Injections and Penile Suppositories
Surgical Intervention and Prostheses
Impotence is one of the most common sexual problems for men and is often age-related.
It is estimated that approximately 20% of all men suffer from Impotence but not everyone is equally distressed by the problem.
The process of erection is, in itself, fairly simple:
At the end of the activity this process reverses, the brain terminates the erection; the arteries markedly decrease blood inflow, and the veins open. Blood leaves the penis and erection subsides.
Low levels of sexual desire, lack of energy, mood disturbances and depression can all be symptoms of low testosterone. A simple blood test can determine if the testosterone level is abnormally low, and testosterone can be replaced using a number of different delivery systems (e.g., injections, skin patches, gels, pills placed under the tongue).
One effect of atherosclerosis is to reduce blood flow to the penis, resulting in impotence. It has been estimated that smokers run twice the risk of impotence compared to non-smokers. Even secondary smoking is a significant risk factor.
Normal sexual function depends upon the coordination of nervous system, the hormones and the blood vessels that supply the penis. Smoking can affect all these systems and so lead to impotence.
A 1994 study of men with impotence, who also smoked, showed that smoking is associated with an abnormal reduction in penile blood pressure and that those, who smoked 40 or more cigarettes per day, suffered from the "softest" night-time erections.
The good news is that men may completely or partially recover normal erectile function when they stop smoking. The degree of recovery is related the extent of the damage caused to the erection system - the longer a man has smoked, the greater the damage.
However, some men, who 'lost' an erection before orgasm, recovered completely after giving up smoking.
These processes, acting over time, can lead to a degeneration of the penile blood vessels, leading to restriction of blood inflow through the arteries and also to leakage of blood through the veins during erection.
The choices we make in life can lead to degeneration of the erectile tissue and the development of Impotence. Smoking, drug or alcohol abuse, particularly over a long period of time, will compromise the blood vessels of the penis.
Lack of exercise and a sedentary lifestyle will contribute to the development of Impotence. Correction of these conditions will contribute to overall health and may in some individuals correct mild Impotence.
Treatment of many medical conditions can interfere with normal erections. Drugs used to treat these risk factors listed above may also lead to or worsen Impotence.
Patients undergoing surgery or radiation therapy for cancer of the prostate, bladder, colon or rectum are at high risk for the development of Impotence.
Nothing happens in the body without the brain; worrying about your ability to get an erection can itself interfere with the process.This condition is called performance anxiety and can be overcome with education and treatment.
All men experience performance failure at some point in their lives. And at any one time, 1 in 3 men have this problem and whether there is an underlying physical issue or not, psychological factors make matters worse.
It is possible to download cognitive hypnotherapy treatments for home use from Sounds Positive, a company we would recommend.
For most patients, the diagnosis will require a simple medical history and they can begin treatment without the need for extensive testing. The choice of testing and treatment depends on the goals of the individual.
If erection returns with simple treatment like oral medication and the patient is satisfied, no further diagnosis is necessary.
If the initial treatment response is inadequate or the patient is not satisfied, then further steps may be taken. In general, as more invasive treatment options are chosen, testing may be more complex.
Men with Impotence take these pills before beginning sexual activity and the drugs boost the natural signals that are generated during sex, thereby improving and prolonging the erection itself. These medications are safe and fairly effective, with improvement in erection in nearly 80 percent of patients using these drugs.
Early concerns about possible bad effects on the heart have not proven true; after extensive testing and several years of use, sildenafil citrate can be used safely by all heart patients except those using medications called nitrates because of an interaction between these two classes of drugs.
The side effects of PDE-5 inhibitors are mild and usually transient, decreasing in intensity with continued use. The most common side effects are headache, stuffy nose, flushing and muscle aches. In rare cases, sildenafil can cause blue-green shading of vision due to high blood levels of sildenafil exerting a brief effect on the retina of the eye. This is of no long-term risk and is gone within a short time as the amount of sildenafil in the blood decreases.
It is important to follow the instructions for using these medications in order to get the best results. Tests have shown that 40 percent of men who do not respond to sildenafil will respond when they receive proper instruction on medication use.
For men who do not respond to oral medications another drug, alprostadil, is approved for use in men with Impotence.
This drug comes in two forms: injections that the patient places directly into the side of the penis and a transurethral suppository.
Success rates with self-injection can reach 85 percent. Modifying alprostadil to allow transurethral delivery avoids the need for an injection, but reduces the effectiveness of the agent to 40 percent.
