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VIAGRA (sildenafil citrate), an oral therapy for erectile dysfunction, is the citrate salt of sildenafil, a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5).

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Smoking is public enemy number one. The longer you smoke, the more likely you are to suffer from erectile dysfunction. Quitting can help. A study published in BUJI found that 25% of men with ED experienced improvement after a year of giving up smoking. But you must quit, you can’t just switch to e-cigarettes. Early tests suggest vaping has a negative effect on endothelial function and messes up erectile function.
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We do the first injection here in our office so we can show you how to do it yourself at home. It also helps us determine the correct dose for your needs.
Cleveland Clinic: "Erectile Dysfunction: Waist Size Matters," "Low Testosterone (Male Hypogonadism)," "Medications That May Cause Erectile Dysfunction."

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Your GP will arrange a re-assessment after an initial period of drug usage. If the drugs prove ineffective, there are significant side-effects (seen in 15%) or they cannot be used, other measures may need to be considered. This will entail referral to your local Erectile Dysfunction Clinic where the available treatments include:
Tadalafil may affect the way other medicines work, and other medicines may affect the way Tadalafil works, causing side effects. Especially tell your healthcare provider if you take any of the following:

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Thankfully, a few of our top recommendations for the best ED treatment include complimentary consultations with a physician who can help you. Here are some topics that you might discuss during a consultation.

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Sildenafil is cleared predominantly by the CYP3A4 (major route) and CYP2C9 (minor route) hepatic microsomal isoenzymes. The major circulating metabolite results from N-desmethylation of sildenafil, and is itself further metabolized. This metabolite has a PDE selectivity profile similar to sildenafil and an in vitro potency for PDE5 approximately 50% of the parent drug. Plasma concentrations of this metabolite are approximately 40% of those seen for sildenafil, so that the metabolite accounts for about 20% of sildenafil's pharmacologic effects.

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Categories: About BHRT, BHRT for Men, BHRT for Women, Erectile Dysfunction, Hormone Therapy, Low Sex DriveJune 21, 2019 Share on FacebookShare on Facebook TweetShare on Twitter Pin itShare on Pinterest Share on WhatsAppShare on WhatsApp Share on LinkedInShare on LinkedIn
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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1324914/ Irmanie Hemphill, MD, FAAFP Dr. Hemphill is an award winning primary care physician with an MD from Florida State University College of Medicine. She completed her residency at Halifax Medical Center. The Cost of Viagra in 2022 Viagra is one of the most well-known erectile dysfunction medications, however, there are potentially serious side effects that must be known prior to starting this medication. In this article, we cover the cost of Viagra, the best time to take it, how long it takes to work, and the side effects of which you should […] Apple Cider Vinegar For Erectile Dysfunction Most men have challenges with their erections from time to time. Stress, exhaustion, anxiety, and too much alcohol can all have detrimental effects on your ability to achieve or maintain an erection. But if erection challenges are happening often enough that they are causing emotional or psychological issues, impacting your relationships, or hurting your self-esteem, […] Exercises to Alleviate Erectile Dysfunction Many men have issues with getting or maintaining an erection from time to time. When people feel overly anxious or stressed, drink too much alcohol, or take certain medications, it can affect sexual performance. For some, entering into a sexual experience with a new partner or having sexual intercourse too soon after masturbating can negatively […] Interactions Between Cialis and Alcohol Cialis (tadalafil) is a prescription medication primarily used by those who experience difficulty having and maintaining an erection (a condition called erectile dysfunction, or impotence). Alcohol consumption can contribute to or cause erectile dysfunction and can also cause harmful side effects when mixed with the drug used to treat it. This article will cover everything […] Effective Home Remedies for Premature Ejaculation As embarrassing and frustrating as premature ejaculation can be, there are ways to address the disorder. And while it may take some trial and error to find what works for you and your partner(s), that’s also a great reason to have more sex and try new things—even ones not meant to address ejaculation troubles. From […] Similarities and Differences Between Cialis and Viagra Erectile dysfunction (ED), or impotence, is the inability to achieve or sustain a firm erection long enough to enjoy sexual activity. The condition becomes more common with older age, but young men can also experience ED: One study from 2013 found that around 25 percent of erectile dysfunction patients were 40 or younger. It’s estimated […] Can Viagra Make You Last Longer in Bed? Approximately 50% of adult men over the age of 40 experience some amount of erectile dysfunction (ED), and the prevalence increases with age. Viagra, a prescription drug that contains the active ingredient sildenafil, is one of the most popular medications available for treating this condition. Over the decades that Viagra has been available, some myths […] Horny Goat Weed Uses and Side Effects Thanks to its name, horny goat weed stands out from other herbal supplements and pills marketed to boost sexual performance. And if you spend a little time Googling, you’ll learn it’s used in traditional Chinese medicine (TCM) to treat erectile dysfunction (ED) and other sexual dysfunction. Still, just because something is natural doesn’t mean it’s […]

In the past, erectile dysfunction was considered to be a psychological issue about 90 percent of the time. But as physicians learned more about erectile dysfunction — and as effective treatments were developed — today, only about 10 percent of cases are considered to have psychological causes.
A general physical examination will be performed to assess the development of your male sexual characteristics and to detect any abnormality of your penis or testicles. Your blood pressure, height and weight will normally be measured as part of this examination.
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Of the total number of subjects in clinical studies of Viagra, 18% were 65 years and older, while 2% were 75 years and older. No overall differences in safety or efficacy were observed between older ( > 65 years of age) and younger ( < 65 years of age) subjects.

