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Go to 111.nhs.uk or call 111. Call 111 if you're worried about a child under the age of 5 years. Immediate action required: Call 999 or go to A&E now if: you or someone around you has a seizure or fityou have a prolonged or sometimes painful erection, especially if it lasts for more than 2 hours Immediate action required: Call 999 now if:
Not everyone can use these medicines. Your doctor may talk to you about alprostadil if oral medicines aren’t an option for you. Alprostadil is a synthetic version of prostaglandin E. It can be injected into the penis or inserted as a tiny suppository into the urethra (the hole at the end of the penis). Your doctor will help you decide which treatment is best for you. .

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A very rare side effect of sildenafil is an alteration in color perception due to the drug’s inhibition of PDE-6 in addition to PDE-5. Vardenafil is somewhat more selective in this regard, having no known effect on PDE-6, and thus no known effect on color perception. And while vardenafil is less thoroughly researched than sildenafil, there are still numerous studies looking at thousands of users over nearly two decades, so its safety and efficacy are without question.

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Table 3. Factors associated with recreational use of sildenafil in Gondar town, 2017.

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23. Goldstein I, Young JM, Fischer J, Bangerter K, Segerson T, Taylor T. Vardenafil, a new phosphodiesterase type 5 inhibitor, in the treatment of erectile dysfunction in men with diabetes: a multicenter double-blind placebo-controlled fixed-dose study. Diabetes Care. 2003;26(3):777-783.

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While these over-the-counter “Viagra alternatives” may be effective, there is no guarantee that they are safe. Some of the options sold online may contain ingredients that are dangerous to ingest.

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    Statistical analysis was conducted using IBM SPSS version 20. Descriptive analysis was conducted and results were presented using tables. Binary logistic and multi-variable logistic regression analyses were conducted to determine the association between the dependent and independent variables. Variables that were significant at a P-value of <0.05 in the binary logistic regression were selected for multivariable logistic regression and in the multivariable regression analysis, those variables that were significant at a p-value of <0.05 with a 95% confidence interval were regarded as significant factors that contribute to the recreational use of sildenafil citrate.

    But Erectile Dysfunction can also be caused by emotional issues – like stress, anxiety or depression -- or lifestyle choices – smoking, drinking and inactivity. These often respond well to natural treatment.
    Nitric oxide (NO) mediates the vasodilation (widening of blood vessels) in the penis, increasing blood flow. Let’s break that down a bit further. Nitric oxide tells specific muscles in the penis to relax. The relaxation of those muscles allows blood flow to increase to the erectile tissues of the penis, causing the penis to enlarge and grow rigid, forming an erection.

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    Medical risk factors for ED include diabetes mellitus, cardiovascular conditions (e.g., hypertension, hypercholesterolemia, atherosclerosis, and a recent history of myocardial infarction), pituitary/gonadal dysfunction, anemia, and renal/hepatic failure. Psychogenic causes can include depression and anxiety. Besides, medications may be a causal factor in which ~25% of cases of ED are caused by either prescription or over-the-counter medications. Drugs used socially such as nicotine, alcohol (in excess), and other recreational drugs also increase the prevalence of organic ED (2).

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    During sexual activity, if you become dizzy or nauseated, or have pain, numbness, or tingling in your chest, arms, neck, or jaw, stop and call your doctor right away. You could be having a serious side effect of sildenafil.

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    Nearly 1000 years later, the Egyptian Papyrus Ebers, a medical Egyptian document dated 1600 BC, describes a cure for impotence in which baby crocodile hearts were mixed with wood oil and applied topically to the penis.4

    Viagra (sildenafil citrate) is a phosphodiesterase-5 (PDE5) inhibitor used to treat impotence (or erectile disfunction, ED, the inability to attain or maintain a penile erection).
    If pills don't work for you or the side effects bother you severely, we can use alternative treatments. These include: injections, suppositories, vacuum devices, shockwave therapy, or surgery. ED Vacuums

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    PAH PDE-5 inhibitors are administered orally as tablets or suspensions, or as intravenous injections in the treatment of the following conditions: Pulmonary arterial hypertension: To improve exercise ability and slow down the progression of disease in patients with: Idiopathic PAH Inherited PAH PAH caused by connective tissue diseases Erectile dysfunction Benign prostatic hyperplasia (prostate enlargement) SLIDESHOW How to Lower Blood Pressure: Exercise Tips See Slideshow