The most common adverse effects of alprostadil use are a burning sensation in the penis and the risk of over correcting the problem, resulting in a prolonged erection lasting over four hours and requiring medical intervention to reverse the erection.
For men who cannot or do not wish to use drug therapy, an external vacuum device may be acceptable.
This device combines a plastic cylinder or tube that slips over the penis, making a seal with the skin of the body. A pump on the opposite end of the cylinder creates a low-pressure vacuum around the erectile tissue, which results in an erection.
To keep the erection, once the plastic cylinder is removed, a rubber constriction band goes around the base of the penis and this maintains the erection.
Patients most likely to fall into this group are men with advanced diabetes, men who suffered from Impotence before undergoing surgical or radiation treatment for prostate or bladder cancer and men with deformities of the penis called Peyronie's disease.
For these patients reconstructive prosthetic surgery (placement of a penile prosthesis or "implant") will restore erection, with patient satisfaction rates approaching 90 percent. Surgical prosthetic placement normally can be performed in an outpatient setting or with one night of hospital observation.
Possible adverse effects include infection of the prosthesis or mechanical failure of the device.
The treatments compensate for but do not correct the underlying problem in the penis.
So it is important to follow-up with your doctor and report on the success of the therapy. If your goals are not reached or if your erection is not of sufficient quality or duration and you are still distressed, you should explore the alternatives with your doctor.
As the medications used are not correcting the problems leading to Impotence, your response over time may not be what it once was. If this happens, you should discuss the remaining treatment options with your doctor.
We now realize that most men have underlying physical causes.
Nothing happens in the body without the brain; worrying about your ability to get an erection can itself interfere with the process.
This condition is called performance anxiety and can be overcome with education and treatment.
This is often done but because of the risk of prolonged erections with drug therapy it should only be performed under a doctor's supervision.
If you are fairly certain that a specific drug has caused the problem, discuss the possibility of a medication change with your doctor.
If you must remain on the specific medication causing the problem, the treatment options outlined above can still be used in most cases.
What is Viagra?
Viagra is a treatment for male erectile dysfunction (ED), often called impotence. It is a discreet pill you only take when you plan to have sex. Viagra helps men to get and maintain an erection when they become sexually aroused, either physically or visually. According to trials conducted, Viagra improves erections in four out of every five men who use Viagra. These results are irrespective of age or length the patient has suffered from ED. Viagra does not automatically cause an erection, you need to be sexually aroused.
How does Viagra work?
Viagra enables many men with erectile dysfunction to respond to sexual stimulation. When a man is sexually aroused, the arteries in the penis relax and widen, allowing more blood to flow into the penis. As the arteries in the penis expand and harden, the veins that normally carry blood away from the penis become compressed, restricting the blood flow out of the penis. With more blood flowing in and less flowing out, the penis enlarges, resulting in an erection. If the nerves or blood vessels associated with this process aren't working properly, a man may not be able to get an erection. Viagra increases blood flow to the penis, so that when a man is sexually aroused, he can get and keep an erection. When the sexual encounter is over, the erection goes away.
Will Viagra work immediately?
Viagra is effective in as little as 30 minutes and stays effective for up to 4 hours.
Does Viagra automatically cause an erection?
No. With Viagra, you must be sexually aroused to get an erection. It is not an aphrodisiac. It's a prescription medication that can improve erectile function of most men with erection problems.
How often can I take Viagra?
For most patients, Viagra should be taken once a day as needed. In patients taking certain protease inhibitors (such as for the treatment of HIV), it is recommended to not exceed a maximum single dose of 25 mg of Viagra in a 48-hour period.
How much Viagra can I take?
Viagra comes in different doses (25 mg, 50 mg, and 100 mg). Like many medicines, your healthcare provider may have to adjust your initial Viagra dose if it doesn't produce the desired results or you're bothered by side effects. Do not take more Viagra than your healthcare provider prescribes. Viagra can be used up to once a day as needed. If you are older than 65 years, have a serious liver or kidney problem, or are taking protease inhibitors, such as for the treatment of HIV, your healthcare provider may start you at the lowest (25-mg) dose of Viagra.
Can I cut my Viagra pills in half?
They are not designed to be cut in half. Half a tablet may not be effective. Cutting pills in half is not recommended.
Will Viagra make me have an erection for hours?
