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Coadministration with nitrates (either regularly and/or intermittently) and nitric oxide donors Consistent with the effects of PDE5 inhibition on the nitric oxide/cyclic guanosine monophosphate pathway, PDE5 inhibitors may potentiate the hypotensive effects of nitrates A suitable time interval following PDE5 dosing for the safe administration of nitrates or nitric oxide donors has not been determined. Elicits vasodilatory properties, resulting in mild and transient decreases in blood pressure. Use with caution in patients with anatomic deformation of penis (eg, angulation, cavernosal fibrosis, or Peyronie disease), conditions potentially predisposing to priapism (eg, sickle cell anemia, multiple myeloma, or leukemia), cardiovascular disease, bleeding disorders, active peptic ulcer disease, liver disease, renal impairment, multidrug antihypertensive regimens, retinitis pigmentosa, concomitant use of CYP3A4 inhibitors. Pulmonary vasodilators may significantly worsen cardiovascular status of patients with pulmonary veno-occlusive disease. Patient taking alpha blocker should be stabilized before starting phosphodiesterase (PDE)-5 inhibitor, which should be initiated at lowest dose; if patient is already taking optimized dose of PDE-5 inhibitor, alpha blocker should be initated at lowest dose to avoid hypotension. Sudden decrease or loss of hearing, which may be accompanied by tinnitus and dizziness. Viagra: Patients should stop sildenafil and seek medical care if a sudden loss of vision occurs in 1 or both eyes, which could be a sign of nonarteritic anterior ischemic optic neuropathy (NAION); use with caution, and only when the anticipated benefits outweigh the risks, in ... More

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CVD and hypertension cause a narrowing and hardening of the arteries, leading to reduced blood flow to the corporal bodies, which is essential for achieving an erection. Diabetes is a common aetiology of sexual dysfunction, because it can affect both the blood vessels and the nerves that supply the penis. Men with diabetes are four times more likely to experience ED, and on average, experience ED 15 years earlier than men without diabetes.7 Obesity is also correlated to the development of several types of dysfunction, including a decrease in sex drive and an increase in episodes of ED.8. There are hundreds of medications that have the side effect of ED and/or decreased libido. Examples of drugs implicated as a cause of ED include hydrochlorothiazides and beta-blocking agents. Medications used to treat depression, particularly the SSRIs such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Prozac Weekly, Sarafem), fluvoxamine (Luvox, Luvox CR), paroxetine (Paxil, Paxil CR, Pexeva) and sertraline (Zoloft), may also contribute to ED.9 Bupropion (Wellbutrin) which has a predominant effect on blocking the reuptake of dopamine is an antidepressant with lower incidence of ED.10 The side effects of 5ARIs occurring in fewer than 5% of patients can include gynaecomastia, ED, loss of libido and ejaculatory dysfunction.11. Men being treated for prostate cancer with treatments such as radical prostatectomy, radiation therapy or the use of Lutenizing hormone-releasing hormone (LHRH) agonists and antagonists can expect that ED may accompany these treatments.12. Smoking, excessive use of alcohol and illicit drugs are also associated with ED.13 A study in 2005 ... More

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Men with psychogenic erectile dysfunction may relate the onset of problems to a "stressor," such as failed relationship. Your doctor may suggest a test to determine if you have erections during sleep, which may suggest that there may be a psychological cause of the erectile dysfunction. Erectile dysfunction may be a symptom of underlying medical conditions, which if not detected may cause further medical problems. A prior history of cigarette smoking, heart attacks, strokes, and poor circulation in the extremities (for example, intermittent claudication or cramping in your leg[s] when you walk) suggest atherosclerosis as the cause of the erectile dysfunction. Loss of sexual desire and drive, lack of sexual fantasies, gynecomastia (enlargement of breasts), and diminished facial hair suggest low testosterone levels. A prior history of pelvic surgery or radiation and trauma to the penis/pelvis/perineum can cause problems with the nerves and blood vessels. Symptoms of intermittent claudication of the lower extremities with exercise may suggest a vascular problem as a cause of the erectile dysfunction. Is the patient taking medications that can contribute to erectile dysfunction (see causes above), including prescribed, over-the-counter, or recreational drugs? It is important to discuss your prescribed medications, as well as over-the-counter medications and drugs of abuse such as opiates, alcohol, etc. The physical examination can reveal clues for physical causes of erectile dysfunction. A doctor will perform an assessment of BMI and waist circumference to evaluate for abdominal obesity. A genital examination is part of the evaluation of erectile dysfunction. The ... More