    Natural remedies that can aid with erectile dysfunction (ED) involve simple lifestyle changes that work to improve one’s overall physical and emotional well-being.
    The information provided in VIAGRAHCP.com is intended only for healthcare professionals in the United States. take any medicines called nitrates, often prescribed for chest pain, or guanylate cyclase stimulators like Adempas (riociguat) for pulmonary hypertension. Your blood pressure could drop to an unsafe level are allergic to sildenafil, as contained in VIAGRA and REVATIO, or any of the ingredients in VIAGRA an erection that will not go away (priapism). If you have an erection that lasts more than 4 hours, get medical help right away. If it is not treated right away, priapism can permanently damage your penis sudden vision loss in one or both eyes. Sudden vision loss in one or both eyes can be a sign of a serious eye problem called non-arteritic anterior ischemic optic neuropathy (NAION). Stop taking VIAGRA and call your healthcare provider right away if you have any sudden vision loss sudden hearing decrease or hearing loss. Some people may also have ringing in their ears (tinnitus) or dizziness. If you have these symptoms, stop taking VIAGRA and contact a doctor right away

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All men receiving testosterone replacement need to have periodic measurement of haemoglobin and haematocrit to monitor for erythrocytosis. Feldman HA , Goldstein I , Hatzichristou DG , et al . Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol 1994;151:54–61. Araujo AB , Esche GR , Kupelian V , et al . Prevalence of symptomatic androgen deficiency in men. J Clin Endocrinol Metab 2007;92:4241–7. doi:10.1210/jc.2007-1245 Lindau ST , Schumm LP , Laumann EO , et al . A study of sexuality and health among older adults in the United States. N Engl J Med 2007;357:762–74. doi:10.1056/NEJMoa067423 Shah J . Erectile dysfunction through the ages. BJU Int 2002;90:433–41. doi:10.1046/j.1464-410X.2002.02911.x Mobley D . Early history of inflatable penile prosthesis surgery. Asian J Androl 2015;17:225–9. Roumeguère T , Wespes E , Carpentier Y , et al . Erectile Dysfunction is associated with a high prevalence of hyperlipidemia and coronary Heart Disease Risk European Urology.44:355–9. Klein R , Klein BE , Lee KE , et al . Prevalence of self-reported erectile dysfunction in people with long-term IDDM. Diabetes Care 1996;19:135–41. doi:10.2337/diacare.19.2.135 Larsen SH , Wagner G , Heitmann BL . Sexual function and obesity. Int J Obes 2007;31:1189–98. doi:10.1038/sj.ijo.0803604 McWaine DE , Procci WR . Drug-induced sexual dysfunction. Med Toxicol Adverse Drug Exp 1988;3:289–306. doi:10.1007/BF03259941 Croft H , Settle E , Houser T , et al . A placebo-controlled comparison of the antidepressant efficacy and effects on sexual functioning of sustained-release bupropion and sertraline. Clin Ther 1999;21(4):643–58. doi:10.1016/S0149-2918(00)88317-4 Janeway M , Baum N . Managing the enlarged prostate gland in elderly men. Clinical Geriatrics http://www.consultant360.com/articles/managing-enlarged-prostate-gland-elderly-men. Kumar RJ , Barqawi A , Crawford ED . Adverse events associated with hormonal therapy for prostate Cancer. Rev Urol 2005;7 Suppl 5:S37–S43. Aksam A , Yassin A , Saad F . Testosterone and erectile dysfunction. J Andrology 2008;29. Gades NM , Nehra A , Jacobson DJ , et al . Association between smoking and erectile dysfunction: a population-based study. Am J Epidemiol 2005;161:346–51. doi:10.1093/aje/kwi052 Mobley D , Baum N . Smoking: it’s impact on urologic conditions. Rev Urology 17 2015. Stein RA . Endothelial dysfunction, erectile dysfunction, and coronary heart disease: the pathophysiologic and clinical linkage. Rev Urol 2003;5(Suppl 7):S21–S27. Andersson K , Stief C . Penile erection and cardiac risk: pathophysiologic and pharmacologic mechanisms. Am J Cardiol 2000;86:23–6. doi:10.1016/S0002-9149(00)00887-0 Feldman HA , Johannes CB , Derby CA , et al . Erectile dysfunction and coronary risk factors: prospective results from the Massachusetts male aging study. Prev Med 2000;30:328–38. doi:10.1006/pmed.2000.0643 Vlachopoulos C , Ioakeimidis N , Terentes-Printzios D , et al . The triad: erectile dysfunction-endothelial dysfunction-cardiovascular disease Curr Pharm Des. 2008;14:3700–14. Watts GF , Chew KK , Stuckey BG et al . The erectile-endothelial