Viagra works by helping you get an erection in response to sexual stimulation. Once a man takes Viagra and has sex, his erection will go away after intercourse, just like it would normally. Viagra takes about 30 minutes before it's ready to work, and remains ready to work for about 4 hours after that. Take your time and go at your own pace. In the event of an erection lasting more than 4 hours, see your doctor.
I don't get erectile dysfunction often. Does this mean that Viagra isn't for me?
Even if it happens infrequently, it's still erectile dysfunction. Most men with erectile dysfunction have it just some of the time.
I tried Viagra once, but it didn't work. Does this mean it's not for me?
You might need to try Viagra several times to get it right for you. You may also need to change your dose.
What if I haven't had sex in a while?
Because sexual activity can be demanding on the heart, doctors sometimes determine that for men with certain heart conditions, sex is not recommended, with or without medication for erectile dysfunction. Patients who are in poor cardiovascular health should talk to their doctor before engaging in any strenuous activity. If you are not sure of your cardiovascular health, talk to your healthcare provider.
Who should not take Viagra?
Viagra is only for patients with Erectile Dysfunction. Viagra is not prescribed for women. Do not let anyone else take your Viagra. Viagra must be used only on prescription. Before you start any treatment with Viagra, be sure to ask your healthcare provider if your heart is healthy enough. If you use nitrate drugs for heart conditions, like nitroglycerine, never take Viagra. The combination of Viagra and nitrates can make your blood pressure suddenly drop to unsafe levels. You could get dizzy, faint, or even have a heart attack or stroke. Nitrates are found in many prescription medications that are used to treat angina (chest pain due to heart disease) such as:
What if Viagra doesn't work?
While Viagra is effective in up to 4 of 5 men, it's not effective for everyone. If it doesn't work for you, contact your healthcare provider to discuss other treatment options.
Can I take Viagra with alcohol?
Drinking alcohol can temporarily impair the ability to get an erection. To get the maximum benefit from your medication, you are advised not to drink large amounts of alcohol before taking Viagra.
Can I take Viagra after eating?
Yes, but taking Viagra after a high-fat meal may cause the medication to take a little longer to start working.
What are the side effects of Viagra?
Like all medications, Viagra can cause some side effects. These are usually mild and don't last longer than a few hours. Some of these side effects are more likely to occur with higher doses of Viagra. With Viagra, the most common side effects are headache, facial flushing, and upset stomach. Viagra may also briefly cause bluish or blurred vision or sensitivity to light. In the rare event of an erection lasting more than 4 hours, seek medical help.
What is Cialis?
Manufactured by Lilly ICOS LLC.Cialis(TM)(tadalafil) is an oral PDE5 inhibitor for the treatment of ED ( Erectile Disfunction) Cialis is a revolutionary new drug used to treat Erectile Disfunction, which has been approved for distribution and sale within the E.U.
What is 1-a-Day Cialis?
Cialis (Tadalafil) is now offered in an innovative one-a-day version. This is designed to take away the last vestiges of anxiety from sufferers of erectile dysfunction by taking away the need to guesstimate if they are going to need to take a Cialis pill prior to sexual activity. Instead they can now take one tablet per day, every day, to ensure that given the right circumstances, they will be able to complete sexual intercourse successfully on any day at any time of day.
The tablets are available in two strengths, 2.5mg and 5.0mg. As ever, it is advised to try the lower dose first and only move onto the stronger dose if the lower one does not work satisfactorily. The action is the same as the 10mg and 20mg tablets, which are designed to be effective for up to 36 hours. They were approved for the UK and Europe some time ago and are available on prescription.
This new tried and tested version of the established drug is aimed at men who suffer from some degree of erectile dysfunction and would like to be fairly regularly sexually active without having to worry about when to take a tablet. It will initially take several days for the full effect of the drug to be experienced, so some patience is needed at first. However, once it is present in the system a man should be able to have sex any time he wants.
Does Cialis Work In A Similar Way To Viagra?
Yes. Cialis works by blocking an enzyme called phosphodiesterase-5 or PDE-5, helping the smooth muscles in the penis to relax and widen. This allows more blood to enter the penis, resulting in a faster and easier erection.
Why is Cialis different to Viagra?
Cialis works much faster than Viagra. Clinical test and trials showed that the majority of men who took Cialis were able to engage in sexual intercourse within 30 minutes or less. As well as this, Cialis also stays in the body for up to 24 hours, compared with Viagra, where typically the drug stays in the system for about 4 hours. As an added benefit, Cialis comes in smaller doses than Viagra, producing fewer and milder side effects than Viagra.
