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Sildenafil citrate is designated chemically as 1-[[3-(6,7-dihydro-1-methyl-7-oxo-3-propyl-1H-pyrazolo[4,3d]pyrimidin-5-yl)-4-ethoxyphenyl]sulfonyl]-4-methylpiperazine citrate and has the following structural formula:

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A detailed medical history, sexual history, and physical exam are warranted to identify causative or reversible factors involved in ED.4 Select laboratory tests (e.g., serum testosterone, serum blood glucose, fasting lipid panel, thyroid-stimulating hormone) may be obtained to identify causative factors of ED. Additionally, a detailed medication history is necessary to identify medications that may be contributing to ED (see TABLE 1).4,5
Physicians should warn patients that prolonged erections greater than 4 hours and priapism (painful erections greater than 6 hours in duration) have been reported infrequently since market approval of VIAGRA. In the event of an erection that persists longer than 4 hours, the patient should seek immediate medical assistance. If priapism is not treated immediately, penile tissue damage and permanent loss of potency may result [see WARNINGS AND PRECAUTIONS]. .

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Before using this medication, tell your doctor or pharmacist your medical history, especially of: heart problems (such as heart attack or life-threatening irregular heartbeat in the past 6 months, chest pain/angina, heart failure), stroke in the past 6 months, kidney disease, liver disease, high or low blood pressure, dehydration, penis conditions (such as angulation, fibrosis/scarring, Peyronie's disease), history of painful/prolonged erection (priapism), conditions that may increase the risk of priapism (such as sickle cell anemia, leukemia, multiple myeloma), eye problems (such as retinitis pigmentosa, sudden decreased vision, NAION).
On the horizon is gene therapy that would deliver genes that produce products or proteins that may not be functioning properly in the penile tissue of men with ED. Replacement of these proteins may result in improvement in erectile function. Experimental animal models have demonstrated improvement in erectile function with gene therapy. Human studies may also demonstrate success with this therapy. Gene therapy may take a long time for regulatory approval and public acceptance.

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This is usually caused by stress, tiredness, anxiety or drinking too much alcohol, and it's nothing to worry about.
Communication is the central pillar of any relationship. There’s nothing like opening up with your partner, and with a professional too perhaps, to help reduce your anxiety.

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VITAMINS & SUPPLEMENTS CENTERFind a Vitamin or SupplementVitamin Lifestyle GuideAssess Your Vitamin Needs Viagra - Uses, Side Effects, and More Generic Name(S): sildenafil View Free Coupon

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    MUSE offers an alternative route for administration of prostaglandin using a small pellet inserted using an applicator into the tip of the urethra (water pipe opening). Once massaged the prostaglandin is released and helps the blood to flow into the penis to gain an erection. Some men experience a mild burning sensation afterwards in the water pipe but this is a good alternative option for men who do not like the idea of using injection therapy.

    These are not all the possible side effects of VIAGRA. For more information, ask your healthcare provider or pharmacist.
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    Harvard Health Publishing also notes that ED can be a sign of heart disease. The physical implications of poor lifestyle habits can severely impact the heart’s function, which can, in turn, manifest as impotence. Seeking to improve one’s overall health may not only lead to better sexual performance but also boost their quality of life.

    Insertion of a penile prosthesis (implant) (pictured) is an end stage solution when all other treatment options have failed. It involves a surgical procedure through a small incision in the junction between the penis and scrotum. Patients go home the following day if the procedure is uncomplicated, and the prosthesis can be used for sexual intercourse at 6 weeks following the operation. Complication rates are low in centres that conduct the surgery in large numbers. The risk of infection is <2% and over 85% of the devices are still functioning at 10 years.
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    Your urine will normally be tested to see whether it contains sugar (which might indicate diabetes), or blood (which may be a sign of infection or require further investigation).

    “It’s not like you go into the forest and just eat a leaf,” he says. “You don’t take them right before sex. But there are real natural approaches that work by building up sexual health over time.”
    A vacuum device (VED) is an external device (not a drug) that goes over the penis. When pumped, it pulls blood into the penis then a special ring is placed over the base of the penis to keep it erect.

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    The U.S.-licensed pharmacy ships your sildenafil (generic Viagra) or tadalafil (generic Cialis) right to your door.

    The pathogenesis of organic ED is related to dysfunction of the endothelium. Endothelial cells can become injured through a variety of mechanisms, most of which cause oxidative stress on the tissues. Many of these causes of oxidative stress are related to lifestyle issues which lead to hypertension, diabetes and dyslipidaemia (figure 1). Endothelial cell dysfunction results in reduction of endothelium-dependent vasorelaxation as well as increased adhesion of leukocytes to the endothelium. Endothelial cell injury then leads to a variety of sequelae, including ED, other types of vasoconstriction, atherosclerosis and thrombus formation.18
    There is often a vicious cycle linking performance anxiety and erectile dysfunction. If you still have erections at times and the problem started rapidly (except after surgery), this usually means psychological reasons are involved.

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Salmon increase the levels of dopamine in the brain and increases blood flow to improve sexual desire.

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Sexual activity can put an extra strain on your heart, especially if your heart is already weak from a heart attack or heart disease. Ask your doctor if your heart is healthy enough to handle the extra strain of having sex.

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Some insurance policies cover ED treatment if it’s medically necessary. Check with your insurance provider.

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