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Severe

infection

The bacteria then produce toxins that affect blood vessels, leading to a profound and life-threatening decline in blood pressure. Allergic reaction (anaphylaxis): Anaphylactic shock is a sometimes-fatal allergic reaction that can occur in people who are highly sensitive to drugs such as penicillin, to

certain

This type of shock is characterized by breathing problems, hives, itching, a swollen throat and a sudden, dramatic fall in blood pressure.

Neurally mediated hypotension: Unlike orthostatic hypotension, this disorder causes blood pressure to drop after standing for long periods, leading to symptoms such as dizziness, nausea and fainting. This condition primarily affects young people and occurs because of a miscommunication between the heart and the brain.

Nutritional deficiencies: A lack of the essential vitamins B-12 and folic acid can cause anemia, which in turn can lead to low blood pressure.

A single lower-than-normal reading is not cause for alarm, unless you are experiencing any other symptoms or problems. If you experience any dizziness, lightheadedness, nausea or other symptoms, it’s a good idea to consult with your healthcare provider. To help with your diagnosis, keep a record of your symptoms and activities at the time they occurred. Your donation helps empower people everywhere to learn the facts and take action to lower their risk of heart problems.

The staff and providers at WHS Urology are proud to have built a reputation for delivering quality urology care with sincere friendliness and compassion. Our goal is to provide the highest quality medical care to our patients in a timely, professional and pleasant manner. We deliver comprehensive state of the art medical and surgical treatment of the urology system.

We believe that a prompt diagnosis, early intervention and prevention are

essential

WHS Urology offers a comprehensive array of diagnostic and surgical treatments to residents of the tri-state area with a convenient location in Washington County.

If you have any questions or concerns, please contact our office at (724) 229-2424. Visit Back2BU for the latest updates and information on BU's response to COVID-19. Students can find additional information in the Undergraduate Student Guide and Graduate & Professional Student Guide. Goals Center for Sexual Medicine Faculty and Staff Make an Appointment For Health Care Professionals Training Opportunities.

The most common sexual dysfunctions in men include lack of interest, premature ejaculation and erectile dysfunction.

The latter affects 52% of men between the ages of 40 and 70, including mild, moderate and complete forms of ED. Organic or physical causes for sexual dysfunction in men include vascular, hormonal and neurologic factors. Concerning vascular causes, the risk factors for atherosclerosis (including smoking, high blood pressure, diabetes (diabetics do not respond well to pills like sildenafil (Viagra)) and high cholesterol are ALSO risk factors for erectile dysfunction.

Since a straddle injury or use of a narrow saddle can obstruct and impair arteries to the penis, bicycle riding is also considered a risk factor for erectile dysfunction.

Little attention has been paid to endocrine factors.

Testosterone modulates desire, arousal and orgasmic function.

Concerning the orgasmic response, testosterone modulates the integrity of genital sensory receptors. Concerning the arousal response, decreased testosterone blood levels can influence the efficacy of sildenafil (Viagra).

If the sildenafil response is not reliably improving erection, the physician should first check if the patient is taking the pill correctly. The physician should also check the patient’s testosterone level.

One investigator in Italy gave testosterone to patients with low testosterone who did not respond to sildenafil (Viagra).

When daily testosterone was given, subsequent sildenafil (Viagra) use resulted in IIEF (the International Index of Erectile Function questionnaire used to determine erectile function) scores improving significantly.

Other risk factors for erectile dysfunction include neurologic problems (multiple sclerosis, stroke), depression and medications for treating diabetes, hypertension, heart disease and depression.

There are many oral therapies for erectile dysfunction, but the only approved medication in the US is the PDE 5 enzyme inhibitor sildenafil (Viagra).

Unapproved therapies, some of which are available in the US and some elsewhere, some of which have data to prove efficacy and some not, include tadalafil (Cialis), vardenafil (Levitra), yohimbine, phentolamine, trazodone, apomorphine and neutraceuticals.

