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Talking honestly with your partner about your needs and concerns may also help to overcome many barriers to a healthy sex life. Medications such as sildenafil (Viagra®), vardenafil (Levitra®), or tadalafil (Cialis®) may help improve sexual function in men by increasing blood flow to the penis. Men who are on medicines that contain nitrates such as nitroglycerine should not take oral ED medications. The combination of nitrates and these specific medications can cause low blood pressure (hypotension). The most common side effects of these medications are indigestion, nasal congestion, flushing, headaches and a temporary visual disturbance. Aids such as vacuum devices and penile constriction rings serve as erectile aids for some men. A vacuum constriction device (above) is a cylinder that is placed viagra online stores over the penis. The air is pumped out of the cylinder, which draws blood into the penis and causes an erection. The erection is maintained by slipping a band off of the base of the cylinder and onto the base of the penis. The vacuum device can be safely used to treat most causes of erectile failure. Lack of spontaneity, discomfort, and cumbersomeness of the device seem to be the biggest concerns of patients. Penile injection therapy (intracavernosal injection therapy) Men are taught how to inject medications directly into the erection chambers of the penis to create an erection. Injection therapy is effective in treating a wide variety of erection issues caused by blood vessel, nerve and psychological conditions. Using a tiny needle and syringe, the man injects a small amount of medicine into the side of his penis. The medicine relaxes the blood vessels, ... More

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They may expect to obtain medications through a phone call to their doctor or even over the Internet, with minimal or no physician contact at all. In such cases, the physician’s role may have to include efforts to educate patients about realistic sexual expectations (see Patient Education). These efforts can help prevent the misuse or overuse of these remarkable medications. Although this article focuses primarily on the male with ED, it is essential to remember that the sexual partner plays an integral role in treatment. If successful and effective management is to be achieved, evaluation and discussion of any intervention must include both partners. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition ( DSM-5 ), classifies erectile disorder as belonging to a group of sexual dysfunction disorders typically characterized by a clinically significant inability to respond sexually or to experience sexual pleasure. [8] Sexual functioning involves a complex interaction among biologic, sociocultural, and psychological factors, and the complexity of this interaction makes it difficult to ascertain the clinical etiology of sexual dysfunction. Before any diagnosis of sexual dysfunction is made, problems that are explained by a nonsexual mental disorder or other stressors must first be addressed. Thus, in addition to the criteria for erectile disorder, the following must be considered: Partner factors (eg, partner sexual problems or health issues) Relationship factors (eg, communication problems, differing levels of desire for sexual activity, or partner violence) Individual vulnerability factors (eg, history of sexual or emotional abuse, existing psychiatric ... More

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It is important for a health professional to take a full sexual history that includes all of these areas. If you are experiencing sexual difficulties, a full sexual history, a physical examination and evaluation of cardiovascular risk needs to be done. Tests should include the measurement of testosterone levels, blood fats and sugars, and blood pressure. Your doctor should talk to you about reversible lifestyle risk factors that might affect erection quality (such as cigarette smoking, substance use, obesity or a sedentary lifestyle). A full history should also include an inventory of all medications taken (such as antidepressants and antihypertensives) and recreational drugs (including anabolic steroids, alcohol and psychoactive substances) as these may be related to erectile dysfunction. Your doctor might consider a change in your treatment regimen. This might be appropriate if your impotence started soon after starting the drug. Medications such as sildenafil ( Viagra ), tadalafil ( Cialis ), vardenafil ( Levitra ) and avanafil ( Spedra or Stendra ) are used to treat erectile dysfunction. They work by increasing blood flow to the penis, making it more sensitive to touch. They do not primarily increase sexual desire and only work when you are sexually stimulated. These medications are usually the first-line medical treatment for erectile dysfunction and are effective for about 70% of men. The medications vary in dosage, how quickly they start to work, how long they work for, and their side-effects. Possible side-effects include facial flushing, nasal congestion, headaches and indigestion. There can also be drug-drug interactions with sildenafil tablet price other ... More

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Alpha-blockers are sometimes prescribed for prostate problems or high blood pressure. In some patients, the use of VIAGRA ® with alpha-blockers can lead to a drop in blood pressure or to fainting Medicines called HIV protease inhibitors, such as ritonavir (Norvir ® ), indinavir sulfate (Crixivan ® ), saquinavir (Fortovase ® or Invirase ® ), or atazanavir sulfate (Reyataz ® ) Oral antifungal medicines, such as ketoconazole (Nizoral ® ) and itraconazole (Sporanox ® ) Antibiotics, such as clarithromycin (Biaxin ® ), telithromycin (Ketek ® ), or erythromycin Other medicines that treat high blood pressure K antagonists (like coumadin or warfarin) Other medicines or treatments for ED Sildenafil is the same medicine found in VIAGRA ® and REVATIO ® . REVATIO ® is used to treat a rare disease called pulmonary arterial hypertension (PAH). VIAGRA ® should not be used with generic prescription for viagra REVATIO ® or with other PAH treatments containing sildenafil or any other PDE5 inhibitors (such as Adcirca [tadalafil]) Know the medicines you take. Keep a list of your medicines and show it to your doctor and pharmacist when you get a new medicine. Withholding or providing inaccurate information about your health and medical history in order to obtain treatment may result in harm, including, in some cases, death. How should I take sildenafil 20 mg tablets (Revatio)? Sildenafil may be prescribed to you as tablets or an oral suspension Take sildenafil tablet or oral suspension 3 times a day about 4 to 6 hours apart Take sildenafil tablets or oral suspension at the same times every day. Sildenafil oral suspension will be mixed for you by your pharmacist. Do not mix sildenafil oral ... More

