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The erectile dysfunction (ED)

The most common male sexual dysfunctions are erectile dysfunction (ED), decreased libido, and ejaculatory dysfunction (including premature ejaculation [PE] in men ages 18 to 59 years). One or more dysfunctions can coexist in an individual.

The inability to achieve and/or maintain an erection sufficient for satisfactory sexual intercourse is a distressing and common symptom, affecting up to 1/3 of adult men.

ED is common in men with systemic disorders such as ischemic heart disease, hypertension, and diabetes mellitus, and the risk increases with age.

Sexual dysfunction can also affect younger men (ages 18 to 25 years). So health care professionals should ask men of all ages about sexual dysfunction as part of their routine psychosocial assessment.

When to buy viagra?

We will discuss here one of The nonsurgical management ways of sexual dysfunction by using the famous group of drugs called phosphodiesterase-5 (PDE5) inhibitors include sildenafil (viagra), tadalafil (Cialis).

Phosphodiesterase-5 inhibitors should be considered as initial therapy of ED, because of their efficacy, ease of use, and favorable side-effect profile.

viagra,

tadalafil, vardenafil, and the newest option, avanafil, are equally effective, but tadalafil has a longer duration of action and avanafil has a more rapid onset.

An evaluation for the cause of the ED should be done before initiating therapy with PDE5 inhibitors. Other risk factors and comorbid diseases and concomitant drugs must be evaluated firstly, for example, PDE inhibitors are contraindicated in men taking nitrates and should be used cautiously in men receiving a group of drugs called alpha-adrenergic blockers such as doxazosin, alfuzosin, tamsulosin.

Viagra —

Many clinical trials have demonstrated the efficacy of viagra or sildenafil. In a quantitative meta-analysis of 27 trials in 6659 men with ED, a higher percentage of successful sexual intercourse was achieved with sildenafil.

Similar results are seen in men with diabetes and men with prostate cancer who have undergone prostatectomy or radiation therapy (although most effective in those who have undergone nerve-sparing prostatectomy). PDE5 inhibitors also may be effective in treating ED caused by spinal cord injury.

How is Viagra best taken?

For maximum effectiveness, take sildenafil orally on an empty stomach approximately one hour before sexual intercourse. The initial dose is 50 mg and may be reduced to 25 mg if side effects occur. On the other hand, the dose can be increased to 100 mg if the response is not satisfactory. The duration of action is approximately four hours.

Take care

Tell your doctor or pharmacist your medical history before using viagra, especially if you have heart problems (such as chest pain/angina, heart attack or life-threatening irregular heartbeat in the past 6 months, heart failure), kidney disease, stroke in the past 6 months, liver disease, a severe loss of body water (dehydration), high or low blood pressure, penis conditions (such as fibrosis/scarring or angulation), history of painful/prolonged erection (priapism), conditions that may increase the risk of priapism, eye problems.

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interaction

Care should be exercised by people who are also taking protease inhibitors for the treatment of HIV infection. Protease inhibitors inhibit the metabolism of sildenafil, effectively multiplying the plasma levels of sildenafil, increasing the incidence and severity of side effects. Those using protease inhibitors are recommended to limit their use of sildenafil to no more than one 25 mg dose every 48 hours.^[4] Other drugs that interfere with the metabolism of sildenafil include erythromycin and cimetidine, both of which can also lead to prolonged plasma half-life levels.

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