In response, a number of erectile dysfunction treatments have been developed, with varying efficacy and side effects.
Caution is advised when PDE5 inhibitors are co-administered with alpha-blockers. PDE5 inhibitors, including VIAGRA, and alpha-adrenergic blocking agents are both vasodilators with blood pressure lowering effects. When vasodilators are used in combination, an additive effect on blood pressure may occur. In some patients, concomitant use of these two drug classes can lower blood pressure significantly [see DRUG INTERACTIONS and CLINICAL PHARMACOLOGY] leading to symptomatic hypotension (e.g., dizziness, lightheadedness, fainting).
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Other side effects associated with the use of sildenafil may include diarrhea, heartburn, difficulty falling asleep or staying asleep, numbness, burning or tingling in the arms, hands, feet or legs, nosebleeds, and sensitivity to light.

Counselling for ED is safe, confidential and effective. To find out which type of therapy would best help you, book an introductory session with a counsellor.
What Are the Best Three Exercises for Erectile Dysfunction? Learn whether exercises can help and what other treatments can help to relieve your symptoms.
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Management of EDOptimal management of ED involves shared decision-making between the patient, his partner, and the treating clinician.6 Underlying disease states and risk factors should be identified and treated or minimized.5 Contributing medications should be discontinued, or the dose should be reduced.5 A variety of nonpharmacologic and pharmacologic treatment options may be considered for ED treatment. Generally, oral medications are trialed first, and more invasive options are reserved for those who fail to respond to initial therapy.5,6

Ira Sharlip, MD, clinical professor of urology, University of California San Francisco School of Medicine. Advisory board member and/or speakers bureau: Pfizer, Lilly, Johnson & Johnson, Shionogi, Boehringer Ingelheim, Plethora Solutions.
Sildenafil is also sometimes used to treat pulmonary hypertension (high blood pressure in the blood vessels that supply the lungs).
Erectile dysfunction (ED), formerly termed impotence, is defined as the persistent inability to develop or maintain a penile erection allowing for satisfactory sexual performance.1 ED is an important public health problem and can cause serious distress to men, particularly affecting their masculinity and self-esteem.2,3 The Massachusetts Male Aging Study reported an overall prevalence of 52% for any degree of ED and demonstrated that prevalence clearly increases with age.3 For instance, the annual incidence rate reported was 12.4 cases per 1,000 man-years, 29.8 and 46.4 for men aged 40 to 49, 50 to 59, and 60 to 69 years, respectively.3
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Recent studies show that ED is relatively uncommon among men who eat a traditional Mediterranean diet, which includes fruits, vegetables, whole grains, heart-healthy fats including nuts and olive oil, fish, and wine, particularly red. !

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How Does Viagra Work? Penile erections occur when blood vessels that carry blood to the penis increase in size and deliver more blood to the penis, and blood vessels that carry blood away from the penis decrease in size and remove less blood from the penis.Sexual stimulation causes the production and release of nitric oxide in the penis, which causes an enzyme, guanylate cyclase, to produce cyclic guanosine monophosphate (cGMP) that is responsible for increasing and decreasing the size of blood vessels carrying blood to and from the penis and causing an erection.When cGMP is destroyed by the phosphodiesterase-5 enzyme, an erection ends. Viagra prevents phosphodiesterase-5 from destroying cGMP so cGMP stays around longer, which leads to a more prolonged erection.
There are a variety of other options to treat erectile dysfunction including medication, surgical options, injections, or vacuum devices:
No dose adjustment is required for mild (CLcr=50-80 mL/min) and moderate (CLcr=30-49 mL/min) renal impairment. In volunteers with severe renal impairment (Clcr < 30 mL/min), sildenafil clearance was reduced, resulting in higher plasma exposure of sildenafil (~2 fold), approximately doubling of Cmax and AUC. A starting dose of 25 mg should be considered in patients with severe renal impairment [see DOSAGE AND ADMINISTRATION and CLINICAL PHARMACOLOGY].
Erectile dysfunction medications are effective for many men, but these oral medications may not work for everybody. Our team offers numerous other non-invasive and minimally invasive treatments for improved outcomes. Many of these can achieve results faster,with fewer side effects and a quicker recovery. We also offer placement of inflatable penile prostheses for men who have failed other forms of treatment for erectile dysfunction.
Physicians should advise patients to stop taking PDE5 inhibitors, including VIAGRA, and seek prompt medical attention in the event of sudden decrease or loss of hearing. These events, which may be accompanied by tinnitus and dizziness, have been reported in temporal association to the intake of PDE5 inhibitors, including VIAGRA. It is not possible to determine whether these events are related directly to the use of PDE5 inhibitors or to other factors [see WARNINGS AND PRECAUTIONS and ADVERSE REACTIONS].