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Liver function: If you have poor liver function you may need lower doses of this medication. Liver disease or reduced liver function may cause this medication to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Nitrate-containing medications: Sildenafil should never be taken with any medications that contain nitrates. Blood pressure may suddenly drop to life-threatening levels if sildenafil is taken with any nitrate-containing medication (e.g., nitroglycerin tablets, spray, or patches) or any other nitrates (e.g., isosorbide dinitrate or amyl nitrite "poppers"). Dizziness, fainting spells, heart attack, or stroke may be experienced. If use of a nitrate-containing medication is considered medically necessary, you must wait 48 hours after the last dose of sildenafil before taking a nitrate, and only under close medical supervision. Penis deformation: As with other medications for erectile dysfunction, men with an anatomical deformation of the penis such as angulation, cavernosal fibrosis, or Peyronie's disease should be closely monitored by their doctors if they take this medication. Prolonged erection: If an erection lasts longer than 4 hours (a rare occurrence), seek immediate medical assistance. If this condition is not treated quickly, tissue damage and permanent loss of the ability to have an erection could result. Prostate problems: Tell your doctor if you are taking medications, such as alpha-blockers (e.g., doxazosin), to treat ... More

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The ideal study for preference evaluation should: (i) be randomized, double?blind, crossover; (ii) not include bias by pre?selection of patients (e.g. only nonresponders to previous treatment); (iii) make fair comparisons, adopting equivalent doses of each drug and giving each drug for equal periods; (iv) be based on an intent?to?treat analysis. He also indicated several pitfalls: drug instructions might differ considerably, e.g. because of differences in duration of action, and invalidate the blinding, or might even condition patient preference; period effects might produce improvements over time that bias results in studies with medications that require an adaptation period cost of generic sildenafil or training; carry?over effects might produce an overlap in the effects of medications, jeopardizing their comparison, when the wash?out interval between periods is too short. He also raised the issue of how patient preference should be assessed. A single question, such as ‘Which treatment did you prefer?’ is limited, as it does provides no context to the answer. A multi?question preference questionnaire, including questions that are related to putative contributing factors, such as time to onset of action, duration of action, quality of erection and side?effects, is preferable. Several published studies are available that evaluated patient preference for tadalafil or vardenafil vs sildenafil teva 100mg price sildenafil and that meet some, but not all, the requirements listed above. The aim of this review is to establish whether current knowledge enables any conclusive judgement. We electronically searched Medline (from 1966 to 2007 week 18) and EMBASE (from 1988 to 2007 ... More

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The study found that the inhibitor prevented the heart from changing shape in patients suffering from left ventricular hypertrophy, a condition that causes thickening and enlargement of the heart muscle. The drug also improved functioning of the heart in patients with a variety of cardiac conditions, with no effect on blood pressure. In fact, researchers found that the drug improved efficiency when the heart pumped blood into vessels, along with relaxation between beats. “Very few drugs used in cardiology can actually affect these parameters. For this reason their implications in the treatment and prevention of heart failure are huge.” However, Isidori notes that because these studies were conducted exclusively on men, the next step should be a larger trial on women. This site is protected by recaptcha Privacy Policy | Terms of Service. "A significant number of subjects suffering from erectile dysfunction are much happier to take pills for heart failure or high blood pressure than to improve their erections." “I am not surprised and it’s good news,” said Dr. Kloner, professor of medicine in the cardiovascular division at the Keck School of Medicine at USC in California. “We can always use a new drug for heart failure." Kloner co-authored the book, “Viagra: How the Miracle Drug Happened & What It Can Do for You.” He said this is not the first time, scientists have looked to Viagra for potential heart benefits. In 1989, British scientists tested sildenafil citrate as a medication to treat high blood pressure and angina. By the 1990s in early trials of the drug, researchers noticed an interesting side effect — an increase in erections. In 1996, the pharmaceutical company ... More