PDE5 inhibitors act to relax penile erectile tissues with sexual stimulation thus enhancing your ability to get an erection.

Sildenafil (Viagra) is effective for all sorts of erectile dysfunction in 69% of people.

In some cases the erection is not hard enough, sometimes sildenafil (Viagra) just doesn’t work.

Structurally vardenafil (Levitra) is similar to sildenafil, while tadalafil (Cialis) is very different.

Vardenafil (Levitra) is almost 10 times more biochemically potent than sildenafil, therefore a lower dose is needed to facilitate the penile erection, potentially resulting in less side effects.

Selectivity is the ability of the drug to attach to the specific enzyme PDE 5 found in penile tissues.

Vardenafil (Levitra) is more selective than sildenafil and tadalafil (Cialis) to PDE5, which again means a lower dose is needed with potentially less side effects. Tadalafil is very specific for PDE5 and is also very specific for the enzyme PDE11. Unfortunately, we don’t know much about PDE11, which is found in the heart, in the pituitary gland in the brain and in the testicles. Pharmacokinetics, half-life, is how long the medication stay s in the blood.

Sildenafil (Viagra) has a half-life of 4 hours and vardenafil (Levitra) has a half-life of 4-6 hours while tadalafil (Cialis) has a half-life of 17.5 hours.

This means that vardenafil (Levitra) should act longer than sildenafil (Viagra) but the clinical significance is not known.

Tadalafil (Cialis) has the longest half-life and allows you to take the medication and not relate the sexual activity to the immediate use of the medication. The drawback is if you need nitrates after using tadalafil (Cialis), this medication lasts a long time in your blood stream and may place you at a higher risk. Younger people might do well treated with tadalafil, (Cialis) while older people with other health issues might be better off using sildenafil (Viagra) or vardenafil (Levitra) but more data are needed.

The side effects of vardenafil (Levitra) are potentially less than sildenafil (Viagra), but more data are needed.

In a recent study on men with erectile dysfunction and diabetes, vardenafil (Levitra) improved their erectile dysfunction. Tadalafil (

Cialis

Many people stop taking drugs because they are experiencing side effects, they no longer have a partner, or they are worried about safety.

Sexual activity is not a major contributor to the risk of a heart attack.

Sexual activity, with or without sildenafil (Viagra) increases the chance of an MI during sexual activity by only 0.1%. If pills fail, there are vacuum devices, Muse, injections, bypass surgery and implants.

The patient making a presentation has had penile bypass surgery.

In addition he takes testosterone and sildenafil as needed..

This is a classic example of why people with ED need complete care: a psychological exam, history and physical exam, and diagnostic studies with long term follow-up care. Patients with ED should not just be prescribed sildenafil (Viagra) and then be lost to follow-up.

Some men with erectile dysfunction, or ED, find they can return to an active sex life by treating an underlying condition, such as high blood pressure, or with counseling and lifestyle changes. But others find they may need medication to get and keep an erection.

The FDA has approved several prescription drugs you take orally to treat ED. All of these work by relaxing your muscles and boosting blood flow to your penis, making erections easier to get and maintain.

They are: Caution: Do not use these ED medications if you take nitrates, such as nitroglycerin or a similar medicine, for chest pain.

The combination can cause dangerously low blood pressure.

These medications all work similarly to each other. However, there are subtle differences in how long they stay effective and how quickly they begin to work. Levitra takes about 30 minutes to start working and the effects last a little longer than Viagra, about 5 hours.

It contains the same active ingredient as Levitra and can begin working in about 15 minutes.

Viagra takes around 30 minutes to become effective and lasts about 4 hours. Cialis lasts much longer -- up to 36 hours in some cases. Stendra can start doing its thing in as little as 15 minutes, and its effects last up to 6 hours.

You may find that one works better for your schedule or that there are differences in the side effects for you.