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Consistent with its known effects on the nitric oxide/cGMP pathway [see CLINICAL PHARMACOLOGY], VIAGRA was shown to potentiate the hypotensive effects of nitrates, and its administration to patients who are using nitric oxide donors such as organic nitrates or organic nitrites in any form either regularly and/or intermittently is therefore contraindicated.

In some cases, ED may simply be as a result of stress. Exercise is a good stress reliever and allows you to maintain a healthy lifestyle. You don’t have to engage is a serious workout, a simple daily walk routine is enough. For men who are obese, sexual performance may be affected by the weight and therefore, exercising will do you some good.
Other medications can affect the removal of sildenafil from your body, which may affect how sildenafil works. Examples include azole antifungals (such as itraconazole, ketoconazole), macrolide antibiotics (such as clarithromycin, erythromycin), HIV protease inhibitors (such as ritonavir, saquinavir), hepatitis C virus protease inhibitors (such as boceprevir, telaprevir), mifepristone, rifampin, among others.
While a study published in the Journal of Urology found that men taking Korean red ginseng saw significantly improved erections compared to their placebo-popping counterparts, the American Urological Association Clinical Guidelines Panel feels this trial group of 45 men is too small to validate its clinical efficacy. In addition, Korean red ginseng can cause added health issues for men who have heart disease, mood disorders, or immune system disorders.
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Peyronie's disease is a condition that results from a penis injury, causing scar tissue to form and the shaft to curve. Sexual intercourse is often difficult.

But even if a prescription treatment isn’t the best course of action, it’s still wise to consult with a healthcare provider. This is because there are so many possible causes of ED, and your erection difficulties might signal an underlying condition that requires medical attention.
He left with a prescription for the drug Cialis to treat his ED, a clearer picture of his health in general and new motivation to make lifestyle changes.
Since endothelial dysfunction, CVD and ED are closely associated in epidemiological studies, the question for clinicians is whether to recommend the man presenting with ED undergo a cardiovascular (CV) evaluation. Clearly, based on numerous studies, ED can be considered at least a ‘marker’ for possible further vascular disease or CVD.15 In their report, Vlachopoulos and coworkers make the point that the man presenting with ED, the clinician, is offered an opportunity to attempt to improve the health of the man by addressing lifestyle modification, and consider further vascular evaluation owing to the clear relationship between endothelial dysfunction, ED and CVD.19
If you have a blockage of one of the larger arteries supplying the area of the pelvis or penis then microsurgical reconstruction of the arteries or anangioplasty to re-establish erections may be indicated. The blockage in these situations normally follows traumatic injuries to the pelvis.
Sexualimpotence in men is a common problem whose frequency tends to increase with age.So before you start losing your sexual power, understand that being impotentdoesn't mean you have to suffer the problem forever.

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VIAGRA (sildenafil citrate), an oral therapy for erectile dysfunction, is the citrate salt of sildenafil, a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5).

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Thankfully, a few of our top recommendations for the best ED treatment include complimentary consultations with a physician who can help you. Here are some topics that you might discuss during a consultation.

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Of the total number of subjects in clinical studies of Viagra, 18% were 65 years and older, while 2% were 75 years and older. No overall differences in safety or efficacy were observed between older ( > 65 years of age) and younger ( < 65 years of age) subjects.

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Other side effects associated with the use of sildenafil may include diarrhea, heartburn, difficulty falling asleep or staying asleep, numbness, burning or tingling in the arms, hands, feet or legs, nosebleeds, and sensitivity to light.

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Doctors also recommend changing your lifestyle to deal with ED. Some of the proposed lifestyle changes include weight loss, quitting smoking, reducing alcohol intake and exercising.

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VIAGRA (sildenafil citrate), an oral therapy for erectile dysfunction, is the citrate salt of sildenafil, a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5).

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Thankfully, a few of our top recommendations for the best ED treatment include complimentary consultations with a physician who can help you. Here are some topics that you might discuss during a consultation.

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Of the total number of subjects in clinical studies of Viagra, 18% were 65 years and older, while 2% were 75 years and older. No overall differences in safety or efficacy were observed between older ( > 65 years of age) and younger ( < 65 years of age) subjects.

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Other side effects associated with the use of sildenafil may include diarrhea, heartburn, difficulty falling asleep or staying asleep, numbness, burning or tingling in the arms, hands, feet or legs, nosebleeds, and sensitivity to light.

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Doctors also recommend changing your lifestyle to deal with ED. Some of the proposed lifestyle changes include weight loss, quitting smoking, reducing alcohol intake and exercising.

Create an account.

Be Part
Of Our
Story!