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ED has vascular, neurologic, psychological, and hormonal causes. Conditions commonly associated with ED include diabetes mellitus, hypertension, hyperlipidemia, obesity, testosterone sildenafil teva 100mg price deficiency, and prostate cancer treatment (Table 2) .6 – 8 Performance anxiety and relationship issues are common psychological causes. Erectile Dysfunction: Related Conditions and Approaches to Evaluation. Endocrine disorders (e.g., hypogonadism, hyperprolactinemia, thyroid disorders) History and physical examination; if an endocrine disorder is suspected, consider laboratory testing. Blood pressure; fasting glucose, high-density lipoprotein, and triglyceride levels; waist circumference. Neurologic conditions (e.g., multiple sclerosis, Parkinson disease, spinal cord injury, stroke) History and physical examination. Prostate cancer treatment (e.g., surgery, radiation, hormone therapy) Psychological conditions (e.g., sildenafil teva 100mg price anxiety, depression, guilt, history of sexual abuse, marital or relationship problems, stress) History and physical examination; if venous leakage is suspected, consider urology consultation for venous flow testing. Erectile Dysfunction: Related Conditions and Approaches to Evaluation. Endocrine disorders (e.g., hypogonadism, hyperprolactinemia, thyroid disorders) History and physical examination; if an endocrine disorder is suspected, consider laboratory testing. Blood pressure; fasting glucose, high-density lipoprotein, and triglyceride levels; waist circumference. Neurologic conditions (e.g., multiple sclerosis, Parkinson disease, spinal cord injury, stroke) History and physical examination. Prostate cancer treatment ... More

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However, it is important never to stop taking a prescribed medicine unless you are advised to do so by a qualified healthcare professional who is responsible for your care. Possible psychological causes of erectile dysfunction include: depression – feelings of extreme sadness that last for a long time anxiety – a feeling of unease, such as worry or fear. Erectile dysfunction can often have both physical and psychological causes. For example, if you have diabetes, it may be difficult for you to get an erection, which may cause you to become anxious about the situation. The combination of diabetes and anxiety may lead to an episode of erectile dysfunction. There are many emotional issues that may also affect your physical ability to get or maintain an erection. These include: relationship problems lack of sexual knowledge past sexual problems past sexual abuse being in a new relationship. Other possible causes of erectile dysfunction include: excessive alcohol intake tiredness using illegal drugs, such as cannabis, heroin or cocaine. Men who cycle for more than three hours per week may be recommended to try a period without cycling to see if this helps improve erectile dysfunction. Riding in the correct position with a properly fitted seat may also help to prevent regular cycling from leading to erectile dysfunction. Erectile dysfunction (ED) can often be diagnosed by your GP. They will talk to you about your situation and may carry out a physical examination. Your GP may ask you about: your symptoms your overall physical and mental health your alcohol consumption whether you take drugs whether you are currently taking any medication. If you do not want to talk to your GP ... More

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As previously mentioned, there is a well-defined sequence of events that take place to enable an erection. ED can occur when any of these events are disrupted. Brooks & Jordan (2001) states the cause in more than 75 % of the cases is physical rather than psychological and that the most common cause is damage either to arteries, smooth muscles or fibrous tissues and those damages accounts for approximately 70 % of the cases. The condition can be categorized as psychological or physical or both. Psychological factors include stress, anxiety, and guilt, lack of self-esteem, depression, and fear of sexual failure. Physical factors are more prominent, and can be things such as: System diseases, for example: cardiac, hepatic, renal, pulmonary, cancer, metabolic, post organ transplant, pelvic irradiation. Androgen deficiency, as androgen resistance, other endocrinopathies. Vascular insufficiency, like atherosclerosis, pelvic steal, penile Raynaud’s syndromE, venous leakage. Neurological disorder: Parkinson’s, Alzheimer’s, Shy-Drager, encephalopathy, spinal cord or nerve injury. Penile disease: Peyronie’s disease, priapism, phimosis, smooth muscle dysfunction, trauma. Many of the above causes of this disease relate to high age. (2007) states that 69.4 % of all 70-76 year old men suffer from erectile dysfunction to some extent. In this study, at the age of 50-54, 26.0 % of all men have ED, which supports the above statement. In the US, erectile dysfunction is more common among obese men and men with diabetes (Carson et al., 2007). ED is and will continue to be a significant problem. Today patients developing ED generally have a higher expectation in terms of quality of life and ... More

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The findings appear to highlight the influence of the quality of a couple's sexual relationship on treatment use. Paul Williams said: "Men's perceptions of their sexual relationships and their emotional readiness for sexual activity are important when considering the most appropriate treatment for a man and his partner." The authors caution that due to an under-reporting of data on duration and severity of erectile dysfunction and relationship status in the majority of the included studies, the influence of these factors on treatment use could not be fully explored in this study. Further research should explore how beliefs affecting treatment adherence can be addressed during treatment to improve the quality of life of men and their partners, according to the authors. The review also highlights the importance of men's beliefs with regards to erectile dysfunction and its treatment, with a potential effect on treatment continuation. Mr Williams said: "Perceived ineffectiveness of treatment has a subjective element based on, for example, treatment expectations prior to treatment. We found that men who reported treatment side effects to a healthcare professional were more likely to continue with treatment. Exploring any misconceptions patients may have in relation to their treatment could potentially be beneficial to increasing treatment utilisation and therefore something that could help health care professionals when faced with treatment failure." The authors suggest that future research would benefit from using psychological theory to explore barriers and enablers to treatment utilisation, as well as from measuring how treatment is utilised by patients. Taking such steps ... More

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