But these medications work the same basic way, so you’re likely to have similar results. Again, do not use these ED medications if you take nitrates, such as nitroglycerin or a similar medicine, for chest pain.

But there are other situations that may make these medications unsafe as well. Before you take Viagra or one of the others, tell your doctor: If you are allergic to any medications, including other ED medications About any prescription or nonprescription medications you take, as well as any herbal and dietary supplements If you are scheduled for surgery, even dental surgery If you take alpha-blockers for blood pressure or prostate problems. These can lower your blood pressure when taken with ED pills.

Always follow the directions on your prescription label carefully.

Also, make sure to ask your doctor or pharmacist to explain anything you don’t understand. If you’ve had a heart attack, stroke, or life-threatening irregular heart rate within the past 6 months, you should discuss other options with your doctor.

You should also avoid these medications if you have uncontrolled high or low blood pressure or if you get chest pain while having sex. You may get: • A headache • Upset stomach or heartburn • Feeling of warmth • Nasal congestion • Changes in vision (lights tinged with color, glare) Warnings. You may need emergency treatment if you get an erection that lasts for more than 4 hours and happens without any sexual excitement. You may hear a doctor call it a “priapism.” Blood becomes trapped in the penis and can’t flow back out.

It can lead to scarring and permanent ED if not treated.

Also get emergency treatment with any of the following: A rash Painful erection Fainting Chest pain Itching or burning during urination. If you’re having chest pain and have taken Viagra in the past 24 hours or Cialis in the past 48 hours, don’t take nitroglycerin. Call for an EMS and make sure you or someone with you tells them which ED medicine you took.

You should also stop these medications and call your doctor right away if you have vision loss.

A rare vision problem called NAION -- short for “nonarteritic anterior ischemic optic neuropathy” -- has been reported by a few men using these drugs. The condition causes a sudden loss of eyesight because blood flow is blocked to the optic nerve.

People who have a higher chance for NAION include those who: Are more than 50 years old Smoke Have heart disease, diabetes, high blood pressure, or high cholesterol levels Have certain other eye problems.

Keep them in their original container and out of reach of children. Store them away from heat and moisture (not in the bathroom). When they expire or you don’t need them anymore, get rid of them.

“Erectile dysfunction (impotence) – Treatment.”.

National Institute of Diabetes and Digestive and Kidney Diseases, “What causes erectile dysfunction?” “Prescribing Erectile Dysfunction Medications.”. Check with your doctor to see if you need to increase your dose.

If you take a prescription drug for erectile dysfunction (ED), you'll want to do everything you can to make sure it's doing its job. Take a few minutes to learn how to get the most out of your medication.

Sometimes eating a big meal right after you take an ED drug may not always be the best idea.

If you swallow sildenafil (Viagra) with a high-fat meal, such as a steak dinner, it may take longer for it to work. You can take other ED drugs with or without food, such as: Make sure you take the right drug for you.

While ED drugs work in similar ways, they're each made up of different chemicals. This can affect how they work, how much time they take to kick in, and the different side effects that you may have. Talk to your doctor about any health problems you have and other medications that you take.

It will help your doctor find the ED drug that should work best for you.

For most ED drugs, you need to wait a while before you can expect them to start working.

Viagra and Levitra take about 30 minutes to work, and the effects last for about 4 hours after you take the pill. You should take Cialis at least 2 hours before you plan to have sex. The effects may last for up to 36 hours after you take it.

Check with your doctor to see if you need to increase your dose.

If the amount of medicine you use now doesn't help you get an erection, you may need to take a bigger dose.

Talk to your doctor to see if an increase in medication is the right for thing for you.

You can't take an ED drug and expect to get an erection right away. The medications boost the effects of a chemical your body makes called nitric oxide, which relaxes the muscles in your penis.

That improves your blood flow and helps you get an erection.