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It is certainly possible for both physical and mental factors to contribute toward a single patient’s erectile dysfunction. Many people with ED discover that a physical issue will lead to stress in a relationship or about sexual performance, which can make their erectile dysfunction even more difficult to deal with. This potentially endless circle can be broken by speaking with a doctor about your erectile dysfunction and what may be causing it to occur. Treatment for Erectile Dysfunction from Las Vegas Urology. Talking with a medical specialist is the first step in getting the proper treatment for erectile dysfunction. This process begins with a physical exam that can include a full analysis of your vascular system, nervous system, thyroid, prostate, and genitals. Once a patient’s particular cause of ED has been identified, our urologists will be able to give their expert recommendations on which type of treatment will offer the best solution for that individual. Common treatment options include: Shockwave therapy Psychological counseling Lifestyle cialis discount coupon cvs changes Drug therapy Penile pumps Injections Penile implants. This simple therapeutic method involves a specialized device that delivers controlled electrical impulses to the patient’s penis. Though this may sound intimidating, shockwave therapy sessions are incredibly gentle and pain free. The electrical currents used during these sessions will help to clear away any plaque within the arteries that may be causing a blockage in blood flow to the penis. If your physician suspects a psychological cause for erectile dysfunction, they may suggest treatment from a psychiatrist, psychologist, sex ... More

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Expert opinion about surgical implants has changed during recent years; today, surgery is no longer so widely recommended. There are many less-invasive and less-expensive options, and surgery should be considered only as a last resort. The obvious risks are the same that accompany any surgery: infection, pain, bleeding, and scarring. If for some reason the prosthesis or parts become damaged or dislocated, surgical removal may be necessary. With a general success rate of about 90 percent, any of the devices will restore erections, but they will not affect sexual desire, ejaculation, or orgasm. Prostheses: Many different types of penile prostheses are available, in three categories: rods, inflatable prostheses, and self-contained prostheses. Semi-rigid or malleable rods are the simplest and least expensive of all. Their main disadvantage is that the penis remains constantly erect, which may the best generic viagra cause problems with concealment. Inflatable prostheses are complex mechanical devices that imitate the natural process of erection. Parts are inserted surgically into the penis and scrotum, and activated by squeezing. When erection is no longer desired, a valve on the pump is pressed, and the penis becomes flaccid. Self-contained single-unit prostheses are similar to the inflatable types, but more compact. When erection is desired, the unit is activated by either squeezing or bending, depending on which of the two types of self-contained prostheses is used. Vascular Reconstructive Surgery corrects defects in penile blood vessels. The surgeon may reconstruct the arterial blood supply, or remove veins when the cause is due to leakage. Less than five percent of men ... More

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These disease related factors must be addressed prior or simultaneously with pharmacologic and/or surgical therapy to effectively treat their SD. As awareness of the complexities of normal sexual function increase so will the recognition of SD in this population. This movement will lead to improved quality of life in men with neurologic disorders, as proven by the strong link between sexual function and quality of life. Conflicts of Interest: The authors have no conflicts of interest to declare. AXOL THERAPY FOR ERECTILE DYSFUNCTION, ENHANCED SEXUAL PERFORMANCE NOW AVAILABLE AT COLORADO UROLOGY. BREAKTHROUGH, NON-INVASIVE TREATMENT CALLED AXOL THERAPY FOR ERECTILE DYSFUNCTION AND ENHANCED SEXUAL PERFORMANCE NOW AVAILABLE AT COLORADO UROLOGY. Axol Softwave Therapy is a new treatment for erectile dysfunction (ED) and for men who want enhanced sexual performance. The in-office treatment is non-invasive, safe, and effective with virtually no side effects. Axol Therapy is an alternative to ED medications, surgical implants, penile pumps, and injections. Denver, CO (February 24, 2020) – The men’s sexual health specialists at Colorado Urology now offer an exciting new treatment option for men living with erectile dysfunction (ED) called Axol Softwave Therapy. This safe and non-invasive treatment option is helping many men with ED achieve spontaneous and natural erections without the help of medications. The therapy can also be used to enhance a man’s sexual performance. About 5 in 10 men experience erectile dysfunction (ED) at some point in their lives. First-line therapies often include oral medication to help men achieve an erection. Now, Axol Therapy is providing a safe and ... More

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Below are the drugs’ most common side effects, according to their manufacturers: Side effect Viagra Cialis Levitra Stendra Stuffy or runny nose x x x x Headache x x x x Dizziness x x Upset stomach x x x Nausea x Indigestion x x Vision changes x Rash x Flushing x x x x Back pain x x x x Pain in the limbs x Muscle aches x x Sore throat x. Tell your doctor if you have any side effects that linger and don’t go away on their own. If you have an erection that lasts longer than four hours, call your doctor right away. This condition, known as priapism, is a risk associated with all of these ED drugs. Unlike Viagra and the other PDE5 inhibitors, Cialis is also approved to treat enlarged prostate. Both Viagra and Cialis can be taken 30 minutes before sexual activity. However, Cialis lasts much longer and is noteworthy for the amount of time it remains in your body. You may feel the effects of the drug up to 36 hours after you take it. The fact that cheapest place to buy sildenafil it comes in a low-dose (2.5 mg) version also means that Cialis can be taken every day. A daily dose will ensure that the drug’s always in your system. This side effect isn’t associated with any other oral ED drugs. Viagra can take 30 to 60 minutes to work in the body, while Levitra takes 60 minutes. Levitra does have fewer common side effects than Viagra, and it isn’t associated with a rash or muscle aches. While vision changes are considered a common side effect of Viagra, changes to color perception are only a rare side effect of Levitra. Stendra is the newest drug on the market, and no generic version is available for sale yet. The 100-mg and 200-mg doses can be taken as shortly as 15 minutes before ... More

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Taking Viagra with drugs used to treat high blood pressure can cause your blood pressure to drop even lower. Examples of drugs used to treat high blood pressure include: If you take a drug for high blood pressure, your doctor might prescribe a dose of Viagra for you that’s lower than the typical dose. If you’re taking a type of blood pressure drug called an alpha-blocker, the extra drop in blood pressure from Viagra could make you feel dizzy or lightheaded. If you’re taking an alpha-blocker, your doctor will recommend a starting dose of 25 mg of Viagra, which is lower than the usual starting dose. Examples of alpha-blocker drugs used for high blood pressure include: If you take one of the drugs listed above, tell your doctor if you feel dizzy or lightheaded, or faint after taking Viagra. You shouldn’t take Viagra with illicit drugs called poppers. Poppers contain nitrate drugs such as amyl nitrate, alkyl nitrate, and butyl nitrate. Taking Viagra with poppers can cause a dangerous drop in your blood pressure that can lead to heart attack or stroke. Viagra hasn’t been tested for use with illicit drugs other than poppers. But it’s possible that taking Viagra with certain other illicit drugs could also have dangerous effects on your heart and blood pressure. Examples of illicit drugs that could have dangerous effects if taken with Viagra include: stimulants, such as cocaine, ecstasy, amphetamines, and speed anabolic steroids. If you’re thinking of using illicit drugs with Viagra, talk with your doctor about whether this is safe for you to do. Certain drugs used to treat benign prostatic hyperplasia (BPH)* can also cause low blood pressure. Taking Viagra with alpha-blockers ... More

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The investigator was provided a sealed copy of the randomisation codes and was instructed to break the treatment code only in the event of an emergency. Active treatment and corresponding placebo tablets were identical in packaging and appearance. During the DB phase, the primary efficacy variables were responses to questions “When you attempted sexual intercourse, how often were you able to penetrate your partner?” (Q3) and “When you attempted sexual intercourse, how often were you able to maintain your erection after you had penetrated your partner?” (Q4) of the 15 item International Index of Erectile Function (IIEF). The IIEF is a validated questionnaire that has been used for the clinical assessment of ED. 18 Each question of the IIEF is scored on a categorical scale of 1 (“almost never/never”) to 5 (“almost always/always”), with a score of 0 indicating “did not attempt sexual intercourse”. Secondary efficacy variables were responses to three global efficacy questions (GEQs): GEQ1: “Compared to having no treatment at all for your erection problem, has the medication you have been taking over the past 4 weeks improved your erections?” and GEQ2: “If yes, has the improvement in your erections allowed you to engage in satisfactory sexual activity?”. GEQ3 asked: “When you took a dose of study drug and had sexual stimulation, how often did you get an erection that allowed you to engage in satisfactory sexual activity?”. Additional secondary efficacy measures were analyses of IIEF domains, for example, orgasmic function (Q9: “When you had sexual stimulation or intercourse, how often did you ejaculate?” and Q10: “When you had sexual stimulation or intercourse, how often did ... More

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