dysfunction nexus: new opportunities for cardiovascular risk prevention. Nat Clin Pract Cardiovasc Med 2007;4:263–73. doi:10.1038/ncpcardio0861 Montorsi F , Briganti A , Salonia A , et al . Erectile dysfunction prevalence, time of onset and association with risk factors in 300 consecutive patients with acute chest pain and angiographically documented coronary artery disease. Eur Urol 2003;44:360–5. doi:10.1016/S0302-2838(03)00305-1 Vlachopoulos C , Rokkas K , Ioakeimidis N , et al . Prevalence of asymptomatic coronary artery disease in men with vasculogenic erectile dysfunction: a prospective angiographic study. Eur Urol 2005;48:996–1003. doi:10.1016/j.eururo.2005.08.002 Mulhall J , Teloken P , Barnas J et al . Vasculogenic erectile dysfunction is a predictor of abnormal stress echocardiography. J Sex Med 2009;6:820–5. doi:10.1111/j.1743-6109.2008.01087.x Hodges LD , Kirby M , Solanki J , et al . The temporal relationship between erectile dysfunction and cardiovascular disease. Int J Clin Pract 2007;61:2019–25. doi:10.1111/j.1742-1241.2007.01629.x Inman BA , Sauver JL , Jacobson DJ , et al . A population-based, longitudinal study of erectile dysfunction and future coronary artery disease. Mayo Clin Proc 2009;84:108–13. doi:10.4065/84.2.108 Ponholzer A , Temml C , Obermayr R , et al . Is erectile dysfunction an indicator for increased risk of coronary heart disease and stroke? Eur Urol 2005;48:512–8. doi:10.1016/j.eururo.2005.05.014 Thompson IM , Tangen CM , Goodman PJ , et al . Erectile dysfunction and subsequent cardiovascular disease. JAMA 2005;294:2996–3002. doi:10.1001/jama.294.23.2996 Banks E , Joshy G , Abhayaratna WP , et al . Erectile dysfunction severity as a risk marker for cardiovascular disease hospitalisation and all-cause mortality: a prospective cohort study. PLoS Med 2013;10:e1001372. doi:10.1371/journal.pmed.1001372 Lewis RW , Fugl-Meyer KS , Corona G , et al . Definitions/epidemiology/risk factors for sexual dysfunction. J Sex Med 2010;7:1598–607. doi:10.1111/j.1743-6109.2010.01778.x Yaman O , Gulpinar O , Hasan T , et al . Erectile dysfunction may predict coronary artery disease: relationship between coronary artery calcium scoring and erectile dysfunction severity. Int Urol Nephrol 2008;40:117–23. doi:10.1007/s11255-007-9293-8 Montorsi P , Ravagnani PM , Galli S , et al . Association between erectile dysfunction and coronary artery disease. role of coronary clinical presentation and extent of coronary vessels involvement: the COBRA trial. Eur Heart J 2006;27:2632–9. doi:10.1093/eurheartj/ehl142 Montorsi P , Ravagnani PM , Galli S , et al . Association between erectile dysfunction and coronary artery disease:matching the right target with the right test in the right patient. Eur Urol 2006;50:721–31. doi:10.1016/j.eururo.2006.07.015 Yassin AA , Saad F . Testosterone and erectile dysfunction. J Androl 2008;29:593–604. doi:10.2164/jandrol.107.004630 Khera M . Androgens and erectile function: a case for early androgen use in postprostatectomy hypogonadal men. J Sex Med 2009;6:234–8. doi:10.1111/j.1743-6109.2008.01159.x Aversa A , Isidori AM , De Martino MU , et al . Androgens and penile erection: evidence for a direct relationship between free testosterone and cavernous vasodilation in men with erectile dysfunction. Clin Endocrinol 2000;53:517–22. doi:10.1046/j.1365-2265.2000.01118.x Wespes E , Amar E , Hatzichristou D , et al . EAU guidelines on erectile dysfunction: an update. Eur Urol 2006;49:806–15. doi:10.1016/j.eururo.2006.01.028

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It's also important to know that drinking alcohol won't help you maintain an erection. In fact, excessive alcohol use can be a cause of erectile dysfunction.

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There are plenty of treatments available for both erectile dysfunction and premature ejaculation but you might be keen to try natural methods of treating the conditions first. Anxiety is a vicious culprit of sexual health issues so it’s important that you feel relaxed and address any mental health problems that are causing concern. Numan is regulated by the Care Quality Commission, the independent regulator of all health and social care services in England

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Here aresome of the most common home remedies for treating male sexual impotence.

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