But for the drugs to work, you need to be sexually aroused. Pay attention to this: Don't take ED drugs if you also take heart medicines called nitrates.

The combination can cause a dangerous drop in your blood pressure.

To make sure you stay safe, talk to your doctor about all of the medications you take. University of California San Francisco Medical Center: "Oral Medications for Erectile Dysfunction." Mayo Clinic: "Erectile Dysfunction: Viagra and Other Oral Medications." National Institute of Diabetes and Digestive and Kidney Diseases: "Erectile Dysfunction." Of All the Oral Erectile Dysfunction Drugs, Which One’s the Best? If you’ve ever been in a situation where you couldn’t get an erection when you expected to, you know the emotional whirlwind that follows.

Feeling of frustration, embarrassment, shame, and anxiety settle in, especially if the problem continues to go unresolved.

It’s a situation you’ll always remember and one that half of all U.S. men between 40 and 70 years old have experienced too.

For many, erectile dysfunction or ED is an all-too-real concern.

Fortunately, there are several ways to manage and treat ED. (Spoiler

alert

We’ll get to that part soon.) What is erectile dysfunction (ED)?

Nowadays, the more commonly used term is "erectile dysfunction".

ED happens when a man isn’t able to get or keep an erection long enough to complete a desired sexual act, such as intercourse. This can include several different situations: You can get an erection but can’t keep it. You can become somewhat erect, but not enough to begin or complete sexual intercourse. You can get an erection sometimes, but sometimes you can’t.

The definition of ED doesn’t include low sex drive (don’t think about sex or have no desire to have sex) or premature ejaculation. While ED isn’t necessarily a severe medical disease itself, viagra pills for sale online it can certainly have profound psychological and emotional effects. Some men who have ED experience an unhappy sex life, loss of intimacy with partners, anxiety, and depression.

In some cases, ED can also prevent a couple from conceiving a child.

Unfortunately, many of the emotional outcomes of ED further contribute to the psychological causes of ED, resulting in a discouraging cycle. ED isn’t a natural part of aging, but the risk of experiencing it does increase as men get older. That’s because many of the underlying causes of ED become more common with increasing age.

Conditions that can contribute to ED include: Nerve damage, which can be caused by diabetes or nerve injuries Heart and blood vessel damage High blood pressure Obesity Stress, anxiety, and depression Alcohol and tobacco use Fatigue Prostate surgery Some prescription medications https://medlineplus.gov/ency/article/004024.htm. Because there are so many potential culprits, one important aspect of diagnosing and treating ED is figuring out the underlying cause.

Lemonaid’s ED service https://www.lemonaidhealth.com/faq#erectile-dysfunction makes it easy not only to confirm an ED diagnosis and get a prescription for treatment, but also to get the tests you need to determine what’s causing your ED.

For many men, oral medications are a standard treatment for ED. There are four oral options on the market: sildenafil (Viagra) tadalafil (Cialis) vardenafil (Levitra, Staxyn) avanafil (Stendra)* The medications all work the same way (however, there are a few differences, which are explained in a chart further down). When a man is sexually stimulated, a gas called nitric oxide (NO) is released and helps relax herbal viagra walgreens the muscles in the penis. As the muscles relax, the penis is able to fill with blood and become erect. Oral ED drugs help increase the effects of NO to assist men who have trouble getting or keeping an erection.

Help you get and keep an erection in response to sexual stimulation Assist in your physical ability to complete desired sexual activities. Increase libido or sexual desire Help every man who has ED.

It’s important to understand that oral ED drugs are not aphrodisiacs. Also, not all men with ED will benefit from these medications. Men with certain medical histories – like diabetes or past prostate surgery – may not respond to oral ED drugs. That’s one reason it’s so important to talk to a doctor before starting any treatment for ED, but there’s another critical reason, too.

Ever-present pop culture references to “the magic blue pill” can make it easy to view oral ED drugs as harmless, brightly-colored, sex-life-savers in pill form.