How Well Does Cialis Work?
Clinical trials showed that Cialis, when tested on 700 men, produced improvement in erections of at least 88% of the participants.
What Are The Side Effects Of Cialis?
The most common side effects found in the clinical trial of Cialis were headache, muscle pain (myalgia), upset stomach (dyspepsia) and back pain. Lower doses produced correspondingly reduced side effects.
Who should Not Take Cialis?
Cialis is only for patients with ED. Cialis is not for newborns, children, or women. Do not let anyone else take your Cialis. Cialis must be used only under a health care provider's supervision. Before you start any treatment of Cialis, be sure to ask your Health Care Provider if your heart is healthy enough. If you're a man who uses nitrate drugs, like nitroglycerine, never take Cialis. The combination of Cialis and nitrates can make your blood pressure suddenly drop to unsafe levels. You could get dizzy, faint, or even have a heart attack or stroke. Nitrates are found in many prescription medications that are used to treat angina (chest pain due to heart disease) such as:
If you are not sure if any of your medications contain nitrates, or if you do not understand what nitrates are, ask your health care provider or pharmacist.
What is Levitra?
Levitra (vardenafil HCl) is a PDE-5 inhibitor and is the newest treatment option available for 30 million men in Europe affected by erectile dysfunction (impotence).
How does Levitra work?
Levitra acts in the same way as Viagra, by blocking an enzyme called phosphodiesterase-5, or PDE-5. This helps the smooth muscles in the penis to relax, which effectively increases blood flow.
Who makes it?
Levitra is made by Bayer of Germany and GlaxoSmithKline (GSK) plc of the UK. In November 2001, Bayer and GlaxoSmithKline (GSK) signed a worldwide co-promotion and co-development agreement to launch a new treatment
for men seeking to improve their erectile function. Since then, both companies have been working together on the development of Levitra.
With these companies strong histories in healthcare and pharmaceuticals, the Bayer and GSK co-promotion represents a powerful partnership committed to improving mens health through new treatment options.
What is the normal recommended dosage?
The suggested dose is to start with 10mg of Levitra, and to adjust the strength depending on the results. However, the doctor may override your selection if he/she feels that based on your medical circumstances a different dose is more suitable.
What are the side effects of taking Levitra?
Whilst the side effects may not affect everybody and may vary from patient to patient, the most commonly reported side effects are headaches, flushing, rhinitis and flu.
Has Levitra been approved in the UK?
Levitra was approved on March 7, 2003, by the European Commission and it has now been approved for the UK. This was based on the quality, safety and efficacy data submitted. These data included results from more than 3,750 men representing a broad patient population.
What are the differences between Viagra and Levitra?
Levitra generally comes in smaller doses (5, 10, and 20mg), has fewer side effects, and delivers a faster reaction time than Viagra. In clinical research, patients taking Levitra began experiencing results in 30 minutes or less.
How long does Levitra stay active within your body?
In tests, Levitra stayed active and working in the system for an average of 12 hours in patients 65 years or older and 9 and a half hours in younger participants. Clinical studies have shown that Viagra has the ability to remain in the system for up to 4 hours.
Your first port of call should be your Family Doctor but it has become obvious that many Family Doctors are reluctant to prescribe Viagra, Cialis and Levitra on the NHS; they may refuse to prescribe under any circumstances or may only offer to provide a Private Prescription (at a suitable fee of course).
If you find yourself in that situation, there are many internet web-sites that will offer to sell Viagra, Cialis and Levitra to you.
Our best advice is Be Cautious
It has been widely reported that as much as 50% of the Viagra, Cialis and Levitra for sale on the internet is either counterfeit or a generic medication masquerading as the real thing.
We recommend that you:
It can be worse - much worse. In May 2009, the BBC reported that fake Viagra was being peddled in car parks and other places that can't remotely be considered as a reasonable or acceptable place to obtain genuine presciption medications.
A manufacturer's chemical analysis of the tablets discovered that many of the counterfeit drugs "contained dangerous chemicals".
There is no reason to believe that things have improved since then.
The full BBC story is here.
If there isn't a consultation, there can be no medical overview of your order and you may well be buying medication that could turn out to be harmful to you.
If you still want to buy Viagra, Cialis or Levitra online, a website that satisfies all of these criteria is: