildenafil treatments should NOT be used by women or children. Elderly men are especially sensitive to the effects of these medical treatments, which may increase their chance of having side effects. Testosterone replacement therapy may improve energy, mood, and bone density, increase muscle mass and weight, and heighten sexual interest in older men who may have deficient levels of testosterone. Testosterone supplementation is not recommended for men who have normal testosterone levels for their age group due to the risk of prostate enlargement and other side effects. Testosterone replacement therapy is available as a cream or gel, topical solution, skin patch, injectable form and pellet form placed under the skin. Two types of implants are used to treat ED, including: Inflatable Penile Prosthesis (3-piece hydraulic pump). A pump and two cylinders are placed within the erection chambers of the penis, which causes an erection by releasing a saline solution; it can also remove the solution to deflate the penis. Two semi-rigid but bendable rods are placed within the erection chambers of the penis, which allows manipulation into an erect or non-erect position. Infection is the most common cause of penile implant failure and occurs less that 2 percent of the time. Implants are usually not considered until other methods of treatment have been tried but they have a very high patient satisfaction rate and are an excellent treatment goodrx coupon for ... More

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Erectile dysfunction (impotence) affects many men, mainly as they age. In some cases it has psychological roots but it can also be an early indication of other conditions, particularly those relating to blood flow (vascular disease) and the heart. We offer expert diagnostic advice, rapid access to a range of tests that can help identify the cause. Erectile dysfunction (or impotence) affects many men – particularly those over 40. Research suggests that up to 45% of men aged between 40 and 70 have some difficulty getting or maintaining an erection (source: Journal of Urology 2012 May). We understand that suffering with erectile dysfunction can be distressing. It can undermine your self-confidence and self-esteem and prevent you having a full relationship with your partner. Although it is often caused by psychological factors, impotence can also be an early warning sign of more serious physical health conditions. We have the skills and expertise to be sensitive to patient privacy and treat you as an individual. Our expert consultants and experienced multi-disciplinary care teams can help diagnose the causes of your impotence and work with you in agreeing appropriate treatment. Some of the tests we offer will establish whether your impotence is related to risk factors associated with vascular (blood vessels such as veins and arteries) or cardiac disease. Knowing the underlying cause(s) of your condition gives you the chance to work with your doctors on putting it right. This might include certain treatments such as artery stenting or penile implants. Recognising the complex factors at play, we’ll draw on the expertise of experienced and caring clinicians from a range of ... More

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An inflatable implant uses two cylinders that are surgically placed inside the penis. When an erection is desired, the man uses a pump to fill the cylinders with pressurized fluid. Alternatively, a malleable implant with surgically implanted rods can be used to bolster erections. Psychotherapy can be beneficial for men with erectile dysfunction even when erectile dysfunction has a known physical cause. The therapist can instruct the man and his partner in techniques to reduce performance anxiety and improve intimacy. Therapy can also help couples adjust to the use of vacuum devices and implants. Erectile Dysfunction Treatment: Alternative Therapies. Men with erectile dysfunction should talk with their doctors before trying supplements for erectile dysfunction. They can contain 10 or more ingredients and may complicate other health conditions. Asian ginseng and ginkgo biloba (seen here) are popular, but there isn't a lot of good research on their effectiveness. Some men find that taking a DHEA supplement improves their ability to have an erection. Unfortunately, the long-term safety of DHEA supplements is unknown. There are dozens of "dietary supplements" that claim to treat erectile dysfunction, but the FDA warns that many of these are not what they seem. One investigation discovered that supplements for erectile dysfunction can often contain prescription drugs not listed on the label, including the active ingredient in Viagra. These can put the man at risk for dangerous drug interactions. To reduce your risk of erectile dysfunction, exercise and maintain a healthy weight, stop smoking, avoid alcohol and substance abuse, and keep your diabetes under control, if you have ... More

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It’s my opinion that oral ED medications should be reserved for when lifestyle optimization fails to improve sexual issues. This may be at odds with some physicians who find it convenient to simply prescribe meds, and with some patients who want a quick and easy fix. However, as good as Viagra, Levitra, Cialis and Stendra may be, they are expensive, have side effects, are not effective for every patient and cannot be used by everyone, as there are medical situations and certain medications that may prevent their use. In this category, I also include mechanical, non-pharmacological, non-surgical devices, including low-intensity penile shockwave therapy, vacuum suction devices, vibration devices and penile traction devices. Low-intensity shockwave therapy is an exciting new treatment option that uses acoustic energy to cause mechanical stress and microtrauma to erectile tissues. This stimulates the growth of new blood vessels and nerve fibers and potentially enables penile tissue to regain the ability for spontaneous erection. Vacuum suction devices are mechanical means of producing an erection in which the penis is placed within a plastic cylinder that is connected to a manual or battery-powered vacuum. Negative pressure engorges the penis with blood and a constriction band is temporarily placed around the base of the penis to maintain the erection. 80% of men can achieve good rigidity, but many do not continue using the device because of its cumbersome nature. Venous constriction sildenafil 100mg discount devices are used in conjunction with the vacuum suction devices to trap blood in the penis and help maintain the erection. They also can be used without the suction ... More

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However, there’s evidence that suggests that once adequate blood pressure control is regained – even for those on medication – ED becomes less likely. Hyperglycemia can have a negative impact on several aspects of erectile function. Complications and changes associated with diabetes can compromise macrovascular and microvascular structures, the nervous system, and blood vessel linings. One study indicated that intensive glycemic control might decrease the chances of ED in diabetic men. In response, a number of erectile dysfunction treatments have been developed, with varying efficacy and side effects. ED Medications: Among the most popular treatment options for erectile dysfunction are pharmaceuticals. Drugs such as Viagra (Sildenafil), Levitra (Vardenafil), and Cialis (Tadalafil) are popular and boast an 80% success rate. These drugs are classified as phosphodiesterase-5 inhibitors (PDE-5) – which enable an erection, temporarily, but are not the best for maintaining an erection over time. Prescriptions are heavily relied upon, having to be taken 15 minutes to 36 hours before sexual activity is initiated – not only reducing the spontaneity of one’s sex life but oftentimes fostering dependence. This route typically isn’t recommended for men taking nitrate drugs or alpha-blockers, and all medications, including over-the-counter herbs and supplements, should be shared with your doctor to prevent negative interactions. The commonly reported potential side effects of phosphodiesterase-5 inhibitors include headache, flushing, runny nose, stomach pain, back pain, indigestion, vision changes, and dizziness. Treatment options for erectile dysfunction don’t have to be so much ... More

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Diffuse plaque can be likened to heavy salt water – the plaque has not scaled and hardened to edges of the penis – buts its density and weight and causing the pipes to operate less efficiently and more cumbersome. Endothelial analysis provides a detailed analysis of blood flow rates throughout your body. It doesn’t do any good to improve blood flow within the penis if the providing resource isn’t offering adequate pressure and quality to support penile function. We can’t begin to tell you the number of patients we treated who had seen countless doctors who found nothing wrong with their penis and suggested they pursue a lifetime dependency on penile injections or an implant when in reality – the erection problems was actually stemming from the body vs. After a review of findings with the urologist, our clinical director shares our proprietary 65-point patient scorecard that exhibits all the results, how they fare against the norm with other men of the same age – and what our urologists can do to overcome deficiencies – without any surgery or prosthetic, We do our best to offer solutions regardless of available time, health insurance coverage or financial resources. Each treatment plan is custom based upon all factors relating to a patient’s personal health. Receive a discreet reply from the Morganstern Health patient care team. We are here to help and will answer your questions discretely. Complete the form below and we will contact you as soon as possible. 5 Best Herbal Supplements to Boost Your Sexual Health. It is quite common for men and women to have sexual problems. The reasons behind the problems can be many, ranging from medical problems to emotional disconnect. ... More

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In cases of overdose, standard supportive measures should be adopted as required. Renal dialysis is not expected to accelerate clearance as sildenafil is highly bound to plasma proteins and it is not eliminated in the urine. VIAGRA (sildenafil citrate), an oral therapy for erectile dysfunction, is the citrate salt of sildenafil, a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5). Sildenafil citrate is designated chemically as 1-[[3-(6,7-dihydro-1-methyl-7-oxo-3-propyl-1 H -pyrazolo[4,3- d ]pyrimidin-5-yl)-4-ethoxyphenyl]sulfonyl]-4-methylpiperazine citrate and has the following structural formula: Sildenafil citrate is a white to off-white crystalline powder with a solubility of 3.5 mg/mL in water and a molecular weight of 666.7. VIAGRA is formulated as blue, film-coated rounded-diamond-shaped tablets equivalent to 25 mg, 50 mg and 100 mg of sildenafil for oral administration. In addition to the active ingredient, sildenafil citrate, each tablet contains the following inactive ingredients: microcrystalline cellulose, anhydrous dibasic calcium phosphate, croscarmellose sodium, magnesium stearate, hypromellose, titanium dioxide, lactose, triacetin, and FD & C Blue #2 aluminum lake. The physiologic mechanism of erection of the penis involves release of nitric oxide (NO) in the corpus cavernosum during sexual stimulation. NO then activates the enzyme guanylate cyclase, which results in increased levels of cyclic guanosine monophosphate (cGMP), producing smooth muscle relaxation in the corpus cavernosum and allowing inflow of blood. Sildenafil enhances the effect of NO by inhibiting phosphodiesterase type 5 (PDE5), which ... More

