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Algorithm for evaluating and managing the patient with ED. CV, cardiovascular; CVD, cardiovascular disease; ED, erectile dysfunction.

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The leading specialists at Chesapeake Urology have helped thousands of patients through a range of treatments: Testosterone therapy Oral Medications Penile Implants Injection Therapy Vacuum Devices Shockwave Therapy
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Depression can have many sexual side effects, including erectile dysfunction. Medications called selective serotonin reuptake inhibitors (SSRIs) that are used to treat depression can also affect sex drive, erectile function, and the ability to orgasm.
Over time, your best value will depend a little on the conclusions from your doctor’s consultation. They might think a 45mg dose may be just right for you, and a company like BlueChew offers precisely that. So, even if you can get a better deal on a 40mg dose elsewhere, it may not be as effective. However, different dosage needs – for instance, if you only need 20mg doses of sildenafil – or a desire to use a different medication like Stendra instead might mean a company like Roman or Hims offers better value for you.

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VEDs are generally safe (although there have been some very rare but serious complications). Pros Cons Works Well No drug effects Cheapest option Cumbersome Unnatural erection Bruising or burst blood vessels Penile pain Pain with ejaculation Numbness "Hinging" or instability of erection Penis may feel cold to partner Poor overall satisfaction ED Injections
ED can be related to mental or emotional distress which may require other types of treatment such as counseling, but in most cases it is a matter of poor blood flow that could be related to diabetes, heart disease, hypertension, or metabolic syndrome.

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If you need something to ease the discomfort, try taking an antacid, but do not put off going to the doctor if it bothers you. They may be able to prescribe an extra medicine to protect your stomach. Stuffy nose

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If you smoke, talk to your doctor about quitting and whether prescription aids can help you.

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    8. When choosing an injection site, avoid any area where a vein is clearly visible. We recommend changing injection sites from left to right as well as up and down the shaft and back again to ensure that you do not develop scar tissue at one specific site.

    6. Burnett AL, Nehra A, Breau RH, et al. Erectile Dysfunction: AUA guideline. J Urol. 2018;200(3):633-641.
    Where Viagra needs initial stimulation with foreplay, a relaxed mind, and a peaceful environment, penile pumps do not require these steps. Since Viagra works on the chemicals in the body, called neurotransmitters, any chemical or psychological problem in these pathways can cause it to fail. Contrarily, penile pumps act as mechanical stimulators by working directly on the penis and inducing an erection by drawing in blood.

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    Facial flushingHeadachesStomach painNasal congestionNauseaDizzinessRashUrinary tract infections (UTIs)DiarrheaInability to differentiate between the colors green and blue

    Sildenafil does not protect against sexually transmitted diseases (such as HIV, hepatitis B, gonorrhea, syphilis). Practice "safe sex" such as using latex condoms. Consult your doctor or pharmacist for more details.
    If you’re ready to start seeing improvements, consider trying some of the natural remedies for impotence explained below. These remedies include eating an anti-inflammatory diet, getting more exercise, using essential oils and other supplements, and of course, getting a handle on stress.

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    The tests performed will be left to your doctor's discretion. It is common to measure kidney function, liver function, cholesterol, as well as checking your blood cells for anaemia or other problems. A fasting blood sugar measurement will be performed to exclude diabetes. A PSA (prostate specific antigen) blood test may also be carried out if necessary.

    It's good for your sex life in lots of ways. It helps your heart and blood vessels stay healthy, keeps your weight in check, lowers stress, and in general just makes you feel good. And your workout doesn't even have to be strenuous. A study shows that even a 30-minute walk each day could lower your chance of having ED.
    In fixed-dose studies, the incidence of some adverse reactions increased with dose. The type of adverse reactions in flexible-dose studies, which reflect the recommended dosage regimen, was similar to that for fixed-dose studies. At doses above the recommended dose range, adverse reactions were similar to those detailed in Table 1 below but generally were reported more frequently.

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    This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

    Table 1: Adverse Reactions Reported by ≥ 2% of Patients Treated with VIAGRA and More Frequent than Placebo in Fixed-Dose Phase II/III Studies (n=607) Headache 16% 21% 28% 7% Flushing 10% 19% 18% 2% Dyspepsia 3% 9% 17% 2% Abnormal vision† 1% 2% 11% 1% Nasal congestion 4% 4% 9% 2% Back pain 3% 4% 4% 2% Myalgia 2% 2% 4% 1% Nausea 2% 3% 3% 1% Dizziness 3% 4% 3% 2% Rash 1% 2% 3% 1% †Abnormal Vision: Mild to moderate in severity and transient, predominantly color tinge to vision, but also increased sensitivity to light, or blurred vision.
    Professor Vlachopoulos noted that changing hypertensive medications in men with erectile dysfunction must be handled with caution. He said: “First, if a co-existing disease dictates using a specific drug category (for example, beta blockers for coronary artery disease and heart failure, diuretics for heart failure), then switching is not advocated. Alternatives might be considered if patients are at risk of stopping lifesaving therapy because of the detrimental impact of erectile dysfunction on their life.”

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Research shows a link between the sleep disorder and ED. When you get treated for sleep apnea, you may see improvements in your erection problems as well. So if you think you might have sleep apnea, or if you know you have it and aren't doing anything about it, it's time to talk to your doctor.

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The following events occurred in < 2% of patients in controlled clinical trials; a causal relationship to VIAGRA is uncertain. Reported events include those with a plausible relation to drug use; omitted are minor events and reports too imprecise to be meaningful:

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What's the connection between impotence and heart health? "An erection is a hydraulic event dependent on the dilation of blood vessels that carry blood to the penis," explained Wittert. "These blood vessels are similar to those that supply blood to the heart muscle."

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Available coupons Save up to 80% on your prescription with WebMDRx View FREE WebMDRx coupon Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use. CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

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