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For example, patients taking erythromycin should not take more than a 5 mg dose of Levitra and a maximum dose of 2.5 mg Levitra once every 72 hours is the maximum recommended dose for patients who are taking the protease inhibitor ritonavir (Norvir) for HIV/AIDS. Levitra should not be taken by men in whom sexual activity is inadvisable because of their underlying cardiovascular status (heart condition). Patients should inform their doctor about any heart problems they have experienced before taking Levitra. Levitra is not recommended in patients who have suffered a heart attack or stroke within the last six months, or patients who have significantly low blood pressure, uncontrolled high blood pressure, unstable angina, severe liver impairment, end stage renal disease requiring dialysis, or the eye disorder retinitis pigmentosa. The most common side effects reported in clinical trials included headache, flushing, rhinitis (runny nose), and indigestion. A small number of patients taking Levitra also reported abnormal vision. Before taking Levitra, patients are advised to undergo a thorough medical history and physical examination to diagnose the underlying cause of the erectile dysfunction and to identify appropriate treatment. Levitra confers no protection against AIDS or other sexually transmitted diseases. Levitra is manufactured by Bayer Corporation in Germany and will be distributed by Glaxo Smith Kline. User Reviews for Levitra to treat Erectile Dysfunction. The following information is NOT intended to endorse any particular medication. While these reviews might be helpful, they are not a substitute for the expertise, knowledge and judgement of healthcare ... More

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3) Patients not using long-acting nitrates but requiring nitrates sublingual for treatment of episodes of angina should be informed about the hazarg of using sildenafil, unless the nitrate can be replaced by an alternative medication with no risk of interaction with sildenafil. 4) Any use of nitrate is contraindicated in the 24 hours following the use of sildenafil. Sildenafil is also contraindicated if any nitrate has been used in the preceding 24 hours. 5) High-risk cardiovascular patients, including patients with atherosclerotic disease, NYHA functional classes II and III patients individuals above 65 years of age, hypertensive and, diabetic patients, smokers, patients with moderate to severe dyslipidemia, and obese individuals, even if not having asked for sildenafil, should be informed about the potential severe risk of sildenafil-nitrate interaction. This should be done because patients may obtain sildenafil by other means without the recommendations necessary for its use. 6) High-risk cardiovascular patients should be previously assessed through a treadmill stress test. The risk of ischemia during coitus is low if they do not develop clinical or electrocardiographic signs, of ischemia and or arrhythmia, until a load of 5 to 6 METs is reached. These load limits are valid for coitus with the usual partner, in a familiar environment, and without additional overload of excessive consumption of food and alcoholic beverages. Patients without sexual activity for a long period should be advised to moderate their physical activity and anxiety during their return to sexual activity. 7) In patients without ischemia and or arrhythmia, or both, on the treadmill stress test ... More

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An alternative to both Levitra and Viagra is Cialis, which does not contain either Vardenafil or Sildenafil. Instead, it contains a different active ingredient called Tadalafil. By increasing blood flow to the penis, it works in a similar way to both Levitra and Viagra. However, Cialis helps men: Achieve an erection within 30 minutes Maintain an erection for up to 36 hours. The main difference is that Cialis stays in your system for much longer than both Levitra and Viagra, therefore helping men to achieve an erection for longer. Levitra dosages and Cialis dosages available are very similar: 5mg, 5mg, 10mg, and 20mg. Viagra, by comparison, is available in larger three doses: 25mg, 50mg, and 100mg. To see what actual users thought about Cialis as a treatment for ED read our Cialis reviews. As the name suggests, Cialis Daily is designed to be taken every day. The medication is for men who like to have spontaneous sex more than three times a week. When taking Cialis Daily, you don’t need to take a pill 30 minutes or an hour before sex. Instead, you keep your body topped up with the medication on a permanent basis, meaning you should be able to achieve an erection whenever you want to engage in sexual activity and without the need to plan ahead. Compared to Levitra, Cialis Daily is only available in smaller packets of 2.5mg and 5mg tablets. Below you will find a table comparing Levitra, Viagra, and Cialis by price, dosages, how long it takes to work, and more. Comparison of clinical trials with sildenafil, vardenafil and tadalafil in erectile dysfunction. 1 The University of Queensland, School of Biomedical Sciences, Australia. Comparison of clinical trials with sildenafil, ... More

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Our urologists and nursing staff are trained and experienced in all treatments for ED. In addition to administering treatment, our staff provide patients with detailed and practical education for each treatment option. Treatment for Erection Problems: When you need testosterone treatment and when you don’t. Most men have problems with erections from time to time. This is when it is hard to get or keep an erection that’s firm enough for sexual intercourse. If you have ED, you may think that testosterone treatment will help. After age 50, men’s levels of testosterone slowly go down and ED becomes more common. But unless you have other signs and symptoms of low testosterone, you should think twice about the treatment. Here’s why: Testosterone treatment is not necessarily helpful for ED. Testosterone treatment does not improve erections in men with normal testosterone levels. And studies show that it does sildenafil citrate over the counter walgreens not always help men with low testosterone levels if ED is their only symptom. ED is usually caused by low blood flow to the penis or a problem with the nerves that control erections. This is a result of other conditions, such as hardening of the arteries, high blood pressure, and high cholesterol or diabetes. These conditions narrow the blood vessels and reduce blood flow to the penis or damage the erectile nerves. Low testosterone may affect the desire for sex, but it usually does not cause ED. Testosterone treatment can cause the body to retain too much fluid. It can also cause acne, an enlarged prostate, and enlarged breasts. Other side effects include lower fertility; an increase in the number of red blood cells, which can ... More

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